[ PHIC PHILHEALTH CIRCULAR NO. 03, S. 2004, January 27, 2004 ]
REIMBURSEMENT OF CLAIMS FOR DRUGS LISTED IN THE PNDF VOL. 16TH EDITION - SECTION 1.0 AND 4.0
The National Formulary Committee of the Department of Health has released the official list of drugs under Section 1.0 Drugs acting on the nervous system and Section 4.0 Immunologicals, of the latest edition of the Philippine National Drug Formulary (PNDF) which is the 6th edition Vol. 1.
Pursuant to Section 37 of Republic Act 7875 and PhilHealth Board Resolution No. 265 s. 1999 which provides for the use of the latest edition of the PNDF for reimbursement, the said list of drugs shall be implemented as follows:
All other issuances inconsistent with this circular are hereby repealed and modified accordingly.
Adopted: 27 Jan. 2004
(SGD.) FRANCISCO T. DUQUE III, MD, MSc
President and CEO
* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.
Pursuant to Section 37 of Republic Act 7875 and PhilHealth Board Resolution No. 265 s. 1999 which provides for the use of the latest edition of the PNDF for reimbursement, the said list of drugs shall be implemented as follows:
- Newly listed drugs preparations contained in Sections 1.0 and 4.0 of the PNDF, Vol. 1 6th edition (see Annex 1* ), shall be compensable for claims with admission dates starting January 1, 2004.
- To give a reasonable time for adjustment on the non-reimbursability of delisted drugs and drug preparations in the 6th edition of the PNDF (see Annex 2* ), they shall continue to be compensated for claims with admission dates until March 31, 2004.
However, PhilHealth shall no longer reimburse these delisted drugs and drug preparations (see Annex 2) for claims with admission dates starting April 1, 2004.
- Please note that ketorolac trometamol 30 mg/mL, 1 mL ampule (IM, IV) which is included in the PhilHealth Positive List until December 31, 2003 as per PhilHealth Circular Nos. 208, s. 2002 and 33, s-2003, has already been included in the 6th edition of the PNDF under Section 1. Drugs Acting on the Nervous System.
Hence, PhilHealth shall continue reimbursing ketorolac trometamol 30mg/mL, 1 mL ampule (IM, IV) for claims with admission dates starting January 1, 2004.
All other issuances inconsistent with this circular are hereby repealed and modified accordingly.
Adopted: 27 Jan. 2004
President and CEO
* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.