AMENDING CERTAIN SECTIONS OF REPUBLIC ACT NUMBERED SIXTY-ONE HUNDRED ELEVEN OTHERWISE KNOWN AS THE "PHILIPPINE MEDICAL CARE ACT OF 1969."

• Number: Presidential Decree No. 273
• Sections: 7

Preamble

WHEREAS, actuarial studies indicate that the Health

Insurance Fund of Program I of the Philippine Medical Care Plan has a sizeable

reserve after settlement of all claims against it; and

WHEREAS, such Health Insurance Fund reserve permits an

increase in the extent and scope of benefits of the beneficiaries of the

Plan;

NOW, THEREFORE, I, FERDINAND E. MARCOS, President of the

Philippines, by virtue of the powers in me vested by the Constitution as

Commander-in-Chief of all the Armed Forces of the Philippines, and pursuant to

Proclamation No. 1081, dated September 21, 1972, and General Order No. 1, dated

September 22, 1972, as amended, do hereby order and decree, that:

Section 1

SECTION 1. Section 5 (d) of Republic Act Sixty One Hundred

Eleven, otherwise known as the "Philippine Medical Care Act of 1969," is hereby

amended to read as follows:

"(d) To authorize actuarial studies for the purpose of determining and

fixing, from time to time, the contributions necessary and the extent and scope

of benefits of the beneficiaries of the Plan as its resources may permit in

order to ensure adequate financing and disbursement of funds to all participants

in the Plan; And, whenever the resources of the Plan permits without

necessitating additional contributions from the employees and employers, the

Commission shall effect increases in the extent and scope of benefits of the

beneficiaries of the Plan."

Section 2

SEC. 2. Section 13 (b) of the same Act is hereby amended to

read as follows:

"(b) Special charge expense benefit for charges necessary for the care of the

employee, such as laboratory examination fees, drugs, X-ray and the like, not to

exceed one hundred fifty pesos."

Section 3

SEC. 3. Section 14 of the same Act is hereby amended to read

as follows:

"SEC. 14. Surgical Expense Benefit. — Under such

rules, regulations and/ or conditions as the SSS or GSIS may prescribe, subject

to the approval of the Commission, an employee who shall have undergone a

surgical procedure in a hospital shall be entitled to surgical expense benefits,

as may be determined by the SSS or the GSIS, as the case may be, taking into

account the nature and complexity of the procedure as follows:

(a) Surgeon's fees not to exceed fifty pesos for a minor operation, one

hundred fifty pesos for a medium operation and three hundred fifty pesos for a

major operation;

(b) Anesthesiologist's fees not to exceed twenty five pesos for a minor

operation, fifty pesos for a medium operation and one hundred pesos for a major

operation;

(c) Operating room fees not to exceed twenty pesos for a minor operation,

forty pesos for a medium operation and sixty pesos for a major

operation."

Section 4

SEC. 4. Any provision of existing law, rule, regulation or

order that is contrary to, or inconsistent herewith is hereby repealed or

modified accordingly.

Section 5

SEC. 5. The benefits provided by this Decree shall

be effective as of July 1, 1973.

Section 6

SEC. 6. This Decree shall take effect immediately.

Done in the City of Manila, this 14th day of August, in the year of Our Lord,

nineteen hundred and seventy-three.

(Sgd.) FERDINAND E. MARCOS

President

Republic of the Philippines

By the President:

(Sgd.) ROBERTO V. REYES

Assistant Executive Secretary