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PhilHealth, not paying stem cell therapy August 23, 2013

THE Corporation clarifies that PhilHealth is not paying, currently, the stem cell therapy.

If in the future, the said treatment has been certified as a standard care, this shall undergo evaluation prior to a benefit development package. Accordingly under its law, Republic Act (RA) 10606, the National Health Insurance Program of 2013, as amended, "the Corporation shall not cover expenses for health services considered... as cost-ineffective through health technology assessment... In keeping with its protection objectives and financial sustainability."

Health technology assessment is a field of science that investigates the value of health technology such as procedure, process, products or devices specifically on their quality, relative cost effectiveness and safety which has implications on policy, decision to adopt/invest in these technologies, or in health benefit coverage. As such, all new technologies including stem cell therapy shall undergo the process of assessment if they can be developed into a benefit package or be excluded from the same.

At present, PhilHealth provides for preventive and promotive benefits through its Primary Care Benefit (PCB1) and curative care benefits through its hospitalization benefits, whether in-patient or out-patient for day surgeries. Other than these, the Corporation pays for special benefits like Z benefit packages for catastrophic cases, MDG benefits like maternity care packages, newborn care package, animal bite package, HIV package, TB Dots package, malaria Package and others.

And "to provide maximum financial protection, the No Balance Billing (NBB) policy has been adopted for the sponsored (indigents) members and their qualified dependents. If they are admitted in a service accommodation of a government facility, under our case rate packages, they shall not be charged for hospital and professional fees anymore, hence no out of pocket payment," PCEO Alexander A. Padilla said.

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