PHIC PHILHEALTH CIRCULAR NO. 33, S. 2009 AMENDMENT TO PHILHEALTH CIRCULAR NO. 25, S. 2009 - PHILHEALTH COVERAGE FOR CONFIRMED CASES OF NOVEL INFLUENZA A (H1N1) IN HUMANS September 01, 2009

Date Filed: 23 September 2009

Relative to the increasing number of confirmed Influenza A (H1N1) cases in the country and the Department of Health’s policy of shifting from containment of infection to mitigation strategy, the revised rules in claims reimbursement of benefit for Influenza A (H1N1) are as follows:

1. Payment of benefit for Influenza A (H1N1) stated in PhilHealth Circular No. 25, s. 2009 is applicable to all accredited hospitals.

2. However, starting September 1, 2009, the benefit payment stated in PhilHealth Circular No. 25, s. 2009 shall only be applicable to Level 3 & 4 (Tertiary) hospitals. On the other hand, payment for Level 1 (Primary) and Level 2 (Secondary) hospitals are as follows:

BENEFIT ITEMS	Level 1 (Primary)	Level 2 (Secondary)
Members/Dependent	HCW	Members/  Dependents	HCW
Room and Board	500 per day Max = 10,000	500 per day Max = 20,000	700 per day Max = 10,000	700 per day Max = 20,000
Drugs and Medicines X-ray, Laboratory and Others •Supplies including PPE •Transfer services(Ambulance) Operating Room Fee	50,000	100,000	50,000	100,000
Professional Fee	500 per day Max=15,000	500 per day Max=30,000	700 per day Max=15,000	700 per day Max=30,000
TOTAL	75,000	150,000	75,000	150,000

All other provisions of previous issuances which are not inconsistent with this Circular remain in full force and effect.

Please be guided accordingly.

Adopted: 01 Sept. 2009