REPUBLIC ACT 11223: UNIVERSAL HEALTH
CARE ACT
Section 1: Title
- These rules and regulations shall be
known as the Implementing Rules and
Regulations of Republic Act No.
11223, otherwise known as the Universal
Health Care Act, hereinafter referred to
as the Act Hereinafter, these rules and
regulations shall be referred to as the
Rules.
- Signed into law: 2019
- Release by the DOH: 2019
Aim: To provide all Filipinos with access to
QUALITY and AFFORDABLE HEALTH CARE
SERVICES.
SOME KEY DETAILS OF THE IRR
- The creation of a Philippines Health
Security Corporation (PHSC) to oversee
the implementation of the UHC program.
- The Inclusion of all Filipinos in the
National Health Insurance Program
(NHIP), regardless of their income or
employment status
- The expansion of coverage for health
services, including primary care,
hospitalization, and medicines.
- The establishment of a system for the
collection and pooling of funds to finance
the program.
- The provision of incentives for health
workers and facilities that provide
services under the program.
Section 4: Definition of Terms
Health care provider – Refers to any of the
following:
COMMUNITY-BASED HEALTHCARE
ORGANIZATIONS
- Barangay Health Workers (BHWs) –
Trained to provide basic health services
at the brgy. Responsible for promoting
health and disease prevention in their
communities.
- Barangay Health Centers (BHCs) –
provide basic health services to the
residents of a particular barangay.
- Rural Health Units (RHUs) –
government-funded health facilities
providing healthcare services to rural
communities.
- Health Promotion and Education
Centers (HPECs) – Promote health and
prevent d/s through health education,
information dissemination and
community-based activities.
- Local Government Unit (LGU) Health
offices-local government-run health
offices responsible for the
implementation of health programs and
services in their respective municipalities
or cities.
- Non- government Organizations
(NGOs) – Independent organizations
that work to improve the health and well-
being of communities through various
health-related programs and services.
ANGAT BUHAT FOUNDATION/ ANGAT
PINAS INC.
- Non-Profit, non-governmental
organization based in the Philippines.
- It was founded and officially launched on
July 1, 2022, a day after its founder Leni
Robredo's term as Vice President of the
Philippines expired.
- Founcer: Leni Robredo, VPP
- Education, health, food security and
nutrition, and disaster risk response
- Incorporated as Angat Pinas, Inc.,
- The foundation aims to continue the
anti-poverty and pandemic response
programs started during Robredo's
tenure as vice president, which all went
under the same umbrella name of "Angat
Buhay" (a Tagalog word meaning
'improve life's condition'; lit. 'Lift Life').
- The foundation is focused on four key
areas: health, education, food
security, and disaster risk response
- It was launched with a two-day street
party and art exhibit, the proceeds
from which were made part of the
foundation's program funds.
- On June 30, 2022, the foundation
announced that its first project would
be a dormitory for the indigent
students of Southern Luzon State
University (SLSU) in Quezon.
Section 4: Definition of Terms
Primary care
- Refers to initial-contact, accessible,
continuous, comprehensive and
coordinated care that is accessible at the
time of need including a range of services
for all presenting conditions, and the
ability to coordinate referrals to other
health care providers in the health care
delivery system, when necessary.
Section 5: Population Coverage
- Coordination of PhilHealth with other
agencies for the inclusion of all Filipinos
in its databases at no cost.
Section 6: Service Coverage
COMPREHENSIVE OUTPATIENT
BENEFITS
- Including outpatient drug benefits and
emergency medical services
- Services of healthcare professionals,
laboratory, dental and other medical
services, personal preventive services,
prescription drugs and biologicals.
REGISTRATION OF FILIPINOS TO
PRIMARY CARE PROVIDER NETWORKS
- Register with public or private primary
care provider.
- LGUs with DOH and PhilHealth will
registers its constituents to a primary
care provider within their jurisdiction;
guideline of registration to a primary care
provider (Processes, procedures,
guideline, data management)
- DOH-issue guidelines for primary care
provider guidelines.
Section 7: Financial Coverage
- Financed by the national government
through the DOH; free of charge for all
(population-based)
- National government shall support LGUs
in financing (population-based)
- Individual-based health services will be
financed through social health insurance,
health insurance and HMO plans.
Section 8: Program Membership
- Legal spouse/s who is/are not an active
member;
- Unmarried and unemployed legitimate.
Illegitimate children, and legally adopted
or stepchildren as defined in RA 10165
(Foster Care act of 2012); and,
- Parents who are sixty (60) years old and
above not otherwise an enrolled
member.
Section 13. PhilHealth Board of Directors
- Max of thirteen (13) members, consisting
of the following:
- Five (5) ex officio members:
Secretary of Health: Teodoro Herbosa
Secretary of Social Welfare: Rex
Gatchalian
Secretary of Budget and Management:
Amenah Pangandaman
Secretary of Finance: Ralph Recto
Secretary of Labor and Employment:
Bienvenido Laguesma
 - Three (3) expert panel members with
expertise in
o Public health management
o Finance
o Health economics
- Five (5) sectoral panel members
representing the
o Direct contributors
o Indirect contributors
o Employers’ group
o Health care providers
o Representative of the elected
local chief executives.
Section 14: President and Chief Executive
Officer (CEO) of PhilHealth
- Upon the recommendation of the Board,
the President of the Philippines shall
appoint the President and CEO of
PhilHealth form the Board’s non-ex
officio members
- Filipino citizen
- Must have at least seven (7) years of
experience in the field of public health,
management, finance, and health
economics or a combination of any of this
expertise.
Section 17: Population-based Health
Services
Health services shall be classified as
population-based health services if they
fulfill any of the following criteria:
- Intended to be received by populations or
identified groups of people, of which
outcomes contribute to the general public
health, safety and protection; and
- Rendered in response to a public health
emergency or disaster or any
circumstance of equal magnitude, such
as diseases for elimination, that has
affected, or can potentially affect a
population.
Section 18: Individual-based Health Services
Health Services shall be classified as
individual-based, whether accessed through
health care facilities or remotely through the
use of digital technologies for health,
- if these can be definitively traced back to
one (1) recipient, has limited effect at a
population level,
- and does not alter the underlying cause
of illness.
- Examples: ambulatory and inpatient
care, medicines, laboratory tests and
procedures.
Section 25. Scholarship and Training
Programs
Expansion of Degree and Non-Degree
Training Programs
- CHED, TESDA, PRC and DOH shall
develop and plan the expansion of
existing and new allied and health-
related degree and training programs
based on the health needs of the
population especially those in
Geographically Isolated and
Disadvantages Ares (GIDAs)
- It shall be incorporated into the
National Health Human Resource
Master Plan which becomes the basis
of the number and cadre, including
categories, where applicable, of health
care professionals and health care
workers needed to meet the health needs
of the population, especially those in
underserved and unserved areas.
PRC and Its Accredited Organizations
- Review and updated, if necessary, the
accreditation standards and admission
policies or requirements for medical
residency and sub-specialty training
- Regulate the number of trainees pre
program in favor of producing enough
medical and allied health professionals.
- Assist national government agencies,
LGUs, and the private sector in the
establishment of accredited programs.
CHED AND TESDA Section 45: Effectivity
- Review and update, as necessary, all - Effect fifteen (15) days after its
recognition or accreditation policies and publication in the Official Gazette or in
guidelines for health education any newspaper of general circulation.
programs, prioritizing the expansion of
undersubscribed courses;
- Develop support programs to assist
graduates acquire necessary and
relevant qualifications, such as
professional licenses.
- Regulate the number of enrollees per
program in favor of producing sufficient
allied and health-related degree
graduates based on the health needs of
the population.
Expansion of Scholarships for Health
- DOH and CHED source funds for
scholarship grants
o Full for supplementary payment
for subsidies to complete tuition
fees and other school fees (living,
book, and uniform allowance)
- Require corresponding return service
obligation to national or local
government;
- Priority: Residents of underserved and
unserved areas or members of
indigenous peoples.
Section 26: Return Service Agreement
- All graduates of allied and health-related
courses who must enter into a return
service agreement (RSA).
- Required to serve in one of the DOH-
specified priority health facilities, within
the public sector in the Ph, on a full-time
basis for at least three (3) full years,
within one (1) year upon graduation or
acquiring the necessary license to
practice;
- Provided, that those who will server for
additional two (2) years shall be provided
with additional incentives as determined
by the DOH.