Guideline in Price Information of All Health Services and Goods AO 2021-008.pptx

Price information

1. DOH AO 2021-008: Guidelines in Public Access to Price Information of All Health Services and Goods in Health Facilities in the Philippines

2. Legal Basis of AO 2021-008: RA 11223 UNIVERSAL HEALTH CARE ACT (UHC ) SECTION 28.16 IRR “ Healthcare Facilities and Providers shall be required to make readily available to the Public and Patients and Submit to DOH and PhilHealth , all pertinent, relevant and up to date information regarding the prices of health services being offered ”

3. Legal Basis of AO 2021-008: DOH Department Circular 2019-558 Public Access to Price Information by all Healthcare Providers Department Circular No. 2021-0216 Addendum to the Current Assessment Tools to Monitor for Compliance with the Administrative Order No. 2021-0008, titled “Guidelines in Public Access to Price Information of All Health Services and Goods in Health Facilities in the Philippines”

4. PRICE TRANSPARENCY Availability of an updated price list shall be a requirement for the Initial and Renewal applications for DOH — License to Operate or DOH — Certificate of Accreditation of health facilities. Assessment tool to ensure compliance to the provisions of AO No. 2021- 0008 is hereby developed, to be used by regulatory officers from the DOH HFSRB and CHD RLED during the inspection and monitoring activities. It shall serve as an addendum to all current Assessment Tools for licensing and accreditation of health facilities.

5. OBJECTIVES Set guidelines in ensuring that the pricelist of all health services and goods being offered in the hospitals and other health facilities are accessible and available to the public SCOPE: Apply to all hosp i tals and other health facilities, whether government-owned or privately-owned

6. DEFINITION OF TERMS: GOODS - refers to health products which are primarily used for medical, surgical, therapeutic and diagnostic purposes which shall include but not limited to drugs, medicines and medical supplies. HEALTH SERVICES - any service performed by healthcare professionals, or by other under their direction, aimed at contributing to improved health or to diagnosis, treatment and rehabilitation of people with health issues.

7. GENERAL GUIDELINES: 1. All health facilities shall ensure that an updated price list of all their health services and goods are readily accessible to the public and their patients at all times. 2. The price list of all health services shall be itemized comprehensively and all fees indicated clearly, including outsourced services, if applicable. 3. All health facilities shall ensure complete transparency of all prices and fees and that there are no hidden charges. It shall be consistent with the actual charges being billed to the patient. 4. All health facilities shall be monitored by the HFSRB or CHD-RLED to ensure continuous compliance to this order.

8. SPECIFIC GUIDELINES 1.The price list shall include but not limited to the ff : a. Price per type of accommodation, critical care units and emergency rooms b. Fees for Medical and Surgical procedures c. Price of Laboratory Test d. Price of Imaging Diagnostic Test e. Professional Fees, and f. Price of drugs, medicines and medical supplies g. Bundle/Package Price of Health services h. Corresponding PhilHealth Case rate packages and Z-packages rates, if applicable i . Corresponding Health Maintenance Organization (HMO) rates, if applicable

9. SPECIFIC GUIDELINES 2. The price and fees may be presented in ranges, if applicable 3. The price list may be presented in any form, but not limited to the following: a. Printed Handout b. Menu Booklet c. Interactive Digital Forms ( example: use of tablet and computers) d. Posters or Tarpulins

10. SPECIFIC GUIDELINES 4. The price list shall be readily available to the public in a conspicuous area, such as but not limited to the lobby, reception area, information kiosk and business office 5. The price list shall be accessible to the public through the health facility’s official website, if available, and shall be regularly updated. 6. The health facility shall update the price list at least annually, or as needed. The date when the price list was last updated shall be indicated.

11. SPECIFIC GUIDELINES 7. The patient or patient’s guardian shall be informed of the price list upon admission or before provision of out-patient services or procedures. This includes information on the No Balance Billing Policy for basic accommodation. There shall be a documented proof that the price list was presented and explained, and that it was understood and accepted by the patient or patient’s guardian 8. All health facilities shall submit information regarding its prices and charges for all goods and services, including professional fees, once the guidelines have been developed by DOH and PhilHealth, and once the system is fully functional. 9. The availability of an updated price list, in accordance to this order, shall be a requirement for Initial and Renewal of DOH-LTO or DOH-COA of the health facility

12. VII. VIOLATIONS AND PENALTIES 1. SECTION 3 OF EXECUTIVE ORDER NO. 102 s 1999, Redirecting the Functions and Operations of the Department of Health -formulate policies and standards for health. Non-compliance to the provisions stated in this order is considered a Violation. -basis for suspension/revocation of DOH authorizations issued to the hospitals and other health facilities 2. DOH ADMINISTRATIVE ORDER 2007-022 Violations under the One Stop Shops for Hospitals 3. DOH ADMINISTRATIVE ORDER 2018-0016 Revised Guidelines in the Implementation of the One Stop Shop Licensing System 4. RA 7394 Consumer Act of the Philippines

13. APPEAL -Within 10 days after receipt of Notice of Decision, may appeal to Health Regulation Team(HRT) - if decision of HRT still contested Secretary of Health Final decision

14. TRANSITORY PROVISION 1. All Health Facilities applying for Initial DOH- LTO or DOH-COA shall IMMEDIATELY comply with the provision of this order 2. All currently DOH-licensed or DOH-accredited health facilities shall be required to comply within 60 days after effectivity of this order. ( APPROVED-January 18, 2021; PUBLISHED in PHILIPPINE STAR last February 1, 2021) 3. The price list shall be part of the requirements for the renewal of DOH-LTO or DOH-COA for CY 2022 and onwards

15. REPEALING CLAUSE THE FOLLOWING GUIDELINES ARE RESCIND: DOH AO 2008-002, POSTING OF SCHEDULE OF FEES FOR LABORATORY AND OTHER DIAGNOSTIC SERVICES OF HOSPITALS AND OTHER HEALTH FACILITIES DOH DC 2019-0558, PUBLIC ACCESS TO PRICE INFORMATION BY ALL HEALTHCARE PROVIDERS

16. DEPARTMENT CIRCULAR No. 2021-0216 -Addendum to the Current Assessment Tools to Monitor for Compliance with the Administrative Order No. 2021-0008, titled “Guidelines in Public Access to Price Information of All Health Services and Goods in Health Facilities in the Philippines -an assessment tool to ensure compliance to the provisions of AO No. 2021- 0008 is hereby developed, to be used by regulatory officers from the DOH HFSRB and CHD RLED during the inspection and monitoring activities. -It shall serve as an addendum to all current Assessment Tools for licensing and accreditation of health facilities.

17. ASSESSMENT TOOL FOR ENSURING PUBLIC ACCESS TO PRICE INFORMATION OF ALL HEALTH SERVICES AND GOODS IN HEALTH FACILITIES IN THE PHILIPPINES CRITERIA INDICATOR 1. The price list shall be readily available to the public in a conspicuous area Observe Availability of the Price List in a conspicuous area such as but not limited to, lobby, reception area, information kiosk and business office The price list maybe presented in any form, but not limited to the following: Printed Handout Menu Booklet Interactive Digital Form Posters or Tarpulins

18. ASSESSMEN T TOOL FOR ENSURING PUBLIC ACCESS TO PRICE INFORMATION OF ALL HEALTH SERVICES AND GOODS IN HEALTH FACILITIES IN THE PHILIPPINES CRITERIA INDICATOR 2. The price list of all health services shall be itemized comprehensively and all fees indicated clearly, including outsource services, if applicable Document Review The Price List shall include but not limited to the ff: a. Price per type of accommodation, critical care units and emergency rooms b. Fees for Medical and Surgical procedures c. Price of Laboratory Test d. Price of Imaging Diagnostic Test e. Professional Fees, and f. Price of drugs, medicines and medical supplies g. Bundle/Package Price of Health services h. Corresponding PhilHealth Case rate packages and Z-packages rates, if applicable i . Corresponding Health Maintenance Organization (HMO) rates, if applicable *May be presented in ranges if deemed appropriate

19. ASSESSMEN T TOOL FOR ENSURING PUBLIC ACCESS TO PRICE INFORMATION OF ALL HEALTH SERVICES AND GOODS IN HEALTH FACILITIES IN THE PHILIPPINES CRITERIA INDICATOR 3. For health facilities that have official website, the price list shall be readily available and regularly updated OBSERVE Updated Price List is available on the health facility official website The date when the price list was last updated shall be indicated

20. ASSESSMEN T TOOL FOR ENSURING PUBLIC ACCESS TO PRICE INFORMATION OF ALL HEALTH SERVICES AND GOODS IN HEALTH FACILITIES IN THE PHILIPPINES CRITERIA INDICATOR 4. The health facility shall update the price list at least annually, or as needed. Documents Review Price List is updated least annually The date when the price list was last updated shall be indicated

21. ASSESSMEN T TOOL FOR ENSURING PUBLIC ACCESS TO PRICE INFORMATION OF ALL HEALTH SERVICES AND GOODS IN HEALTH FACILITIES IN THE PHILIPPINES CRITERIA INDICATOR 5. The patient or patient’s guardian shall be informed of the price list upon admission or before provision of out-patient services or procedures. Documents Review Documented proof that the price list, including the No Balance Billing was presented and explained Documented proof that the information was understood and accepted by the patient or patient’s guardian

22. ASSESSMEN T TOOL FOR ENSURING PUBLIC ACCESS TO PRICE INFORMATION OF ALL HEALTH SERVICES AND GOODS IN HEALTH FACILITIES IN THE PHILIPPINES CRITERIA INDICATOR 6. All health facilities shall submit information regarding its prices and charges for all goods and services, including professional fees to PhilHealth, Documents Review Proof of submission of data to the Information System of DOH and PhilHealth, once the system is fully functional.

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