REVISED PHILIPPINE
MEDICAL
CARE ACTPRESIDENTIAL DECREE
NO. 1519, AS AMENDED
REVISING THE
PHILIPPINE MEDICAL CARE ACT
OF NINETEEN HUNDRED AND SIXTY NINE
(As amended by Executive
Orders
Nos. 105, 106 and 269)
WHEREAS, Republic Act
Number Sixty-One Hundred Eleven entitled "An Act Establishing the
Philippine
Medical Care Plan and Creating the Philippine Medical Care Commission,
Prescribing Its Duties and Powers and Functions and Appropriating Funds
Therefor" enacted on August 4, 1969 requires revision in order to
be
responsive to the situation;
WHEREAS, such revision
is a condition to the more effective implementation of the law and the
achievement of its goals;
WHEREAS, the Medical
Care Program is one of the vital Projects of the government in the New
Society;
NOW, THEREFORE, I, FERDINAND
E. MARCOS, President of the Philippines, by virtue of the powers vested
in me by the Constitution, do hereby order and decree:
SECTION 1. Short Title.
- This decree shall be known as the "Revised Philippine Medical
Care Act."
SECTION 2. Declaration
of Policy. - It is hereby declared to be the policy of the
government
to gradually provide total medical services to our people by adopting
and
implementing a comprehensive and coordinated medical care plan based on
the following concepts of health care:
(a) There shall be
comprehensive
medical care according to the needs of the patient.
(b) The use of government
and
private medical facilities shall be coordinated as public service
instrumentalities
for the people.
(c) Optimum health care
shall
be achieved by preserving and promoting a proper inter-relationship
among
physicians, patients and hospitals. SECTION 3. Purposes
and
Objectives. - The main purposes and objectives of this Decree are:
a) To provide medical
care
to residents of the country in an evolutionary way within our economic
means and capability as a nation.
b) To provide our people
with
a viable means of helping themselves to pay for adequate medical care. SECTION 4. Definition
of Terms. - For the purpose of this Decree, the following terms
shall
mean as follows:
a) Commission - The Philippine
Medical Care Commission created under R.A. No. 6111.cralaw:red
b) Philippine Medical Care
Plan - The total Plan consisting of Programs I and II.cralaw:red
c) SSS - The Social Security
System created under Republic Act Number Eleven Hundred Sixty One, as
amended.cralaw:red
d) GSIS - The Government
Service Insurance System created under Commonwealth Act Number One
Hundred
Eighty Six, as amended.cralaw:red
e) Employee - Any person
compulsorily covered by either the GSIS or SSS.cralaw:red
f) Beneficiary - Any
person entitled to medical care benefits under this Decree.cralaw:red
g) Employer - The employer
of the employee.cralaw:red
h) Legal Dependent -
Persons other than members and contributors who are entitled to
benefits
under this Decree in accordance with such terms and conditions as the
Commission
may prescribe.cralaw:red
i) Medical Care Benefits
- Services relative to illness or injury, including major dental
surgery
or operation which needs hospitalization subject to reasonable
limitations
as will be imposed by the technical organization and finances of the
Philippine
Medical Care Plan.cralaw:red
j) Hospital - Any medical
facility, government or private, accredited in accordance with rules
and
regulations promulgated by the Commission.cralaw:red
k) Medical or Dental Practitioner
- Any doctor of medicine or doctor of dental medicine duly licensed to
practice in the Philippines and who is accredited by the Commission in
accordance with its rules and regulations. (As amended by Sec. 1,
Executive
Order 269)
l) Service Beds - Private
and government hospital beds set aside for beneficiaries of the
Philippine
Medical Care Plan as may be prescribed by the Commission.cralaw:red
m) Single Period of Confinement
- A single confinement or series of confinements for the same illness,
with intervals of not more than ninety (90) days.cralaw:red
n) Medical or Dental Attendance
- Medical or dental care of a patient by a physician or medical
staff
or dentist or dental staff of the hospital.cralaw:red
SECTION 5. Philippine
Medical Care Commission. - To carry out the purposes and objectives
of this Act, the Philippine Medical Care Commission created by Republic
Act No. 6111, hereinafter referred to as the Commission, shall be
composed
of the Secretary of Health as Chairman; an Undersecretary of Health
designated
by the former as Vice-Chairman; the Administrator of the Social
Security
System; the President and the General Manager of the Government Service
Insurance System; the Secretary of Finance; the Secretary of Local
Government;
the Secretary of Labor and Employment; and four other members, one each
representing the beneficiaries, the private employers, the physicians
and
the hospitals. The four other members shall be appointed by the
President
of the Philippines for a term of six (6) years.cralaw:red
The ex-officio members
may designate their representatives who shall exercise the plenary
powers
of their principals as well as enjoy the same benefits available to the
latter. (As amended by Sec. 2, Executive Order No. 269).
SECTION 6. Functions
of the Commission. - The Commission shall have the following
functions
and powers:
a) To formulate policies, administer
and implement the Philippine Medical Care Plan, consistent with the
National
Health Plan.cralaw:red
b) To ensure that medical care
is provided to members covered by the Philippine Medical Care Plan.cralaw:red
c) To organize its offices,
fix the compensation of and appoint its Secretary and such other
personnel
as may be deemed necessary, subject to pertinent budget and
compensation
laws, rules and regulations.cralaw:red
d) To accredit medical and dental
practitioners, government and private hospitals and other facilities
for
participation in the Medical Care Plan under such terms and conditions
as the Commission may set.cralaw:red
e) To promulgate or prescribe
rules and regulations as may be necessary to carry out the provisions
and
purposes of this Act.cralaw:red
f) To recommend to the President
from time to time according to sound actuarial procedures the
contributions
and benefits under the Philippine Medical Care Plan as well as
alternative
system in order to insure adequate financing and effective delivery of
medical care to all beneficiaries of the plan.cralaw:red
g) To ensure a homogenous distribution
of adequate hospital accommodations for inpatient care through national
network of government and private medical care facilities; and to
coordinate
with the Department of Health in the implementation of the Hospital
Licensure
Act.cralaw:red
h) To acquire in behalf of the
Republic of the Philippines, real or personal property which may be
necessary
or expedient for the attainment of the purposes of the Commission
i) To enter into agreements
or contracts in the manner and under such terms and conditions as the
Commission
may deem proper for the efficient and effective administration of the
Commission.cralaw:red
j) To adopt control measures
to prevent abuses of the Philippine Medical Care Plan.cralaw:red
k) To render decisions, orders
or resolutions on any investigation conducted upon its own initiative
or
upon complaint in writing for any violation of this law or its rules
and
regulations, and after notice and hearing, impose administrative fines
of not less than P5,000 but not more than P10,000 against any person,
natural
or juridical, found guilty of such violation: Provided, That
should
the violation be committed by a hospital, drugstore, medical or dental
practitioner, the accreditation so extended shall, in addition, be
suspended
for a period not exceeding six months: Provided, furthermore,
That
any decision, order or resolution rendered by the Commission shall be
appealable
to the Office of the President in accordance with the procedure
established
under Administrative Order No. 18, Series of 1987: Provided,
finally,
That the administrative sanctions provided herein shall be without
prejudice to the penal provisions under Section 28 hereof.cralaw:red
l) To issue as soon as the decision,
order or resolution has become final and executory, writs of execution
enforceable in accordance with the Rules of Court of the Philippines.cralaw:red
m) To deputize any law enforcement
agency or official in the execution of its final decisions, orders or
resolutions
and to serve such other processes of the Commission.cralaw:red
n) To submit to the President
of the Philippines annually within the first ten days of each year, a
report
covering its activities in the administration of this Act during the
preceding
fiscal years.cralaw:red
o) To coordinate with other
appropriate government agencies in the development of the medical and
allied
manpower based on the needs of the health care delivery system.cralaw:red
p) To approve rules and regulations
to ensure uniform evaluation of claims as may be elevated by the
beneficiary
hospitals or practitioners.cralaw:red
q) Generally to exercise all
powers necessary to attain the purposes and objectives of this Act.
(As amended by Sec. 3, Executive Order No. 269).
SECTION 7. Meetings
and Hearings of the Commission. - The meetings and hearings of the
Commission shall be held as often as necessary at the discretion of the
Chairman or at the request of the majority of the members of the
Commission.
The presence of six (6) members of the Commission shall constitute a
quorum.
The members of the Commission shall receive a per diem for
every
meeting and hearing attended subject to pertinent budget laws, rules
and
regulations on compensation, honoraria and allowances. Each member of
the
Commission shall receive a monthly commutable allowance subject to the
aforementioned laws, rules and regulations, except those who are
already
receiving the same from the government offices they are appointed to. (As
amended by Sec. 4, Executive Order No. 269).
SECTION 8. Chairman
and Vice-Chairman of the Commission. - (a) The Chairman shall
preside
over the meetings of the Commission and shall implement its decisions.
He shall exercise supervision and control over all operations of the
Commission.cralaw:red
(b) When the Chairman is temporarily
unable to perform his functions or in case of vacancy of the Office of
the Chairman, the Vice-Chairman shall serve as Acting Chairman. He
shall
perform such other functions as may be assigned to him by the Chairman.
(As amended by Sec. 5, Executive Order No. 269).
SECTION 9. Executive
Director of the Commission. - The Commission shall have an
Executive
Director who shall be appointed by the President of the Philippines for
a term of six (6) years. The Executive Director shall have at least ten
(10) years experience in technical and administrative fields related to
the purposes and objectives of this Act. He shall hold office on a
full-time
basis and shall not be removed except for cause. He shall receive such
salary and remuneration as may be determined by the Commission, subject
to pertinent laws, rules and regulations on compensation, honoraria and
allowances.cralaw:red
The Executive Director shall
be responsible for the general conduct of the operations and
administration
of the Commission. (As amended by Sec. 6, Executive Order No. 269).
SECTION 10. The Philippine
Medical Care Plan. - The Philippine Medical Care Plan shall consist
of the following which shall provide medical care benefits:
a) Program I - for members
of the SSS and the GSIS including their legal dependents.cralaw:red
b) Program II - for those
not covered under Program I. This shall be in accordance with
Section
33 hereof.cralaw:red
SECTION 11. Program
I. - All members of the SSS and GSIS and all their legal
dependents
as defined under Section 4 hereof shall be provided with medical care
benefits.cralaw:red
In case a person is covered
by both the SSS and the GSIS, he may choose under which system he shall
be covered for Medicare purposes, under such rules as the Commission
may
prescribe. (As amended by Sec. 7, Executive Order No. 269).
SECTION 12. Medical
Care Benefits. - Under such rules, regulations and/or conditions
as
the SSS or the GSIS may prescribe, subject to the approval of the
Commission,
a beneficiary under Program I who suffers from sickness or
injury
requiring hospitalization/surgical operation shall be entitled to the
following
benefits:
a) The medical care benefits
to Medicare beneficiaries covered by the Social Security System (SSS)
shall
not exceed the rates indicated below:
BENEFIT
PRIMARY SECONDARY
TERTIARY
1. Room and Board not exceeding
45 days per year
for each member of Program
I and another 45 days
to be shared by his
legal
dependents:
P55/Day
P100/Day
P145/Day
2. Medical Expense Benefit
(Per Single Period of
Confinement)
2.1. Ordinary
Cases
2.1.1. Drugs &
Medicines
595
790
1,015
2.1.2.
X-Ray/Laboratory/Others
150
360
635
2.2. Intensive
Care Cases
2.2.1. Drugs &
Medicines
350
1,620
2,915
2.2.2X-Ray/Laboratory/Others
325
830
1,260
2.3. Catastrophic
Cases
2.3.1. Drugs and
Medicines
3,650
4,170
2.3.2.
X-Ray/Laboratory/Others
1,620
3,845
3. Medical/Dental Practitioner’s
Fee shall be P55.00
per day
for a General Practitioner and P80.00 for a
Specialist
but not to exceed:chanroblesvirtuallawlibrary
3.1. For
Ordinary Cases
(Per Single Period of Confinement)
For General
Practitioner
300
For
Specialist
450
3.2. For
Intensive Care/Catastrophic Cases
(Per Single Period of Confinement)
For General
Practitioner
450
For
Specialist
750
4. Surgeon’s Fee shall be in
accordance with the
Relative
Value Scheme prescribed by the
Commission
not to exceed P7,080.00.cralaw:red
5. Anesthesiologist’s Fee not
to exceed 30% of the
allowable
Surgeon’s Fee.cralaw:red
6. Operating Room Fee for Surgical
Procedures
under the
following brackets of Relative Unit Value
(RUV):chanroblesvirtuallawlibrary
1. RUV of 5.0 and below
-
170
295
470
2. RUV 5.1 to 10.0 units
-
505
600
3. RUV above 10 units
-
960
1,550
7. Fees for Surgical Family
Planning Procedures
(For
members and spouses only):chanroblesvirtuallawlibrary
1. Vasectomy
-
400
2. Tubal
Ligation
500
b) The Medical Care benefits
of Medicare beneficiaries covered by Government Service Insurance
System
(GSIS) shall not exceed the rates indicated below:chanroblesvirtuallawlibrary
BENEFIT
PRIMARY SECONDARY
TERTIARY
1. Room and Board not exceeding
45 days per year
for each
member and another 45 days to be shared
by
his
dependents:
P55/Day
P100/Day
P120/Day
2. Medical Expense Benefit
(Per
Single Period of Confinement)
2.1. Ordinary
Cases
2.1.1. Drugs &
Medicines
595
790
845
2.1.2.
X-Ray/Laboratory/Others
125
300
530
2.2. Intensive
Care Cases
2.2.1. Drugs &
Medicines
1,125
1,350
2,430
2.2.2.
X-Ray/Laboratory/Others
270
690
1,050
2.3. Catastrophic
Cases
2.3.1. Drugs &
Medicines
3,040
3,475
2.3.2.
X-Ray/Laboratory/Others
1,350
3,205
3. Medical/Dental Practitioner’s
Fee shall be P55.00
per day for a General
Practitioner
and P80.00 for a
Specialist but not to exceed:chanroblesvirtuallawlibrary
3.1. For
Ordinary Cases
(Per
Single Period of Confinement)
For
General
Practitioner
300
For
Specialist
450
3.2. For
Intensive Care/Catastrophic Cases
(Per
Single Period of Confinement)
For
General
Practitioner
450
For
Specialist
750
4. Surgeon’s Fee shall be in
accordance with the
Relative
Value Scheme prescribed by the
Commission
not to exceed P7,080.00.cralaw:red
5. Anesthesiologist’s Fee not
to exceed 30% of the
allowable
Surgeon’s Fee.cralaw:red
6. Operating Room Fee for Surgical
Procedures
under the
following brackets of Relative Unit Value
(RUV):chanroblesvirtuallawlibrary
1. RUV of 5.0 and below
-
140
245
390
2. RUV 5.1 to 10.0 units
-
420
500
3. RUV above 10 units
-
960
1,290
7. Fees for Surgical Family
Planning Procedures
(For
members and spouses only):chanroblesvirtuallawlibrary
1.
Vasectomy
-
400
2.
Tubal
Ligation
-
500
The
beneficiaries shall have the option to
secure the drugs and medicines used for his treatment from either the
hospital
pharmacy wherein he is confined or from any retail drugstore of his own
choice subject to the rules and regulations promulgated by the
Commission
or as provided for in Sections 21 and 22 thereof.
Out-patient
and domiciliary care shall be
carried out by existing government hospitals, rural health units, other
government clinics and all clinics under the supervision of various
government
entities.
As soon as
feasible, the Commission shall
provide expense allowance for ambulatory and domiciliary care benefits
rendered in/by government or private hospitals or clinics to
beneficiaries
of this Medical Care Act subject to rules and regulations promulgated
by
the Commission.
All
government hospitals, sanitaria, clinics,
dispensaries and rural health units shall provide back-up services to
the
medical care plan, especially for patients occupying service beds.
(As
amended by Executive Order No. 106).
SECTION 13.
Participants in the
Delivery of Medical Care Services. - Only the following may
participate
in the delivery of medical services in the Philippine Medical Care Plan
under such rules and regulations as the Commission may set:
a) Hospitals
duly accredited by the Commission.
b) Medical
and dental practitioners duly accredited
by the Commission.
c) Drugstores
duly accredited by the Commission.
SECTION 14.
Free Choice of Hospital,
Medical or Dental Attendance. - Any beneficiary who becomes sick or
is injured shall be free to choose the hospital in which he will be
confined
and the medical or dental practitioner or medical or dental attendance
by whom he will be treated, under such rules and regulations as may be
promulgated by the Commission.
The right of
any beneficiary who so desire
to arrange privately for medical care at his own expense shall not be
prejudiced
by any provision of this Decree.
SECTION 15.
Entitlement to Medical
Care Benefits. - A member who shall have paid at least three
monthly
contributions during the last twelve months prior to the first day of
the
single period of confinement, as well as his legal dependents, shall be
entitled to medical care benefits: Provided, That when he
commits
any violation of this law or its rules and regulations, he and his
legal
dependents shall not be allowed to avail of these benefits by the
Commission
subject to Section 6(K) hereof. The member shall continue to pay his
contributions
during the period of suspension of availment of benefits. (As
amended by Sec. 3, Executive Order No. 105).
SECTION 16.
Supervision. - The
Commission, the SSS and the GSIS shall exercise supervision over the
confined
beneficiaries under such rules and regulations as may be promulgated
for
the purpose. This authority may be exercised by the Commission through
its intermediaries.
SECTION 17.
Health Insurance Fund.
- Payments for medical care benefits under Program I shall
be
borne by the Health Insurance Fund which shall consist of all
contributions
of Medicare members and all accruals thereto collected by the SSS and
GSIS
from the members under the Act. It shall be kept distinct and separate
from all other funds administered by the said agencies.
The Health
Insurance Fund shall be deposited,
invested, administered, and disbursed in the same manner and under the
same conditions, requirements, and safeguards as provided by Republic
Act
Numbered Eleven Hundred Sixty-One, as amended, and Presidential Decree
Numbered Eleven Hundred Forty-Six, as amended, with regard to such
other
funds as are administered by the SSS and GSIS, respectively:
Provided,
That the deposit, investment, administration, and disbursement of
the
funds conform with the policies established by the Commission: Provided,
further, That the SSS and GSIS may disburse each for operational
expenses
not more than twelve percent (12%) of the total contributions and
investment
earnings collected during the year. (As amended by
Sec.
8, Executive Order No. 269).
SECTION 18.
Contributions to the
Health Insurance Fund. - The compulsory contributions of members
to
the Health Insurance Fund shall be in accordance with the schedule of
rates
established by the Commission and approved by the President. (As
amended by Sec. 9, Executive Order No. 269).
Salary
Monthly Salary
Bracket
Wages or
Contribution
Employer’s Employee’s
Number
Earnings
Base
Contributions Contributions
1.
Below - P 49.99 P
25.00
P
0.30
P 0.30
2.
50.00 -
99.99
75.00
0.95
0.95
3.
100.00 - 149.99
125.00
1.55
1.55
4.
150.00 - 199.99
175.00
2.20
2.20
5.
200.00 - 249.99
255.00
2.80
2.80
6.
250.00 - 349.99
300.00
3.75
3.75
7.
350.00 - 499.99
425.00
5.35
5.35
8.
500.00 - 599.99
600.00
7.50
7.50
9.
700.00 - 899.99
800.00
10.00
10.00
10.
900.00 - over
1,000.00
12.50
12.50
SECTION 19. Collection
of Contributions to the Health Insurance Fund. - The employer shall
deduct from his employee’s monthly compensation the employee’s
contribution.
The employee’s contribution and the employer’s counterpart thereof
shall
be remitted by the employer directly to the GSIS and SSS, as the case
may
be, in the same manner as other SSS and GSIS contributions and shall be
subject to the same penalties for late payment. The employer’s
counterpart
contribution shall not in any manner be recovered from the employee.
Failure
of employer to remit to the GSIS or SSS the corresponding employee’s
and
employer’s contributions shall not be a reason for depriving the
employee
of the benefits of this Decree. (As amended by Sec. 10, Executive
Order
No. 269).
SECTION 20.
Effects of Separation
from Employment. - An employee who is no longer obliged under
Section
19 hereof by separation from employment may continue to enjoy medical
care
benefits, subject to such rules and regulations and/or conditions as
the
Commission may prescribe.
SECTION 21.
Payment of Medical Care
Benefits. - Payment of medical care services shall be made directly
to the hospital, the medical or dental practitioner, and the retail
drug
store according to rules, regulations and/or conditions which the
Commission
may set: Provided, that when the charges and fees agreed upon
between
the beneficiary, who choose to occupy a bed more expensive than a
service
bed, and the provider of the service, exceed the amount of benefits
provided
under this Decree, the difference shall be borne personally by the
patient.
Medical care expense incurred while outside the country may be
reimbursed
to the beneficiary under such rules, regulations and/or conditions as
the
Commission may prescribe and research to improve the program. (As
amended
by Sec. 11, Executive Order No. 269).
SECTION 22.
Limitation to Payment
of Benefits. - Claims for payment of services rendered under this
Decree
which are filed beyond sixty (60) days after the discharge of the
patient
from the hospital or from the time a patient has been declared well,
shall
be barred from payment.
Payment for
services rendered may be reduced
or denied when the claimant:
(a) Furnishes
false of incorrect information
concerning any matter required by this Decree or the rules and
regulations
promulgated by the Commission.
(b) Fails
without good cause or legal ground
to comply with any provision of this Decree or the implementing rules
and
regulations of the Commission.
The cost of
medical care benefits of patients
confined in service beds shall be limited to the prescribed medical
care
benefit allowances.
When a claim
is reduced or denied, the amount
thus reduced or denied shall not be charged directly or indirectly to
the
beneficiary involved unless the latter is directly responsible for the
cause of such reduction or denial.
SECTION 23.
Exclusion. - The
benefits granted under the Medical Care Plan shall not cover any
expenses
for:
(a) Cosmetic
surgery or treatment;
(b)
Optometric services;
(c)
Psychiatric illness;
(d) Normal
obstetrical delivery; and
(e) Services
which are purely diagnostic.
SECTION 24.
Records and Reports.
- The Commission, the SSS and GSIS, shall keep records of all
operations
relative to the Program.
SECTION 25.
Program Monitoring,
Study and Research. - The Commission shall undertake a continuing
monitoring
study and research to improve the Program. (As amended by Sec. 11,
Executive
Order No. 269).
SECTION 26.
Hearing Procedures.
- There is hereby created a Hearing Committee composed of nine (9)
members
who shall be designated by the Commission for the purpose of conducting
inquiries and investigations into reported violations of this law or
its
implementing rules and regulations. The Committee may sit in three (3)
divisions, each division composed of three (3) members. The Committee
shall
not be bound by the technical rules of evidence. The Committee may
administer
oaths, certify to official acts, and issue subpoena and subpoena
duces tecum to compel the attendance of witnesses, and the
production
of books, papers and other records deemed necessary in connection with
any question arising under this law. The Commission shall have the same
powers to punish direct and indirect contempts granted to superior
courts
under Rule 71 of the Rules of Court. (As amended by Sec. 4,
Executive
Order No. 105).
SECTION 27.
Preventive Suspension.
- The Hearing Committee may preventively suspend any beneficiary,
duly
accredited practitioner, hospital or other facility from participation
in the Program if any of the following circumstances is present:
a. When the
respondent has been found guilty
of a violation of this Act or of its rules and regulations at least
twice
and there is reasonable ground to believe that the respondent is guilty
of the present charge.
b. When the
respondent, at the time of the
inspection, has committed or is committing a violation.
The
preventive suspension order shall be for
a period of not exceeding three (3) months from the date of its
issuance.
The order: (a) shall specify the violation charged, supported by the
evidence
of the violation; (b) shall require the respondent to answer the
charges
within a period of ten (10) days from receipt thereof; and (c) shall
require
the respondent to appear on the date set for hearing the case. (As
amended
by Sec. 12, Executive Order No. 269).
SECTION 28.
Penal Provisions.
- Any person who, for the purpose of securing entitlement to any
benefit
or payment under this Decree or the issuance of any certificate or
document
for any purpose connected with this Decree, whether for himself or for
some other person, shall commit fraud, collusion, falsification,
misrepresentation
or any similar anomaly, shall suffer the penalties provided for in
Article
172 of the Revised Penal Code.
Whoever fails
or refuses to comply with the
provisions of this law or with the rules and regulations promulgated by
the Commission, including failure or refusal to deduct contributions
from
the employee’s compensation and to remit the same to the Social
Security
System (SSS) or the Government Service Insurance System (GSIS), shall
be
punished by a fine of not less than Ten thousand pesos (P10,000.00) but
not more than Forty thousand pesos (P40,000.00) or imprisonment for not
less than six (6) months nor more than six (6) years, or both, at the
discretion
of the court. (As amended by Par. 1, Sec. 5, Executive Order No.
105).
Any employer
who, after deducting the monthly
contributions from his employee’s compensation, fails to remit the said
deductions to the SSS and GSIS within thirty days from the date they
become
due shall be presumed to have misappropriated such contributions and
shall
suffer the penalties provided in Article 315 of the Revised Penal Code.
Any employer
who shall deduct, directly or
indirectly, from the compensation of the covered employees or otherwise
recover from them his own contribution on behalf of such employees
shall
be punished by a fine of not less than Ten thousand pesos (P10,000.00)
but not more than Forty thousand pesos (P40,000.00) or imprisonment of
not less than six (6) months nor more than six (6) years, or both, at
the
discretion of the court. (As amended by Par. 2, Sec. 5, Executive
Order
No. 105).
Any employee
of the SSS or GSIS who receives
or keeps funds or property belonging, payable or deliverable to the SSS
or GSIS and who shall appropriate the same, or shall take or
misappropriate
or shall consent, or through abandonment or negligence, shall permit
any
other person to take such property or funds, wholly or partially, or
shall
otherwise be guilty of misappropriation of such funds or property,
shall
suffer the penalties provided in Article 217 of the Revised Penal Code.
If the act or
omission, penalized by this
Decree, be committed by an association, partnership, corporation or any
other institution, its managing head, directors or partners shall be
liable
to the penalties provided in this Decree for the offense.
Criminal
actions arising from violation of
the provisions of this Decree may be commenced by the SSS, the GSIS or
the Commission, or the employees concerned either under this Decree or,
in appropriate cases, under the Revised Penal Code: Provided,
That
criminal actions may be filed by the SSS, the GSIS or the Commission in
the city or municipality where the violation was committed or in Metro
Manila, at their option.
SECTION 29.
Appropriation. -
Funds as may be necessary to finance the operations, programs, and
projects
of the Commission in carrying out this Decree are hereby authorized to
be included in the Annual Appropriation Law. (As amended by Sec.
13,
Executive Order No. 269).
SECTION 30.
Government Guarantee.
- The Republic of the Philippines guarantees the benefits under
this
Decree and the solvency of the Community Health Insurance Funds.
SECTION 31.
Program II. - As
soon as feasible, medical care benefits under Program II will be
provided
either through a social insurance medical care service similar to that
of Program I or through the public medical care service under
the
rules and regulations to be promulgated by the Commission. All
provisions
of this Decree as may be applicable to Program II shall so
apply.
Those not covered at present by Program I may seek medical
attention
from existing government hospitals.
Program II
shall be implemented upon
its approval by the President.
SECTION 32.
Separability Clause.
- In the event any provision of this Decree or the application of
such
provision to any person or circumstances is declared invalid, the
remainder
of the Decree or the application of said provision to other persons or
circumstances shall not be affected by such declaration.
SECTION 33.
Repealing Clause. -
Republic Act No. 6111, and all laws, executive orders, administrative
rules
and regulations or parts thereof which are inconsistent with the
provisions
of this Decree are hereby repealed or modified accordingly.
SECTION 34.
Effectivity. - The
Revised Medical Care Act shall be implemented 90 days after its
approval.
Done in the
City of Manila, this 11th of June
in the year of our Lord, nineteen hundred and seventy-eight.
(Sgd.) FERDINAND E. MARCOSPresident
By the President:cralaw:red
(Sgd.) JUAN C. TUVERA
Presidential Assistant
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