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Questions and Answers
What is the purpose of the Health Technology Assessment (HTA) process?
What is the purpose of the Health Technology Assessment (HTA) process?
To provide recommendations to the DOH and PhilHealth for the development of policies, programs, regulation, and the determination of a range of entitlements such as drugs, medicines, pharmaceutical products, and other devices, procedures and services.
Which of the following are key components of the primary care provider network, as mandated by the Universal Health Care Act?
Which of the following are key components of the primary care provider network, as mandated by the Universal Health Care Act?
- Accurate, sensitive, and timely epidemiologic surveillance systems (correct)
- Patient records accessible throughout the health system (correct)
- Integrated and coordinated care that is accessible at the time of need, including a range of services for all presenting conditions (correct)
- Proactive and effective health promotion programs or campaigns (correct)
PhilHealth is required to provide immediate eligibility for a health benefit package to all members.
PhilHealth is required to provide immediate eligibility for a health benefit package to all members.
True (A)
What is the main role of the Health Promotion Bureau?
What is the main role of the Health Promotion Bureau?
What are the three types of funds that PhilHealth will establish?
What are the three types of funds that PhilHealth will establish?
What is the primary purpose of the Joint Congressional Oversight Committee?
What is the primary purpose of the Joint Congressional Oversight Committee?
What is the main objective of the HTA process regarding health interventions?
What is the main objective of the HTA process regarding health interventions?
Which act, as amended, is partially repealed by the Universal Health Care Act?
Which act, as amended, is partially repealed by the Universal Health Care Act?
Which of the following are included in the list of investments that PhilHealth's reserve fund can be placed in?
Which of the following are included in the list of investments that PhilHealth's reserve fund can be placed in?
The Universal Health Care Act mandates that all government hospitals must operate at least 90 percent of their bed capacity as basic or ward accommodation.
The Universal Health Care Act mandates that all government hospitals must operate at least 90 percent of their bed capacity as basic or ward accommodation.
What is the purpose of the Health Impact Assessment (HIA) process?
What is the purpose of the Health Impact Assessment (HIA) process?
What is the main purpose of the Data Privacy Act of 2012 in the context of the Universal Health Care Act?
What is the main purpose of the Data Privacy Act of 2012 in the context of the Universal Health Care Act?
What is the role of the Health Technology Assessment Council (HTAC)?
What is the role of the Health Technology Assessment Council (HTAC)?
What are the main sources of funding for the Universal Health Care Act?
What are the main sources of funding for the Universal Health Care Act?
How often are the provincial burden of disease estimates published by the DOH?
How often are the provincial burden of disease estimates published by the DOH?
The Universal Health Care Act mandates that the DOH must establish the Health Promotion Bureau within two years of the Act's effectivity.
The Universal Health Care Act mandates that the DOH must establish the Health Promotion Bureau within two years of the Act's effectivity.
What is the main objective of the Health Promotion Bureau?
What is the main objective of the Health Promotion Bureau?
What are the key goals of the Universal Health Care Act?
What are the key goals of the Universal Health Care Act?
Flashcards
What is the main objective of the Universal Health Care Act?
What is the main objective of the Universal Health Care Act?
This act ensures all Filipinos have equitable access to quality and affordable health care services, along with protection against financial risk.
What does 'Abuse of authority' mean in the context of the Health Care Act?
What does 'Abuse of authority' mean in the context of the Health Care Act?
It refers to a person's actions exceeding their authorized duties, harming the public good.
What are 'Amenities' in healthcare?
What are 'Amenities' in healthcare?
These are features enhancing comfort or convenience in a health service.
What does 'Basic or ward accommodation' refer to in hospitals?
What does 'Basic or ward accommodation' refer to in hospitals?
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What is 'Co-insurance' in health insurance?
What is 'Co-insurance' in health insurance?
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What is a 'Co-payment' in healthcare?
What is a 'Co-payment' in healthcare?
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Who are 'Direct contributors' to the Universal Health Care Program?
Who are 'Direct contributors' to the Universal Health Care Program?
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What defines an 'Emergency' in the context of the Health Care Act?
What defines an 'Emergency' in the context of the Health Care Act?
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What is the 'Essential health benefit package'?
What is the 'Essential health benefit package'?
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What constitutes a 'Fraudulent act' in the context of the Health Care Act?
What constitutes a 'Fraudulent act' in the context of the Health Care Act?
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Who or what is considered a 'Health care provider'?
Who or what is considered a 'Health care provider'?
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What is a 'Health care provider network'?
What is a 'Health care provider network'?
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What is a 'Health Maintenance Organization (HMO)'?
What is a 'Health Maintenance Organization (HMO)'?
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What is 'Health Technology Assessment (HTA)'?
What is 'Health Technology Assessment (HTA)'?
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Who are considered 'Indirect contributors' to the Universal Health Care Program?
Who are considered 'Indirect contributors' to the Universal Health Care Program?
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What are 'Individual-based health services'?
What are 'Individual-based health services'?
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What are 'Population-based health services'?
What are 'Population-based health services'?
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What is 'Primary care'?
What is 'Primary care'?
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Who is a 'Primary care provider'?
Who is a 'Primary care provider'?
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What is 'Private health insurance'?
What is 'Private health insurance'?
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What is considered an 'Unethical act' within the Health Care Act?
What is considered an 'Unethical act' within the Health Care Act?
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Who is covered by the Universal Health Care Program?
Who is covered by the Universal Health Care Program?
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How does the Universal Health Care Act aim to achieve its goals?
How does the Universal Health Care Act aim to achieve its goals?
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How is membership in the National Health Insurance Program organized?
How is membership in the National Health Insurance Program organized?
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What are the key benefits enjoyed by members of the National Health Insurance Program?
What are the key benefits enjoyed by members of the National Health Insurance Program?
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How are premium contributions determined for direct contributors?
How are premium contributions determined for direct contributors?
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How are premium contributions handled for indirect contributors?
How are premium contributions handled for indirect contributors?
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What purpose does the Program Reserve Fund serve?
What purpose does the Program Reserve Fund serve?
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What is the maximum limit on PhilHealth's administrative expenses?
What is the maximum limit on PhilHealth's administrative expenses?
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Who governs the National Health Insurance Program?
Who governs the National Health Insurance Program?
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How is the President and CEO of PhilHealth selected?
How is the President and CEO of PhilHealth selected?
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How are PhilHealth personnel classified?
How are PhilHealth personnel classified?
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How does the DOH prioritize health service delivery?
How does the DOH prioritize health service delivery?
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How are individual-based health services delivered under the Universal Health Care Act?
How are individual-based health services delivered under the Universal Health Care Act?
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Who manages the Special Health Fund for local health systems?
Who manages the Special Health Fund for local health systems?
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Where does the Special Health Fund get its funding?
Where does the Special Health Fund get its funding?
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Study Notes
Republic Act No. 11223 (Universal Health Care Act)
- Short Title: "Universal Health Care Act"
- Policy of the State: Protect and promote the right to health of all Filipinos, foster health consciousness, adopt an integrated and comprehensive approach.
- General Objectives: Realize universal health care in the country, ensure equitable access to quality and affordable healthcare.
- Definition of Abuse of Authority: Acting beyond authorized duties, adverse to public interest, under amended National Health Insurance Act of 1995 (IRR)
- Definition of Co-insurance: Percentage of medical charge paid by insured, remaining paid by health insurance plan
- Definition of Co-payment: Fixed fee or predetermined rate paid at a point of service
- Definition of Direct Contributors: Those with capacity to pay premiums, employed and bound by employer relationships or self-earning professionals and migrants
- Definition of Emergency: Condition requiring immediate support and treatment to avert significant loss or injury, pregnant woman
- Definition of Essential Health Benefit Package: A set of services from the National Health Insurance Program (NHIP) including primary care, medicine, diagnostics, preventive, curative, rehabilitative services
- Definition of Fraudulent Act: Misrepresentation to gain undue advantage, procedure deviation, financial gain
- Definition of Health Care Provider: Includes medical facilities, healthcare professionals (doctors, nurses, midwives, dentists), community-based healthcare organizations, pharmacies, drug outlets, diagnostic clinics
- Definition of Health Care Provider Network: Integrated, coordinated delivery of healthcare services, primary care provider acting as coordinator
- Definition of Health Maintenance Organization (HMO): Entity providing, offering or covering healthcare services under a premium
- Definition of Health Technology Assessment: Systemic evaluation of health-related technologies, procedures, medicines for solving health problems, and outcomes. Utilizes a multidisciplinary, cost-benefit, social and ethical approach
- Definition of Indirect Contributors: All those not included as direct contributors, including those with special laws
- Definition of Individual-based Health Services: Services uniquely targeted to a given recipient (versus population-based interventions) with limited population-wide impact, e.g. medical care, medicine or procedures.
- Definition of Population-based Health Services: Health-related interventions impacting the general population, e.g., health promotion, disease surveillance, disease vector control
- Definition of Primary Care: Initial, accessible, continuous, comprehensive healthcare encompassing all conditions, referrals
- Definition of Primary Care Provider: Competent healthcare worker certified in primary care, managed by DOH or licensed institution
- Definition of Private Health Insurance: Insurance coverage, financed by personal payments in the form of premium, to insurer
- Definition of Unethical Act: Overbilling, ghost patients or false recruitment, practice contrary to code of ethics, other similar acts impacting NHIP integrity
Chapter II (UHC)
- Population Coverage: All Filipino citizens are automatically included in NHIP
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