Pagadian City Ordinance No. 2005-247 — PAGADIAN CITY MEDICARE PARA SA MASA PARTIAL SUBSIDY SCHEME (MPM-PSS).…

No. 2005-247

PAGADIAN CITY MEDICARE PARA SA MASA PARTIAL SUBSIDY SCHEME (MPM-PSS). Section 2. DEFINITION OF TERMS. For the purpose of this ordinance the following terms are hereby defined to mean: CORPORATION. The Philippine Health Insurance Corporation (PHIC or Philhealth) which is mandated by law to administer the National Health Insurance Program (NHIP) as instituted by R.A 7875 as amended by R.A 9241. LGU. The Pagadian City Government. MEANS TEST. A protocol administered at the barangay level to determine the ability of individuals or households to pay varying levels of contributions to the Program, ranging from the indigent in the community whose contributions should be totally subsidized by government to those who can afford to subsidize part but not all the required contribution for the program. PREMIUM DONORS. Individuals or organizations who donate NHIP premium payment for indigents. Section 3. BENEFICIARIES. The indigents who are proposed to be enrolled by the LGU or Premium Donors but do not qualify for full subsidy under the Means Test rules as provided for in Sec. 29 Rule IV of the IRR of RA 7875 as amended by R.A 9241. Section 4. MEMBER'S PREMIUM SHARE. The premium share of a partially subsidized member is based on the ability to pay a portion of the annual NHIP premium as determined by the Corporation. They shall be paid by a member or a donor, in a most affordable scheme but which shall not exceed two (2) months prior to the LGU remittance of the Medicare Para sa Masa premium. Section 5. PREMIUM SHARING. The sharing scheme shall be done in the following manner: Members payment through Donors. The Donor(s) shall take responsibility of transmitting the premium payment for their adopted beneficiaries. Indigent - LGU sharing, shall be scheduled in the following order: b-1. For the 1st year of enrollment, the LGU gives FULL subsidy. b-2. On the 2nd year, the LGU subsidizes 50% while the member pays 50% of the premium. b-3 On the 3rd year, the LGU subsidizes 25% while the member pays 75% of the premium. b-4. On the 4th year, the member should graduate from the indigent status to SELF-EMPLOYED status, which means the member pays full PHIC premium annually. The Barangay Tanods in each of the 54 barangays of Pagadian City shall be given priority for this Pagadian City Medicare Para sa Masa Partial Subsidy Scheme. Except for those, who, by virtue of the Means Test, will still be found not capable of paying contributions, shall be exempted from the foregoing provisions (Sec. 5 par "b

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ORDINANCE NO: 2005-247

Be it enacted by the Sangguniang Panlungsod of Pagadian City that:

ARTICLE I- GENERAL PROVISIONS

Section 1.	TITLE. This ordinance shall be called the "PAGADIAN CITY MEDICARE PARA SA MASA PARTIAL SUBSIDY SCHEME (MPM-PSS).

Section 2.	DEFINITION OF TERMS. For the purpose of this ordinance the following terms are hereby defined to mean:

CORPORATION.  The Philippine Health Insurance Corporation (PHIC or Philhealth) which is mandated by law to administer the National Health Insurance Program (NHIP) as instituted by R.A 7875 as amended by R.A 9241.

LGU. The Pagadian City Government.

MEANS TEST. A protocol administered at the barangay level to determine the ability of individuals or households to pay varying levels of contributions to the Program, ranging from the indigent in the community whose contributions should be totally subsidized by government to those who can afford to subsidize part but not all the required contribution for the program.

PREMIUM DONORS.  Individuals or organizations who donate NHIP premium payment for indigents.

Section 3.	BENEFICIARIES.  The indigents who are proposed to be enrolled by the LGU or Premium Donors but do not qualify for full subsidy under the Means Test rules as provided for in Sec. 29 Rule IV of the IRR of RA 7875 as amended by R.A 9241.

Section 4.	MEMBER'S PREMIUM SHARE.  The premium share of a partially subsidized member is based on the ability to pay a portion of the annual NHIP premium as determined by the Corporation.  They shall be paid by a member or a donor, in a most affordable scheme but which shall not exceed two (2) months prior to the LGU remittance of the Medicare Para sa Masa premium.

Section 5.	PREMIUM SHARING.  The sharing scheme shall be done in the following manner:
Members payment through Donors.  The Donor(s) shall take responsibility of transmitting the premium payment for their adopted beneficiaries.

Indigent - LGU sharing, shall be scheduled in the following order:
b-1.	For the 1st year of enrollment, the LGU gives FULL subsidy.
b-2.	On the 2nd year, the LGU subsidizes 50% while the member pays  50% of the premium.
b-3	On the 3rd year, the LGU subsidizes 25% while the member pays 75% of the premium.
b-4.	On the 4th year, the member should graduate from the indigent status to SELF-EMPLOYED status, which means the member pays full PHIC premium annually.

The Barangay Tanods in each of the 54 barangays of Pagadian City shall be given priority for this Pagadian City Medicare Para sa Masa Partial Subsidy Scheme.

Except for those, who, by virtue of the Means Test, will still be found not capable of paying contributions, shall be exempted from the foregoing provisions (Sec. 5 par "b")

Other barangay volunteer workers are also to be considered for this scheme.

Section 6.	BARANGAY CONTRIBUTION.  All the existing 54 barangays of the City are enjoined to allocate an initial contribution to the Medicare Para sa MASA Partial Subsidy Scheme, and, thus, be a premium donor.  The amount of a SIX THOUSAND (P6,000.00) pesos is preferred as the minimum contribution of each barangay starting budget year 2006, which amount may be increased every year thereafter.

Section 7.	MEMBERS PREMIUM DEPOSITORY.   The City Treasurer shall be depository of premium paid by the partially subsidized members and premium donors the City Treasurer.  As such, shall maintain a separate account not to be subjected to any other City rules or policy on usage of account, except that of being made available specifically for NHIP premium payment as counterpart of the partially subsidized members of the Medicare Para sa Masa Program of the City Government of Pagadian.

Section 8.	REMITTANCE.  All premium payments from donors and members must be remitted to the Office of the Treasurer at least two (2) months prior to the schedule of the City's remittance to PHIC.

Section 9.	IMPLEMENTING RULES & REGULATION. The implementing rules and regulation of this ordinance shall be formulated/promulgated by the City Social Welfare and Development Office in coordination with the City Local Finance Committee and City Health Office subject to the review and confirmation by the Sangguniang Panlungsod.

Section 10.	SEPARABILITY CLAUSE.  Any action or provision of this ordinance which may be declared unlawful or unconstitutional, shall not disturb the other effective sections or provisions hereto.

Section 11.	REPEALING CLAUSE.  All ordinances, resolutions or policies of local effects not in consonance hereto are hereby modified, superseded or repealed accordingly.

Section 12.	EFFECTIVITY. This ordinance shall take effect upon approval by the City Mayor and the subsequent confirmation of the Sangguniang Panlalawigan of Zamboanga del Sur.

ENACTED AND APPROVED by the Sangguniang Panlungsod (8th City council) of Pagadian City during its 57th Regular Session held on September 20, 2005 at the SP Session Hall.