Executive Order No. 106 (1986)

83 OG No. 4, 275 (January 26, 1987)

[ EXECUTIVE ORDER NO. 106, December 24, 1986 ]

RESTRUCTURING THE MEDICAL CARE BENEFITS UNDER THE PHILIPPINE MEDICAL CARE PLAN

WHEREAS, actuarial studies show that without increasing contributions, current benefits under the Philippine Medical Care Plan, otherwise known as the Medicare Program can be increased for certain items only and at different rates for the two sectors of beneficiaries covered:

NOW, THEREFORE, I, CORAZON C. AQUINO, President of the Philippines, do hereby order:

SECTION 1. The medical care benefits to Medicare beneficiaries covered by the Social Security System (SSS) shall not exceed the rates indicated below: HOSPITAL CATEGORY BENEFIT PRIMARY SECONDARY TERTIARY 1. Room and Board P 30/day P 35/day P 45/day 2. Medical Expense (per single period of confinement) 2.1 Ordinary Cases 2.1.1 Drugs & 175 200 300 Medicines 2.1.2 X-ray / 75 150 350 Laboratories / Others 2.2 Intensive Care Cases 2.2.1 Drugs & 375 400 500 Medicines 2.2.2 X-ray / 125 200 500 Laboratories / Others 2.3 Catastrophic Cases 2.3.1 Drugs & 800 1.000Medicines- 2.3.2 X-ray / 400 1.000 Laboratories / Others 3. Medical / Dental Practitioner's Fee shall be P15.00 per day not to exceed 3.1 For Ordinary 200 200 200 Cases (per single period of confinement) 3.2 For intensive Care 300 300 300 / Catastrophic Cases (Per single period of confinement) 4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed P650.00 5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's fee.

6. Operating Room Fee for Surgical Procedures with Relative Unit Value of: 0 - 5 30 35 65 5.1 - 10 - 120 165 10.1 - Above - 170 225 7. Fees for surgical family planning procedures as may be determined by the commission

SECTION 2. The medical care benefits of Medicare beneficiaries covered by the Government Service Insurance System (GSIS) shall not exceed the rates indicated below: HOSPITAL CATEGORY BENEFIT PRIMARY SECONDARY TERTIARY 1. Room and Board P 20/day P 24/day P 33/day 2. Medical Expense Benefits (Per single period of confinement) 2.1 For OrdinaryCases 2.1.1 Drug & 150 175 250 Medicines 2.1.2 X-ray / 50 75 100 Laboratories / Others 2.2 For Intensive Care Cases 2.2.1 Drug & 250 300 350 Medicines 2.2.2 X-ray / 100 125 250 Laboratories / Others 2.3 Catastrophic Cases 2.3.1 Drugs - 400 450 & Medicines 2.3.2 X-ray / - 150 300 Laboratories / Others 3. Medical / Dental Practitioner's Fee shall be P15.00 per day not to exceed: 3.1 For Ordinary 200 200 200 Cases (per single period of confinement) 3.2 For Intensive 300 300 300 Care / Catastrophic Cases (per single period of confinement) 4. Surgeon's Fee shall be in accordance with the relative value scheme prescribed by the Commission not to exceed P650.00 5. Anesthesiologist's Fee not to exceed 30% of the allowed Surgeon's Fee 6. Operating Room Feefor Surgical Procedures with relative Unit Value of: 0 - 5 30 35 65 5.1 - 10 - 120 165 10.1 - above - 170 225 7. Fees for surgical family planning procedures as may be determined by the Commission

SECTION 3. All laws, orders, issuances, rules and regulations or parts thereof inconsistent with this Executive Order are hereby repealed or modified accordingly.

SECTION 4. This Executive Order shall take effect immediately:

Done in the City of Manila, this 24th day of December in year of Our Lord, nineteen hundred and eighty-six.

(Sgd.) CORAZON C. AQUINO President of the Philippines

By the President:

(Sgd.) JOKER P. ARROYO Executive Secretary