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' PHILIPPINE HEALTH INSURANCE CORPORATION
City State Centre Building
# 709 Shaw Boulevard, Pasig City

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Tel. 637-9999, 637-9852 to 81

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August 28 , 2000

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I . PHILHEALTH CIRCULAR
No. 02& s-2000

II TO ALL ACCREDITED HEALTH CARE PROVIDERS,

CUIMS PROCESSING DEPARTMI!~NTS - NATIONAL

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CAPITAL REGION, REGIONAL HI-SALTI-1 INSURANCE
OFFICES AND ALL OTHERS CONICER!'\ED

SUBJECT Effectivity of i11.1.plementation and/ or wm1;2ensability of

I clai11.1s for drugs/medici11es delisted frdm /added to PNDF
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I SECTION 37 of R. A. 7875 provides, among others, that payment for drugs shall be made only for
those included in the Philippine National Drug Formulary (PNDF) unless explicit exception is granted

I by the Corporation.

In relation thereto, drugs and medicines are delisted and/ or added to tl~e list of teimburseable
drugs/medicines (PNDF) from time to time. To settle the issue on Fhe effectivity of its
I implementation and/ or compensability of claim/ s for drugs /medicines, the followi11g rules are hereby
adapted:

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1.

2.
The effectivity of the 5th Edition of the PNDF shall be July ~4, 2000.

Drugs and medici11es not listed in the PNDF but are approve, by the Buteau of
Food and Drugs (BFAD) and the Healtl1. Technology Assessment (HTA) Committee
I shall be compensable based on PhilHealth's Positive List.

3. Claim/s for drugs/medicul.es that are delisted from the PNDF and were administered
I duting the confinement period when the list takes effect shall remain compensable for
that confinement. I

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Example: Confmement petiod was from January 7-15,
delis ted Januaty 10, 2000.
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Medicines were

Therefore, claim for delisted drugs/medicines fldministered duting

the confmement period January 7-15, 2000 is GOMPENSABLE.
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Pot su:ict compliance.
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,
ENRIQUE M. ZALAMEA

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President and CEO

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drc-drug::;comp

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