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PhilHealth Circular No.

24 - 2015

New PhilHealth Dialysis Package

Publication Date: September 3, 2015/Phil. Star
This shall essentially increase the possible maximum coverage
for dialysis sessions

Hemodialysis Sessions Per Year
45 days 90 days
The new package rate for hemodialysis shall be Php 2,600. The
distribution shall be as follows:

HCI Fee Professional Fee Total Case Rate
Php 2,250 Php 350 Php 2,600
However, just less than a year after the implementation, patients
groups already started to seek further increase for the dialysis
package
Name of requesting party Nature of request Date of communication BDRD action
1 Bicol Dialysis Patient Group 1. Increase of coverage to Php3,500 July 22, 2016 Response letter sent August 1,
2. Increase to 144 sessions per year 2016
3. Use of “Low Flux Dialyzer” for free as package
inclusion
2 SHERWIN T. GATCHALIAN Increase the number of sessions from 90 to 120 September 6, 2016 Response letter sent November
Pasay City treatment sessions 10, 2016
3 DR. RENE VARGAS Full reimbursement of the cost of Hi Flux Dialyzer and September 14, 2016 Response letter sent September
Caraga Kidney Alliance cover 156 dialysis sessions per year 23, 2016

4 ANASTACIO E. REVILLA, JR. Increase the 90 dialysis sessions September 23, 2016 Response letter sent October 11,
Quezon City 2016
5 JOSEFINA FLORES P. BERNAL Increase the 90 dialysis sessions September 27, 2016 Response letter sent October 12,
Quezon City 2016
6 MARVIN AVERION Increase the number of sessions from 90 to a more September 30, 2016 Response letter sent November
Pinoy Dialysis Support Group, Inc. beneficial number of sessions 10, 2016
7 DR. RENE VARGAS Responsive and institutionalized government assistance October 4, 2016 Response letter sent October 11,
Ivory Charities Foundation, Inc. 2016
8 IMELDA M. NONAN Reimburse 100% of the cost of HD treatments, instead October 4, 2016 Response letter sent October 11,
Government Retirees Association of Butuan City of its current policy of reimbursing only 90 out of the 2016
and Agusan del Norte, Inc. prescribed 156 HD sessions per year

9 DIONISIO V. VERZANO Increase the sessions of hemodialysis from 90 to 120 October 19, 2016 Response letter sent November
Valencia, Negros Oriental treatment sessions 11, 2016
10 MAXIMINO C. TABANGCORA, JR. Increase the sessions of hemodialysis from 90 to at least November 3, 2016 Response letter sent November
Hemo-Peritoneal Dialysis Society of the Philippines 130 treatment sessions 22, 2016
11 JAVIER B. VALDEZ Increase the sessions of hemodialysis from 90 to 120 October 19, 2016 Response letter sent January 25,
Barangay Senior Citizens’ Association of treatment sessions. 2017
Ambassador - Tublay, Benguet
12 HON. FLORENCE B. TINGBAOEN Free dialysis treatment for kidney failure for all Filipino 2017 Response letter sent February 23,
Sangguniang Panlalawigan Office citizens 2017
La Trinidad, Benguet
13 PRESENTACION B. ESTAÑO Increase the number of sessions from 90 to a more April 17, 2017 For transmittal
Punta, Dipolog City beneficial number of sessions
14 HON. EDISON R. BILOG Expansion of the dialysis package April 28, 2017 Response letter sent May 16,
Sangguniang Panlungsod 2017
City of Baguio
15 HON. FRANCIS O. TAULI Expansion of the dialysis package April 28, 2017 Response letter sent May 16,
Office of the Sangguniang Panlalawigan - Bontoc, 2017
Mountain Province
16 ARIEL B. BASTIAN Increase the number of sessions from 90 to May 22, 2017 For transmittal
Benguet Renal Patients and Caregivers Association 156 sessions per year
– La Trinidad, Benguet
The NEW requests being received by this Office is asking PhilHealth to cover

one hundred forty four (144) sessions or even higher,

And for case rate to increase from the current P2,600 to P3,500…

Among other requests.
NEW DIALYSIS PACKAGE’S IMPACT IN THE AMOUNT OF
REIMBURSEMENT

Year Count of claims Amount of
Reimbursement
2014 668,639 4,678,139,510

2015 1,120,766 7,413,755,470

2016 1,515,008 7,568,198,950
If PHIC will increase the Dialysis Case Rate to P3,000.00…

Actuarial Certification shows that we can expect “additional P2.7B annually from
the aggregate benefit payment”
RECOMMENDATION

Any further increase in PhilHealth’s dialysis package is not recommended at this time

An outpatient primary care package that would prevent the onset of many cases of dialysis should be set in place
Supporting the Tax Reform Program

PhilHealth, together with the DOF and DSWD, will launch a program that would assist those listed in the DSWD list
with an unconditional cash grant

A MOA will be signed between the partner agencies and the PhilHealth list will of beneficiaries will be given IDs and
will be the basis for the cash transfers