MANILA — A House panel directed the Department of Health on Monday to clarify its No Balance Billing policy, which lawmakers said should cover indigent patients admitted to private rooms in public hospitals due to inadequate bedspace in their ward.

DOH Secretary Teodoro Herbosa promised the House Committee on Appropriations to issue the necessary order.

Under PhilHealth Circular 2017-0006, eligible patients admitted in ward type accommodation shall be covered by the NBB policy, which states that no other fees or expenses shall be charged or paid for by indigent patients above and beyond the package rates during their confinement period. 

If the patient opts to avail of a private accommodation, the NBB policy shall not apply. But If a ward-type accommodation is not available, it is the providers’ responsibility to make the next higher accommodation available for the patient at no added cost.

Some lawmakers said this is not strictly being observed by some hospitals.

“There’s a gap, which is poor patients in many hospitals, because puno ‘yung ward, napupunta sa semi-private and private. In fact, they should also be no balance billing and no out of pocket, pero dahil nasa private, sinisingil. That should not be the case,” House Senior Deputy Minority Leader and Northern Samar 1st District Representative Paul Daza said.

“Kami ang pinupuntahan eh. Kaya alam namin ang problema ng tao… Bakit ‘yung mga kawawa namin na constituents, they end up in a private room, at talagang walang pambayad, because sinisingil sila,” Committee Vice Chairperson and Marikina City 2nd District Representative Stella Quimbo added.

Iloilo 1st District Representative and former DOH Secretary Janette Garin moved to direct the DOH chief to issue an administrative order reiterating the no balance billing policy on all DOH, national government and LGU hospitals, “including those admitted in private rooms simply because the ward is full”. Without any objection, the panel carried Garin’s motion.

“I will promise to issue administrative order to strictly implement the no balance billing… ‘Pag indigent sila, no balance billing,” Herbosa told the panel.

The DOH also called on PhilHealth to settle its arrears to the agency’s hospitals, estimated to be around P13.33 billion. Of this amount, P6.41 billion are claims that are more than two years old, according to Herbosa.

“PhilHealth has to reimburse quickly the public hospitals para hindi mawalan ng operating cash flow,” he said.

Baguio City Representative Mark Go also urged PhilHealth to review their case rates and increase the amount of expenses they cover to reduce the out-of-pocket expenditures for patients.

To assist indigent patients in buying medicines, Quimbo said the DOH should utilize its 2024 funding for Medical Assistance to Indigent and Financially Incapacitated Patients program. P41 billion of which remains unused, according to the agency.