ADMINISTRATIVE

ORDER
No. 2017 __________
SUBJECT:Implementing Guidelines of Republic Act 10754, otherwise
known as "An Act Expanding the Benefits and Privileges of Persons with
Disability", for the Provision of Medical and Health- related Discounts
and Special Privileges
RATIONALE
In the pursuit of achieving "All for Health towards Health for All", the Philippine Health
Agenda (PHA) defines the blueprint of the government's strategies to have an inclusive
and responsive health care for all Filipinos. The PHA guarantees the provision of health
services to all Filipinos especially the poor, marginalized, and vulnerable such as the
persons with disabilities (PWDs). In response, the Department of Health (DOH) ensures
that relevant policies and plans for the Health and Wellness Program for PWDs are
crafted and implemented in accordance with the PHA and current governing laws.

The Republic Act (RA) 10754, otherwise known as "An Act Expanding the Benefits and
Privileges of Persons with Disability", was enacted into law on March 23, 2016 and its
corresponding Implementing Rules and Regulations (IRR) was signed on December 1,
2016. This law expands the benefits and privileges of PWDs by amending Republic Act
7277, otherwise known as the "Magna Carta for Disabled Persons". In particular, Section
1 of RA 10754 amends Section 32 of RA 7277 entitling the PWDs to at least twenty
percent (20%) discount and exemption from the value-added tax (VAT) on the purchase
of certain goods and services from all establishments for the exclusive use, enjoyment,
or availment of the PWD.
As mandated in Rule IV, Secs. 6.4 and 6.5 of the IRR of RA 10754, the
DOH, in coordination with Philippine Health Insurance Corporation
(PhilHealth) and Food and Drug Administration (FDA), shall issue the
corresponding guidelines, circulars or directives related to the purchase
of health and medical goods and availment of services from
medicalestablishments.
In this regard, the DOH is hereby repealing DOH Administrative Order
(AO) 2009-0011 to include the additional benefits and privileges stated
in the RA 10754 and its IRR.
OBJECTIVES
To prescribe the procedure and guidelines for the implementation of at
least 20% discount and VAT exemption in all health related services for
PWDs.

III.COVERAGE AND SCOPE

This Administrative Order applies to all private and government
hospitals and other health facilities, health care professionals,
PhilHealth, pharmacies and other establishments dispensing medicines.
IV. DEFINITION OF TERMS
The following definition shall be adopted as stipulated in the
Implementing Rules and Regulations of RA 7277, RA 9442, and RA
10754:
1. ASSISTIVE DEVICES —any device that is designed, made, or adapted to
assist a person to perform a particular task or activity for daily living.
2. CHILD WITH DISABILITY — shall refer to persons below eighteen (18)
years of age who have disabilities or those over but with mental
capacity as that of a child and are unable to fully take care of
themselves or protect themselves because of mental retardation,
hearing impairments including deafness, speech or language
impairments, visual impairments including blindness, serious
emotional disturbance, orthopedic impairments, autism, traumatic
brain injury, other health impairments or specific learning disabilities
who by reason thereof need special education and other services.
3. DISABILITY — interaction between persons with impairments and
attitudinal and environmental barriers that hinders their full and
effective participation in society on an equal basis with others.
4. ESSENTIAL DRUG/MEDICINE —drug/medicine that satisfies the
priority health care needs of the population and which is selected
based on the evidence of its efficacy, safety and comparative cost
effectiveness.
5.ESSENTIAL DRUG LIST OR NATIONAL FORMULARY --a list of drugs
prepared and periodically updated by the DOH on the basis of health
conditions obtained in the Philippines as well as on internationally
accepted criteria.
6.ESTABLISHMENTS DISPENSING MEDICINES AND ASSISTIVE DEVICES
— shall refer to any drug stores, assistive device stores, government or
private hospital pharmacies, medical clinics, optical clinics, audiology
centers, and similar establishments dispensing medicines and selling
assistive devices duly licensed or franchised by the FDA and/or the local
government unit (LGU).
7. FOODS FOR SPECIAL MEDICAL PURPOSES —category of foods for
special dietary uses which are specially processed or formulated and
presented for the dietary management of patients and may be used only
under medical supervision as described and defined in FDA Codex STAN
180-1991. They are intended for the exclusive or partial feeding of patients
with limited or impaired capacity to take, digest, absorb or metabolize
ordinary foodstuffs or certain nutrients contained therein, or who have
other special medically-determined nutrient requirements, whose dietary
management cannot be achieved only by modification of the normal diet,
by other foods for special dietary uses, or by a combination of the two
8.HEALTH CARE PROFESSIONAL — refers to any licensed physician, dentist,
nurse, midwife, allied medical practitioner, paramedical practitioner, or
other health care professional or practitioner duly licensed to practice in
the Philippines.
8.IMPAIRMENT —any loss, diminution or aberration of psychological or physiological function with
or without an accompanying anatomical structural defect.

9.MEDICAL DEVICE—an instrument, apparatus, equipment, machine, contrivance, implant, in vitro

reagent, or other similar or related article, including a component part, or accessory which is: (1)
intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment,
or prevention of disease, in persons with disabilities; and (2) intended to affect the structure or any
function of the body of PWDs, and which does not achieve any of its primary intended purposes
through chemical action within or on the body of man or other animals and which is not dependent
upon being metabolized for the achievement of any of its primary intended purposes.

10.MEDICAL SERVICES — shall refer to the hospital room accommodation, hospital services, medical
supplies, professional services of health care professionals, diagnostic services, and laboratory
services that are necessary for the prevention, diagnosis, treatment, rehabilitation, and palliation of a
persons' disability, illness or injury. This should not be limited to hospital services but should include
clinics and other health facilities. Further, it refers to health services which include but not limited to
prevention of disability through immunization, nutrition, environmental protection and preservation;
genetic counseling; early detection of disability; and timely intervention, medical or surgical, to arrest
the disabling condition. Intervention includes rehabilitation and provision of assistive devices.
12.MEDICALLY NECESSARY —services required to preserve and maintain
the health status of a person in accordance with accepted standards of
the medical practice in the medical community. This includes services
which are absolutely necessary in treating a patient and which could
adversely affect the patient's condition if it were omitted.
13.MEDICINE/ DRUG —any chemical compound or biological substance,
other than food, intended for use in the treatment, prevention or
diagnosis of disease in humans or animals, including but not limited to:
a. Any article recognized in the official United States Pharmacopoeia —
National Formulary (USP-NF), official Homeopathic Pharmacopoeia of the
United States;. Philippine Pharmacopoeia, Philippine National Formulary
(PNF), British Pharmacopoeia, European Pharmacopoeia, Japanese
Pharmacopoeia, Indian Pharmacopoeia, any national compendium or any
supplement to any of them;
b.Any article intended for use in the diagnosis, cure, mitigation, treatment or prevention
of disease in humans or animals. Any article other than food intended to affect the
structure or any function of the human body or animals;
d.Any article intended for use as a component of any of the articles specified in clauses
(a), (b) and (c) not including devices or their components, parts or accessories;
f.Herbal and/or traditional drugs which are articles of plant or animal origin used in folk
medicine which are: 1) recognized in the PNF; 2) intended for use in the treatment or
cure or mitigation of disease symptoms, injury or body effects in humans; 3) other than
food, intended to affect the structure or any function of the human body; 4) in finished
or ready-to-use dosage form; and 5) intended for use as a component of any of the
articles specified in items Ito 4. For herbs to be classified under this definition, levels and
amounts as well as registration status are required when indicated for therapeutic use;
and
g.This may also include vitamins and minerals provided that these are in accordance
with the FDA's prevailing cut-off on vitamins and minerals classified as drug/medicine
i.e. product containing more than 150% of water- soluble vitamins and more than 102%
of fat soluble vitamins.
V.GENERAL GUIDELINES
1. In all service wards of government facilities, all PWDs are entitled to at least
twenty percent (20%) discount and VAT exemption for the costs of medical,
dental, and rehabilitation services, diagnostic and laboratory fees, as well as
psychological or developmental tests, provided that these are in accordance with
the available Clinical Practice Guidelines (CPGs) or hospital treatment protocols.
The remaining balance of the hospital bill shall be subjected to classification by
the Medical Social Worker based on the existing DOH Guidelines. If the PWD
deserves a free service after evaluation, then such services shall be given free.
2.All persons with disability that are confined in the pay section of the
government health facilities and in all private hospitals and medical facilities are
granted at least twenty percent (20%) discount and VAT exemption for medical,
dental, and rehabilitation services, diagnostic and laboratory fees, psychological
or developmental tests, as well as professional fees of attending doctors provided
that these are in accordance with the available CPUs or hospital treatment
protocols. For outpatient, the same rule shall be followed
3.Services which are not medically necessary for the prevention,
diagnosis, treatment, rehabilitation or palliation shall not be provided
with any discount. This shall include, but not be limited, to cosmetic
surgical procedures, executive check—up packages, and physical
examinations, without clinical evidence of effectiveness and efficiency.

4. The grant of at least twenty percent (20%) discount and VAT

exemption shall be provided in the purchase of generic and branded
medicines as well as food for special medical purposes in all
establishments dispensing medicines for the exclusive use of the PWDs.
Also, a discount of at least twenty percent (20%) and VAT exemption is
granted to special reagents, dyes, contrast media, and radioactive
isotopes used in laboratory and diagnostic tests.
5. Consistent with RA 7875 as amended by RA 10606, otherwise known
as the National Health Insurance Act of 2013, and the Philippine Health
Agenda, all Filipinos shall be encouraged to be PhilHealth members or
at least be a dependent of active PhilHealth members. PWDs may be
enrolled by the national government (if they are included in the
National Housing Target System list) or sponsored by the LOU or an
NGO or private individual/group or voluntarily enroll themselves as
individual paying members. PhilHealth must make available
reimbursement schedules to health 'care practitioners provided it is
consistent with PhilHealth's legal mandates and policies.
VI. IMPLEMENTING RULES AND MECHANISMS FOR THE AVAILMENT OF
PRIVILEGES
1. Subsidized Services in In-Patient and Out-Patient Sections of
Government Health Facilities
a.Hospital Bed
• Hospital bed for a PWD confined in a service ward shall be classified based on AO 51-A
s. 2001 known as the Implementing Guidelines on the Classification of Patients on
Availment of Medical Social Services in government health facilities. Those classified as
Class D shall be free of charge provided that it is necessary to diagnose and treat an
illness or injury and in accordance with the available CPGs or hospital treatment
protocols.
b. Laboratories and Diagnostic Services
• All in-patient and out-patient PWDs shall be given a 20% discount and VAT exemption
for laboratory and diagnostic services, provided that:
i.Diagnosis and/or treatment by the attending physician shall be in accordance with the
available CPGs or hospital treatment protocols and have been medically necessary.
ii.Evidence-based health screening tests had been extensively tested for the local setting
and endorsed by the DOH as medically necessary for the individual.
iii. The laboratory and diagnostic services have been determined by his/her attending
physician as medically necessary.
Note that the balance shall be paid by the PWD based on his/her Medical Social Worker
Classification.
c. Dental Services
All dental services that are deemed to be medically necessary by the
attending dentist shall be granted free of charge.
d.Rehabilitation and Other Specialized Services
Twenty percent (20%) discount and VAT exemption shall be given to
PWDs requiring rehabilitation and other specialized services such as
purchase of assistive devices prescribed by attending physician or by a
rehabilitation specialist.
2. Non-Subsidized Services in Pay Services of Government Health
Facilities and Private Health Facilities
The PWDs confined in the pay sections of government accredited
health facilities and private health facilities shall be granted twenty
percent (20%) discount and VAT exemption for the following services:
a. Hospital Bed
A hospital bed in pay sections of government accredited health facilities
and private health facilities which is deemed medically necessary to
diagnose and treat an illness or injury in accordance with the available
CPGs or hospital treatment protocols.
b. Laboratories and Diagnostic Services
All in-patient and out-patient laboratory and diagnostic examinations
for PWD in pay sections of government health facilities and private
health facilities shall be granted 20% discount and VAT exemption,
provided that:
i. Diagnosis and/or treatment by the attending physician shall be in
accordance with available CPGs or hospital treatment protocols.
ii. All special reagents, dyes, contrast media, and radioactive isotopes
used in laboratory and diagnostic tests shall be provided to PWD
admitted to a health facility, other than the service ward.
c. Dental Services
All dental services that are deemed to be medically necessary by the
attending dentist shall be granted a 20% discount and VAT exemption.
d. Rehabilitation and Other Specialized Services
Twenty percent (20%) discount and VAT exemption shall be given to
PWDs requiring rehabilitation and other specialized services such as
purchase of . assistive devices prescribed by attending physician or by a
rehabilitation specialist.
e. Professional Fees
Professional fees for in-patient and out-patient medical, dental, and
other health care professional services shall be provided with a 20%
discount and VAT exemption. The concerned physician or dentist must
issue the corresponding official receipt.
3.Guidelines for the Twenty Percent (20%) Discount and VAT Exemption in the
Government Health Facilities and Private Health Facilities for PhilHealth-Related
Benefits
The PhilHealth accredited health care institutions shall first deduct 12% VAT
exemption from the total health care institution charges, then deduct the 20%
PWD discount from the difference; then deduct the PhilHealth benefits from
the remaining amount. (It is only after deducting the appropriate discount from
the total bill or statement of account that the accredited health care institution
can file claim for benefit package.)
4.Guidelines for the Twenty Percent (20%) Discount and VAT Exemption in the
Purchase of All Medicines for the Exclusive Use of the PWD
a) All establishments, through their registered pharmacists, must have full
discretion and responsibility in dispensing all medicines for the exclusive use
of PWD.
b) Discounts and VAT exemption shall be granted to PWDs on the purchase of
all medicines and food for special medical purposes provided that it is
supported by the following documentary requirements:
PWD identification (ID) card as issued by Local Government Unit (LGU)
through the City/Municipal Social Welfare and Development Office
(C/MSWDO) or the Persons with Disability Affairs Office (PDAO) of the place
where the PWD resides. National Council on Disability Affairs (NCDA) shall
issue a temporary PWD ID to PWDs in emergency situations such as but not
limited to hospital confinement, provided that the PWD ID number coding
shall be retained in accordance with the official residence of the PWD.
Except for over-the-counter (OTC) drugs, a doctor's prescription shall be
presented for medicines and food for special medical purposes. A
prescription shall have the following information : name of the PWD, age,
sex, address, date, generic name of the medicine, dosage form, dosage
strength, quantity, signature over printed name of physician, physician's
address, contract number of physician or dentist, professional license
number, professional tax receipt number and narcotic license number, if
applicable. The drugstores may limit - the dispensing of OTCs to not more
than a week's supply. Only prescriptions that contain the above information
shall be honored.
iii.Purchase booklet issued by the local social/health office to PWDs for
free containing the following basic information:
1. PWD ID number
2. Booklet control number
3. Name of PWD
4. Sex
5. Address
6. Date of Birth
7. Picture
8. Signature or thumb mark of PWD
9. Information of medicine to be purchased such as name of medicine,
quantity, attending physician and his/her license number, name of
servicing drug store and name of dispensing pharmacist
10. Authorization letter of the PWD who is residing in the Philippines at the
time of purchase, currently dated and the identification card of the authorized
person or representative, in case the medicine is bought by the representative
or caregiver of the PWD.
c. Purchase booklets shall be used to record the kind of OTC medicine
purchased, how many, when and where it was purchased. Likewise, this shall
help the drugstores to monitor the last purchase made for a certain medicine.
d. As a general rule, any single dispensing of medicines must be in accordance
with the prescription issued by a physician and should not exceed one (1)
month supply
e. Drug stores are required to maintain a special record book for PWD subject
to inspection by the FDA and Bureau of Internal Revenue.
f. For partial filling, the establishment's pharmacists will indicate the quantity
partially filled in the purchase booklet (special record book) and the unfilled
balance on the prescription. The PWD shall retain the partially filled
prescription and present the same later to complete the prescribed quantity.
g. Drug stores offering special discounted prices less than 20% of the
regular retail price can deduct the percentage discount of their
promotional campaign from the total of twenty percent (20%) discount as
required by RA 10754. Thus, a total discount of 20% for PWD will still be
observed.
h. These discount privileges and VAT exemption shall be non-transferable
and exclusively for the benefit of the PWD.
i. Double discounts shall not be allowed. The PWD shall avail of the
establishment's offered discount or the 20% discount and VAT exemption
provided herein, whichever is higher and more favorable. In cases where
the person with disability is also a senior citizen entitled to a 20% discount
and VAT exemption under his/her valid senior citizen identification card
(ID), the person with disability shall use either his/her PWD ID Card or
Senior Citizen ID card to avail of the 20% discount and VAT exemption.
j. All establishments dispensing medicines and assistive devices are
enjoined to comply with the above-cited guidelines.
5. Responsibilities of Stakeholders
a. Government Facilities
All government health facilities shall post hospital room rates, laboratory
tests, diagnostic tests fees, medicine prices, and all other fees and rates in
conspicuous places near or at the main entrance to their respective facilities.
The above-described price lists shall be submitted annually to the Health
Facility Development Bureau of DOH and PhilHealth.
i. All government health facilities shall post this Administrative Order in
conspicuous places where PWDs can have access to the information and
policies set forth by this document.
ii. Official receipts shall be issued in every payment for medical and dental
services, laboratory and diagnostic tests, and medicines provided. The
receipts shall state the usual rates or fees and the discounted price; and,
iii. No "Income Means Test" or any other tests shall be applied to the PWD as
a precondition for the availment of free services as herein described.
iv. An express lane for PWDs shall be provided in all government hospitals.
b. Private Hospitals and Medical Facilities and Establishments
I. Private hospitals and medical facilities must post the price of all room rates
in the Admitting Section of all private hospitals and medical facilities. The
prices of diagnostics and laboratory tests based on room and board
accommodation, medical supplies and medicines shall be made available
upon request of the PWD. The list shall ensure validation of the discount
and VAT exemption granted to PWDs.
II. Official receipts shall be issued to every payment for the medical and
dental services and medicines provided. The twenty percent discount and
VAT exemption shall be granted upon full payment of the bill. The billing
statement showing the usual rates or fees and the discounted prices shall
be attached to the official receipt.
III. Set a grievance mechanism for PWDs to entertain questions with regard to
discount and VAT exemption on professional fees.
IV. Inform in writing, copy furnished the aggrieved party, the necessary
sanction for health professionals who refuse to grant the proper discount
and VAT exemption.
v. All health facilities shall be required to post this Administrative Order
in conspicuous places where PWDs can have access to the information
and policies set forth by this document.
vi. An express lane for PWDs shall be provided in all private hospitals
and medical establishments.
c. Health Care Professionals shall:
I. Inscribe his/her name and PRC number in the request for diagnostic
and laboratory tests, and prescription;
II. Make sure that prescriptions made are for the exclusive use of the
PWD to curb abuse of availing discounts for use of non-PWD
citizens;
III. Inform the PWD of the usual fees for the services required; .
IV. Provide an official receipt for the rendered professional services to
the PWD that states the usual fees and the discounted fees and VAT
exemption.
d. Drugstores and other Licensed Establishments Dispensing Medicines
I. Drugstores shall make available upon the PWD's request, a generic
menu card and shall provide an official receipt for drugs and
medicines, which states the usual prices and the discounted prices
and VAT exemption of the drug or medicine.
II. All drug retail stores shall post this Administrative Order in
conspicuous places where the PWDs can access information on the
20% discount and VAT exemption on medicines.
III. Drugstores shall have a designated special lane for PWDs.
IV. During operating hours, all licensed establishments which dispense
medicines shall be prohibited from scheduling or limiting the time
of the PWDs to avail the discounts.
V. Official receipt should be issued to the PWDs for every transaction
on medicines which shall contain the Retail Price, the Discount
Price and VAT Exemption.
e. Rehabilitation Centers shall provide quality care to PWDs and their
families and to treat them with professional conduct and respect.
f. Behavioral testing centers shall provide test that measures general or
specific behavior within educational, vocational, community or house
settings. It shall also provide measurements and interpretations of behavior
in relation to adaptive or social skills and appropriateness or dysfunctions
within settings or situations.
g. Hospices and Palliative Care Centers shall provide a holistic quality care
for patients addressing their physical, psychosocial, emotional and spiritual
pains.

6. Mechanism of Endorsement of Complaints

Section 15 of Rule VI of the IRR of RA 10754, all complaints on non-
compliance with the 20% discount and VAT exemption shall be lodged with
the NCDA and/or to - the respective LGU-PDAO where the purchase was
made or where the PWD resides, whichever is convenient for the PWD.
VII. SEPARABILITY CLAUSE/ REPEALING CLAUSE

This Order repeals DOH Administrative Order (AO) 2009-0011. All other
issuances that are inconsistent herewith are hereby revised or
modified.
If any portion or provision of this Order is declared void or
unconstitutional, the remaining portions or provisions thereof shall not
be affected by such declaration.
VII. EFFECTIVITY
This Order shall take effect immediately after its publication in two (2)
newspapers of general circulation.