I. RATIONALE

Republic Act No. 7277, œAn Act Providing for the Rehabilitation, Self-Development, and Self-Reliance of Persons with Disability and Their Integration into the Mainstream of Society and for Other Purposes,  and otherwise known as œThe Magna Carta for Disabled Persons,  was passed in March 24, 1992. This specifically required the Department of Health (DOH) to, (1) institute a national health program for PWDs, (2) establish medical rehabilitation centers in provincial hospitals, and (3) adopt an integrated and comprehensive approach to the health development of PWD which shall make essential health services available to them at affordable cost.

Rule IV, Section 4, Paragraph B of the implementing rules and regulations (IRR) of this Act required the Department of Health to address the health concerns of seven (7) different categories of disability, which includes the following: (1) Psychosocial and behavioral disabilities, (2) Chronic illnesses with disabilities, (3) Learning (cognitive or intellectual) disabilities, (4) Mental disabilities, (5) Visual/seeing disabilities, (6) Orthopedic/moving, and (7) Communication deficits.

In addition, Republic Act No. 9442, otherwise known as, œAn Act Amending Republic Act No. 7277, otherwise known as the œMagna Carta for Disabled Persons, and for Other Purposes,  states in Section 1 that œ... a new chapter, to be denominated as Chapter 8. Other privileges and Incentives ™ is hereby added to Title Two of Republic Act No. 7277, otherwise known as the œMagna Carta for Disabled Persons , with new Sections 32 and 33, to read as follows:

œCHAPTER 8. Other Privileges and Incentives

œSEC. 32. Persons with disability shall be entitled to the following:

(a) At least twenty percent (20%) discount for the purchase of medicines in all drugstores for the exclusive use or enjoyment of persons with disability;

(b) At least twenty percent (20%) discount on medical and dental services including diagnostic and laboratory fees such as, but not limited to x-rays, computerized tomography scans and blood tests, in all government facilities, subject to guidelines to be issued by the Department of Health (DOH), in coordination with the Philippine Health Insurance Corporation (PHILHEALTH);

(c) At least twenty percent (20%) discount on medical and dental services including diagnostic and laboratory fees, and professional fees of attending doctors in all private hospitals and medical facilities, in accordance with the rules and regulations to be issued by the DOH, in coordination with the PHILHEALTH... 

The Implementing Rules and Regulations also stipulates in Rule IV Section 6, paragraph 10 that, œExpress lanes for persons with disability shall be provided in all private, commercial and government establishments, in the absence thereof, priority shall be given to them in all the transactions of the establishments . LGUs shall ensure that this provision is implemented within their area of jurisdiction. There should be an assigned person in all government agencies/offices and private establishments and to provide a section or desk manned by trained personnel to assist persons with disability. The personnel assigned shall be part of the existing human resource in all other government agencies/offices and private establishments as the case maybe or whenever possible.

Cognizant of the needs of the persons with disabilities and the economic and financial viability of the medical practitioners and hospitals, this Order is issued to support the Implementing Rules and Regulations of RA 9442. Policies and guidelines are enumerated herewith to guide the hospitals and medical, allied medical, paramedical or medical social worker practitioner so as to provide a fair, just and quality health care to PWDs while maintaining the financial and economic viability of the hospitals.

II. OBJECTIVES

To prescribe the procedures and guidelines for the implementation of the 20% discount in all health related services for PWDs

III. COVERAGE AND SCOPE

This Administrative Order applies to all private and government hospitals, health-related facilities, the health care professionals, the Philippine Health Insurance Corporation, and related health-care establishments, pharmacies and other establishment dispensing medicines.

IV. DEFINITION OF TERMS

Consistent with the pertinent definitions used in the Implementing Rules and Regulations of RA 7277 and RA 9442, the following terms shall be defined as follows:

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. For examples, hearing aides, electronic voice products, talking watches and related talking electronic equipment, canes, crutches, walkers, wheel chairs, and shower chairs are all assistive devices.

2. BIRTHING HOME OR CENTER - A medical facility designed to provide a comfortable, homelike setting during childbirth and that is generally less restrictive than a hospital in its regulations, as in permitting the practice of midwifery.

3. CHRONIC ILLNESS - words to describe a group of health conditions that last a long time. It may get slowly worse over time or may become permanent or it may lead to death. It may cause permanent change to the body and it will certainly affect the person ™s quality of life.

4. CLINIC means a place in which patients avail of medical consultations or treatment s on an outpatient basis. However, any clinic or dispensary where there is at least six (6) beds or cribs or bassinets installed for twenty-four hour use by patients shall be construed to fall within the definition of a hospital as described in RA 4226, the Hospital Licensure Act.

5. COMMUNICATION DISABILITY - An impairment in the process of speech, language or hearing: a) Hearing impairment is a total or partial loss of hearing function which impedes the communication process essential to language, educational, social and/or cultural interaction b) Speech and Language Impairments  mean one or more speech/ language disorders of voice, articulation, rhythm and/or the receptive and expressive processes of language.

6. CHILD WITH DISABILITY - persons below eighteen (18) years of age and 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.

7. DENTAL SERVICES - services related to oral examination, cleaning, permanent and temporary filling, extractions and gum treatments, restoration, replacement or repositioning of teeth, or alteration of the alveolar or periodontium process of the maxilla and the mandible that are necessary for the diagnosis and/or treatment of a dental illness, injury or condition.

8. DIAGNOSTIC AND LABORATORY TESTS - any procedure conducted for diagnostic purposes. It shall include such procedures as x-rays, CT-scans, MRI scans, PET scans, blood chemistry exams, his topathology, and immunopa thology, hematology, urine analysis, parasitology, and bacteriology tests, serology, blood banking and all other diagnostic radiology, clinical laboratory and other diagnostic examinations that are necessary for the diagnosis of the disability or medical condition of a disabled person. It shall also include clinical psychological tests, assessment of speech conditions, and tests for hearing acuity, visual acuity, learning impairment, and related psychosocial conditions like drug testing.

9. DISABILITY - The 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.

10. DISABILITY TYPES - the 7 types of disabilities mentioned in RA 7277 are psychosocial disability, disability due to chronic illness, learning disability, mental disability, visual disability, orthopedic disability, and communication disability.

11. ESTABLISHMENTS DISPENSING MEDICINES AND ASSISTIVE DEVICES - 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 BFAD and/or the local government unit.

12. GOVERNMENT HEALTH FACILITY - hospitals, outpatient clinics, health centers, rural health units or stations, clinical laboratory, diagnostic radiology center, audiology centers, optical clinics, psychological testing centers, drug testing centers, and other outpatient health facilities operated and maintained partially or wholly by the national, provincial, city or municipal government, or other political unit; or by any department, division, board or agency thereof. The facilities include DOH retained hospitals, specialty hospitals which are government owned and controlled corporations (GOCCs); medical clinics in GOCCs; and hospital or health facilities owned and managed by local government units, state colleges and universities, the Department of National Defense, the Department of Interior and Local Government and other government agencies.

13. GOVERNMENT HOSPITAL is a hospital operated and maintained either partially or wholly by the national, provincial, municipal, or city government or other political subdivision, or by any department, division, board or other agency thereof.

14. HEALTH CARE PROFESSIONAL - 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.

15. HEARING DISABILITY - moderate or worse hearing impairment in the better ear; that is, the permanent unaided hearing threshold level of the better ear of 41 or 31 decibels or greater in age under 15 years old.

16. HEARING IMPAIRMENT - the complete or partial loss of the ability to hear from one or both ears; with 26 decibels or greater hearing threshold, averaged at frequencies 0.5, 1.0, 2.0, and 4.0 kilohertz.

17. HOSPITAL - means a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment and care of individuals suffering from illness, disease, injury or deformity, or in need of obstetrical or other medical and nursing care. The term shall also be construed as any institution, building or place where there are installed beds or cribs or bassinets for twenty-four hour use of longer by patients in the treatment of diseases, diseased-condition, injuries, deformities or abnormal physical and dispensaries, and such other means by which they may be designated.

18. IDENTIFICATION DOCUMENT - any document or proof of being disabled which shall be used for availment of benefits and privileges under the law, such as the PWD identification card duly signed by anyone of the following: the Mayor, Barangay Captain or Chairperson of the National Council for the Welfare of Disabled Persons (NCWDP) now the National Council on Disability Affairs (NCDA), during the first 3 years. The signatory of the PWD identification card after this period shall be the Chairperson of the NCDA.

19. IMPAIRMENT - any loss, diminution or aberration of psychological or physiological function with or without an accompanying anatomical structural defect.

20. LEARNING DISABILITY - any disorder in one or more of the basic psychological processes (perception, comprehension, thinking, etc.) involved in understanding or in using spoken or written language.

21. MEDICAL DEVICES - 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, (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.

22. MEDICAL SERVICES - shall refer to the hospital room accommodation, hospital services, medical supplies, professional services of physician, allied medical practitioner, or paramedical practitioner and other 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.

23. MEDICALLY NECESSARY - Services required to preserve and maintain the health status of a person in accordance with the accepted standards of the medical practice in the medical community or services which are absolutely necessary in treating a patient and which could adversely affect the patients ™ condition if it were omitted.

24. MEDICINES - refers to both prescription and non-prescription medicines and drugs approved by the Bureau of Food and Drugs, intended for the prevention, diagnosis, cure, mitigation, treatment, rehabilitation, and palliation of diseases, injury or other medical conditions.

25. MENTAL DISABILITY - disability resulting from organic brain syndrome (i.e. Mental retardation, acquired lesions of the central nervous system, or dementia) and or mental illness (psychotic or non-psychotic disorder).

26. MULTIPLE DISABILITY - a PWD with one or more of the 7 types of disabilities.

27. ORTHOPEDIC DISABILITY - disability in the normal functioning of the joints, muscles or limbs.

28. PERSON WITH DISABILITY (PWD) - include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

29. PRIVATE HOSPITAL - is one which is privately owned, established and operated with funds raised or contributed through donations, or by private capital or other means, by private individuals, association, corporation, religious organizations, forms, company or joint stock association.

30. PRIVATE HOSPITALS AND MEDICAL FACILITIES - shall refer to all pay inpatient and outpatient health and medical facilities privately owned, established and operated with funds through donation, principal, investment or other means, by any individual, corporation, association or organization. The facilities include hospitals, clinical laboratories, diagnostic radiology centers, doctor ™s clinics, dental clinics and other health facilities that are licensed by the Bureau of Health Facilities and Services (BHFS) of the DOH and/or the local government.

31. PSYCHOSOCIAL DISABILITY - any acquired behavioral, cognitive, emotional or social impairment that limits one or more activities necessary for effective interpersonal transactions and other civilizing process or activities for daily living such as but not limited to deviancy or anti-social behavior.

32. Service Ward in government facility shall be the same as the Class D classification of Administrative Order No. 51-A, s. 2000 otherwise known as the implementing guidelines on Classification of Patients and on availment of Medical Social Services in Government Hospitals. Class D classification is provided full social services.

33. UNBRANDED GENERIC MEDICINES - drugs not covered by patent protection and which are labeled solely by their international non-proprietary or generic name and without a brand name.

34. VISUAL DISABILITY - A person with visual disability (Impairment) is one who has impairment of visual functioning even after treatment and/or standard refractive correction, and has visual acuity in the better eye of less than (6/18 for low vision and 3/60 for blind), or a visual field of less than 10 degrees from the point of fixation. A certain level of visual impairment is defined as legal blindness. One is legally blind when your best corrected central visual acuity in your better eye is 6/60 or worse or your side vision is 20 degrees or less in the better eye

V. POLICY STATEMENT

The following are the privileges for PWDs:

1. All persons with disability in all service wards of government facilities are entitled to a 20% discount 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 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 sections of the government health facilities are granted twenty (20%) discount for medical and dental services, and diagnostic and laboratory fees, provided that these are in accordance with the available Clinical Practice Guidelines or Hospital Treatment Protocols. For outpatient the same rule shall be followed.

3. All PWDs are granted the privilege of twenty percent (20%) discount in all private hospitals and medical facilities for the costs of medical, dental, rehabilitation, occupational and physical and speech therapies or services, and diagnostic and laboratory fees such as, but not limited to, x-rays, CT-scans, blood tests and others, including professional fees of attending doctors.

4. 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 limited to cosmetic surgical procedures, executive check-up packages, and physical examinations, without clinical evidence of effectiveness and efficiency. 20% discount is granted to specials reagents, dyes, contrast media, and radioactive isotopes used in laboratory and diagnostic tests.

5. The grant of twenty percent (20%) discount shall be provided in the purchase of branded medicines and unbranded generic medicines from all establishments dispensing medicines for the exclusive use of the PWDs.

6. PhilHealth Privileges

Consistent with the National Health Insurance Act of 1995 and the Health Sector Reform Agenda, all Filipinos shall be encouraged to be PhilHealth members or at least be a dependent of active PhilHealth members. Persons with Disability who are not yet non-paying PhilHealth members may become PhilHealth members if they are sponsored or enrolled by their Local Government Unit (LGU) or voluntarily enroll themselves as individually 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-Patients 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 A.O. No. 51-A, s. 2000 known as the implementing guidelines on the Classification of Patients and 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 Clinical Practice Guidelines or Hospital Treatment Protocols.

b. Laboratories and diagnostics services provided to an in-patient PWD in a service ward that are medically necessary as determined by his/her attending physician, shall be given 20% discount, provided that:

i. Diagnosis and/or treatment by the attending physician shall be in accordance with the Clinical Practice Guidelines (CPGs) or Hospital Treatment Protocols.

ii. Evidence-based health screening tests that had been extensively tested for the local setting and endorsed by the DOH as medically necessary for individual cases shall be provided free by the government facility.

iii. This shall also be subjected to the classification of the Medical Social Worker.

All laboratories and diagnostics provided to PWDs admitted in the service ward which are deemed not medically necessary for the illness or injury for which he/she is confined shall not be given a 20% discount.

c. Laboratories and Diagnostic Services for Out-patient PWDs

All PWDs shall be given 20% discount for laboratory and diagnostic services. The balance shall be paid by the Out-Patient PWD based on his/her Medical Social Worker Classification, provided that:

i. Diagnosis and/or treatment by the attending physician shall be in accordance with the available Clinical Practice Guidelines (CPGs) or Hospital Treatment Protocols and have been determined 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 individual.

iii. The laboratory and diagnostic services have been determined by his/her attending physician as medically necessary.

iv. The requesting physician is employed in the government health facility where the laboratory or diagnostic tests shall be conducted.

All requests for laboratory and diagnostic tests from physicians who are not employed in the government health facility shall only be granted a 20% discount upon final evaluation of the recipient government facility as medically necessary.

d. Dental Services

All dental services that are deemed to be medically necessary by the attending dentist shall be granted free of charge.

e. PhilHealth-Related Benefits

In case the PWD is a PhilHealth member or a dependent, government facilities must ensure that the charges for services shall be deducted and charged to the PWDs PhilHealth benefits coverage. It is only after these deductions are made that the PhilHealth accredited health facilities can exercise its right to the PhilHealth reimbursement or coverage for the subsidized services.

f. Rehabilitation and Other specialized Services prescribed by attending physician or by a rehabilitation specialist including the purchase of assistive devices by PWD shall be given 20% discount.

2. Non-Subsidized Services in Pay Sections of Government Health Facilities

The PWDs confined in the pay sections of government health facilities shall be granted twenty percent (20%) discount for the following services:

a. Hospital Bed - A hospital bed in a pay sections which is deemed medically necessary to diagnose and treat an illness or injury in accordance with the available Clinical Practice Guidelines (CPGs) or hospital treatment protocols.

b. Laboratories and Diagnostic Services for In-patient PWD

i. All in-patient and out-patient laboratory and diagnostic examinations for PWD in pay sections shall be granted 20% discount; provided that such diagnosis and/or treatment by the attending physician shall be in accordance with available Clinical Practice Guidelines (CPGs) or hospital treatment protocols.

ii. All inpatient laboratories and diagnostics that are provided to PWD admitted to a health facility other than the service ward shall only be granted a 20% discount.

iii. Twenty percent discount is granted to special reagents, dyes, contrast media, and radioactive isotopes used in laboratory and diagnostic tests.

c. Dental services

All dental services that are deemed to be medically necessary by the attending dentist shall be granted a twenty percent (20%) discount.

d. PhilHealth-Related Benefits

In case the PWD is a PhilHealth member or a dependent, government facilities must ensure that the charges for services shall be deducted and charged to the PWDs PhilHealth benefits coverage. It is only after these deductions are made that the PhilHealth accredited health facilities can exercise its right to the PhilHealth reimbursement or coverage for the subsidized services.

e. Rehabilitation and other specialized Services prescribed by attending physician or by a rehabilitation specialist including the purchase of assistive devices by PWD shall be given 20% discount.

3. Twenty percent (20%) Discount in Private Health Facilities

The PWDs confined in the private health facilities shall be granted twenty percent (20%) discount for the following services:

a. Hospital Bed - A PWD confined in a private hospital is granted a twenty percent (20%) dis count for the hospital bed, provided the requirements stated below are followed:

i. The available room and board accommodation shall be deemed as medically necessary to diagnose and treat illness, injury or disability.

ii. All existing privileges that go with the hospital bed shall also accrue to the PWD.

b. Laboratories and Diagnostic Services

i. All in-patient laboratories and diagnostic services of PWD shall be granted a twenty percent (20%) discount based on the preferred room and board accommodation provided that such diagnosis and/or treatment by the attending physician shall be in accordance with the available Clinical Practice Guidelines (CPGs) or hospital treatment protocols.

ii. All out-patient laboratories and diagnostic services shall be granted a 20% discount provided that such diagnosis and/or treatment by the attending physician shall be in accordance with Clinical Practice Guidelines (CPGs) or Hospital treatment protocols.

c. Dental Services

All dental services that are deemed to be medically necessary by the attending dentist shall be granted a twenty-percent (20%) discount.

d. PhilHealth-Related Benefits

In case the PWD is a PhilHealth member or a dependent, the 20% discount shall not be charged to the PWD ™s PhilHealth benefits coverage. Only the 80% of the fees or charges that the PWD is expected to shoulder may be charged to his/her PhilHealth benefits.

e. Rehabilitation and other specialized Services prescribed by attending physician or by a rehabilitation specialist including the purchase of assistive devices by PWD shall be given 20% discount.

f. Professional Fees

Professional fees for in-patient and outpatient medical, dental, and other health care professional services shall be provided with a 20% discount. The concerned physician or dentist must issue corresponding official receipt.

4. Guidelines for the twenty percent (20%) discount in the purchase of all medicines for the Exclusive Use of PWD

a. All establishments through their registered pharmacists must have full discretion and responsibility in dispensing all medicines for exclusive use of PWD.

b. Discounts shall be granted to PWDs on the purchase of all medicines provided that it is supported by the following:

i. PWD identification card as stated in the Definition of Terms.

ii. Doctors ™s prescription stating the 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, contact number of physician or dentist, professional license number, professional tax receipt number and narcotic license number, if applicable. To safeguard the health of PWDs and to prevent abuse of RA 9257, a doctor ™s prescription is required in the purchase of over-the-counter medicines.

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:

a. PWD ID number
b. Booklet control number
c. Name of PWD
d. Sex
e. Address
f. Date of Birth
g. Picture
h. Signature of PWD
i. Information of medicine purchased:

i.1 Name of medicine
i.2 Quantity
i.3 Attending Physician
i.4 License Number
i.5 Servicing drug store name
i.6 Name of dispensing pharmacist

j. 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 care giver of the PWD.

c. As a general rule, any single dispensing of medicine must be in accordance with the prescription issued by a physician and should not exceed a one (1) month supply.

Drug stores are required to maintain a special record book for PWD subject to inspection by the B FAD and BIR.

d. For partial filling, the establishment ™s pharmacists will indicate the quantity partially filled in the 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.

e. 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 9442. Thus, a total discount of 20% for PWD will still be observed.

These discount privileges shall be non-transferable and exclusive for the benefits of the PWD.

All establishments as defined above are enjoined to comply with the above-cited guidelines.

For purposes of verification, all hospitals, both government and private facilities shall require PWDs to present any of the following requirements:

i. A PWD ID Card issued and signed by the Barangay Captain, Mayor, or NCDA Chairperson

5. Responsibilities of Stakeholders

a. Government Facilities

All government facilities are required to 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 facility.

The above-described price lists shall be submitted annually to the National Center for Health Facility Development - DOH and PHIC.

i. All government facilities are also required to 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 must be issued to 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 œIncome Means Test  or any other tests shall be applied to the PWD as a precondition for the availment of free services as herein described.

b. Responsibilities of Private Hospitals and Medical Facilities

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 granted to PWDs.

ii. Official receipts must be issued to every payment for the medical and dental services and medicines provided. The twenty percent discount 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 regards to discounts 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.

c. Responsibilities of the Health Care Professionals

i. Inscribe his/her name and PRC number in the request for diagnostics and laboratory tests, and prescriptions;

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 citizen.

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.

d. Responsibilities of Drugstores

i. Drugstores are obliged to 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 of the drug or medicine.

ii. Drugstores are obliged to have a designated special lane for PWDs

e. Rehabilitation Centers shall provide quality care to PWDs and their families and to treat them with compassion 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 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, psycho-social, emotional, and spiritual pains.

6. Applications of Penalties and other Sanctions

a. Penalties for Persons who violates any provision

Any person who violates any provision of this Guideline shall suffer the following penalties:

i. For the first violation, a fine of not less than fifty thousand pesos (P50,000.00) but not exceeding one hundred thousand pesos (P100,000.00) and an imprisonment of not less than six (6) months but not more than two (2) years; and,

ii. For subsequent violations, a fine of not less than one hundred thousand pesos (P100,000.00) but not exceeding two hundred thousand pesos (P200,000.00) and imprisonment of not less than two (2) years but not more than six (6) years.

iii. Any person who abuses the privileges granted herein shall be punished with a fine not less than five thousand pesos (P5,000.00) but not more than fifty thousand pesos (P50,000.00) and imprisonment of not less than six (6) months.

iv. If the offender is an alien or a foreigner, he/she shall be deported immediately after the service of sentence without further deportation proceedings.

b. Penalties for Corporations

i. If the offender is a corporation, organization or any similar entity, the officials thereof directly involved shall be liable therefore.

ii. Upon filing of an appropriate complaint, and after due notice and hearing, the proper authorities may also cause the cancellation or revocation of the business permit, permit to operate, franchise, and other similar privileges granted to any business entity that fails to abide by the provisions of this Act.

7. Funding Sources

a. Initially, the funding shall be sourced out from the Philippine Charity Sweepstakes Office budget allocation for government hospitals that are providing free medical services to PWDs. Starting CY 2010, the National Government Agencies or LGUs shall include in their budget proposals the funding necessary to implement programs and services required by this Administrative Order.

b. For Government Owned and Controlled Corporations, total amount of discounts granted to PWDs shall be charged to the Quantified Free Service.

c. For Private health facilities, the cost of the discount shall be funded through the deduction of the discount from gross income for the same taxable year that the discount is granted, provided that the total amount of the claimed tax deduction net of value added tax if applicable, shall be included in their gross sales receipts for tax purposes and shall be subject to proper documentation and to the provisions of the National Internal Revenue Code as amended.

VII. REPEALING CLAUSE

Provisions from previous issuances that are inconsistent or contrary to the provisions of this Order are hereby rescinded and modified accordingly.

VIII. EFFECTIVITY

This Order shall take effect immediately after publication in two (2) national newspapers of general circulation.

Adopted: 20 May 2009

(SGD.) FRANCISCO T. DUQUE III, MD, MSc
Secretary of Health