History

THE call to serve the rural indigents echoed since the early '60s when the Philippine
Medical Association introduced the MARIA Project which prioritized aid to communities
in need of medical assistance. The Project would then be considered a valuable
precursor to the Medicare program, from which a medical care plan for the entire
Philippines was created. On August 4, 1969, Republic Act 6111 or the Philippine Medical
Care Act of 1969 was signed by President Ferdinand E. Marcos which was eventually
implemented in August 1971.
The Philippine Medical Care Commission (PMCC) was tasked to oversee the
implementation of the program which went for almost a quarter of a century.
In the 1990s, a vision for a better, more responsive government health care program
was prompted by the passage of several bills that had significant implications on health
financing. The public's clamor for a health insurance that is more comprehensive in
terms of covered population and benefits led to the development of House Bill 14225
and Senate Bill 01738 which became The National Health Insurance Act of 1995 or
Republic Act 7875, signed by President Fidel V. Ramos on February 14, 1995. The law
paved the way for the creation of the Philippine Health Insurance Corporation
(PhilHealth), mandated to provide social health insurance coverage to all Filipinos in 15
years' time.
PhilHealth assumed the responsibility of administering the former Medicare program for
government and private sector employees from the Government Service Insurance
System in October 1997, from the Social Security System in April 1998, and from the
Overseas Workers Welfare Administration in March 2005.

Agency's Mandate And Functions

Mandate
The National Health Insurance Program was established to provide health insurance
coverage and ensure affordable, acceptable, available and accessible health care
services for all citizens of the Philippines. It shall serve as the means for the healthy to
help pay for the care of the sick and for those who can afford medical care to
subsidize those who cannot. It shall initially consist of Programs I and II or Medicare and
be expanded progressively to constitute one universal health insurance program for the
entire population. The program shall include a sustainable system of funds constitution,
collection, management and disbursement for financing the availment of a basic
minimum package and other supplementary packages of health insurance benefits by
a progressively expanding proportion of the population. The program shall be limited to
paying for the utilization of health services by covered beneficiaries. It shall be
prohibited from providing health care directly, from buying and dispensing drugs and
pharmaceuticals, from employing physicians and other professionals for the purpose of
directly rendering care, and from owning or investing in health care facilities. (Article III,
Section 5 of RA 7875 as amended)
Powers And Functions
PhilHealth is a tax-exempt Government Corporation attached to the Department of
Health for policy coordination and guidance. (Article IV, Section 15 of RA 7875 as
amended). It shall have the following powers and functions (Article IV, Section 16 of RA
7875 as amended by RA 10606):
a) To administer the National Health Insurance Program;
b) To formulate and promulgate policies for the sound administration of the Program;
c) To supervise the provision of health benefits and to set standards, rules and
regulations necessary to ensure quality of care, appropriate utilization of services, fund
viability, member satisfaction, and overall accomplishment of Program objectives;
d) To formulate and implement guidelines on contributions and benefits; portability of
benefits, cost containment and quality assurance; and health care provider
arrangements, payment, methods, and referral systems;
e) To establish branch offices as mandated in Article V of this Act;
f) To receive and manage grants, donations, and other forms of assistance;
g) To sue and be sued in court;
h) To acquire property, real and personal, which may be necessary or expedient for the
attainment of the purposes of this Act;
i) To collect, deposit, invest, administer, and disburse the National Health Insurance
Fund in accordance with the provisions of this Act;
j) To negotiate and enter into contracts with health care institutions, professionals, and
other persons, juridical or natural, regarding the pricing, payment mechanisms, design
and implementation of administrative and operating systems and procedures,
financing, and delivery of health services in behalf of its members;
k) To authorize Local Health Insurance Offices to negotiate and enter into contracts in
the name and on behalf of the Corporation with any accredited government or
private sector health provider organization, including but not limited to health
maintenance organizations, cooperatives and medical foundations, for the provision of
at least the minimum package of personal health services prescribed by the
Corporation;
l) To determine requirements and issue guidelines for the accreditation of health care
providers for the Program in accordance with this Act;
m) To visit, enter and inspect facilities of health care providers and employers during
office hours, unless there is reason to believe that inspection has to be done beyond
office hours, and where applicable, secure copies of their medical, financial, and other
records and data pertinent to the claims, accreditation, premium contribution, and
that of their patients or employees, who are members of the Program;
n) To organize its office, fix the compensation of and appoint personnel as may be
deemed necessary and upon the recommendation of the president of the
Corporation;
o) To submit to the President of the Philippines and to both Houses of Congress its
Annual Report which shall contain the status of the National Health Insurance Fund, its
total disbursements, reserves, average costing to beneficiaries, any request for
additional appropriation, and other data pertinent to the implementation of the
Program and publish a synopsis of such report in two (2) newspapers of general
circulation;
p) To keep records of the operations of the Corporation and investments of the
National Health Insurance Fund;
q) To establish and maintain an electronic database of all its members and ensure its
security to facilitate efficient and effective services;
r) To invest in the acceleration of the Corporation’s information technology systems;
s) To conduct information campaign on the principles of the NHIP to the public and to
accredited health care providers. This campaign must include the current benefit
packages provided by the Corporation, the mechanisms to avail of the current benefit
packages, the list of accredited and disaccredited health care providers, and the list of
offices/branches where members can pay or check the status of paid health
premiums;
t) To conduct post audit on the quality of services rendered by health care providers;
u) To establish an office, or where it is not feasible, designate a focal person in every
Philippine Consular Office in all countries where there are Filipino citizens. The office or
the focal person shall, among others, process, review and pay the claims of the
overseas Filipino workers (OFWs);
v) Notwithstanding the provisions of any law to the contrary, to impose interest and/or
surcharges of not exceeding three percent (3%) per month, as may be fixed by the
Corporation, in case of any delay in the remittance of contributions which are due
within the prescribed period by an employer, whether public or private.
Notwithstanding the provisions of any law to the contrary, the Corporation may also
compromise, waive or release, in whole or in part, such interest or surcharges imposed
upon employers regardless of the amount involved under such valid terms and
conditions it may prescribe;
w) To endeavour to support the use of technology in the delivery of health care
services especially in farflung areas such as, but not limited to, telemedicine, electronic
health record, and the establishment of a comprehensive health database;
x) To monitor compliance by the regulatory agencies with the requirements of this Act
and to carry out necessary actions to enforce compliance;
y) To mandate the national agencies and LGUs to require proof of PhilHealth
membership before doing business with a private individual or group;
z) To accredit independent pharmacies and retail drug outlets; and
aa) To perform such other acts as it may deem appropriate for the attainment of the
objectives of the Corporation and for the proper enforcement of the provisions of this
Act.

Affiliations
International Social Security Association
ASEAN Social Security Association
Philippine Social Security Association
Vision, Mission, Core Values

Vision
"Bawat Filipino, Miyembro,
Bawat Miyembro, Protektado,
Kalusugan ng Lahat, Segurado"

Mission
"Benepisyong Pangkalusugang Sapat at De-kalidad para sa Lahat"

Core Values
Integridad
Inobasyon
Agarang Serbisyo
Taos-Pusong Paglilingkod
Pagmamalasakit
Angkop na Benepisyo
Panlipunang Pagkakabuklod

Ex-Officio Members Representative/Alternate

Francisco T. Duque III, M.D., MSc. Lilibeth C. David, MD, MPH, MPM,
Secretary of Health CESO III
Chairperson Undersecretary

Lyndon L. Lee Suy, MD, MPH

Assistant Secretary

Atty. Charade B. Mercado-

Grande
Assistant Secretary

BGen. Ricardo C. Morales, AFP

(Ret) FICD
PhilHealth President and
Chief Executive Officer (CEO)
Vice-Chairperson

Rolando Joselito D. Bautista Javier R. Jimenez

DSWD Secretary Assistant Secretary
Member Marie Angela S. Gopalan, CESO III
Director
Ex-Officio Members Representative/Alternate

Atty. Silvestre H. Bello III Atty. Jacinto V. Paras

DOLE Secretary Undersecretary
Member

Carlos G. Dominguez III Sharon P. Almanza

DOF Secretary Deputy Treasurer
Member Rosalia V. De Leon
Treasurer

Atty. Janet B. Abuel Tina Rose Marie L. Canda

DBM Acting Secretary Undersecretary
Member Carmencita P. Mahinay
Director
Atty. Ryan S. Lita
Director

Appointive Members

BGen. Ricardo C. Morales, AFP

(Ret) FICD
Indirect Contributors Sector
Member

BGen. Marlene R. Padua, AFP

(Ret.)
Health Care Providers Sector
Member

Alejandro L. Cabading, CPA

Expert Panel
Member

Jack G. Arroyo, Jr., M.D.*

Elected Local Chief Executive
Member

Rex Maria A. Mendoza*

Independent Director of the
Monetary Board
Member
 Ex-Officio Members Representative/Alternate

Celestina Ma. Jude P. Dela Serna,

M.D.*
Filipino Overseas Workers Sector
Member

Roberto M. Salvador Jr., M.D.*

Formal Economy Sector
Member

Roy B. Ferrer M.D., MSc.*

Employers Sector
Member

Office of the Corporate Secretary

Atty. Jonathan P. Mangaoang

Corporate Secretary

*awaiting official action from the Office of the President on courtesy

resignation

Executive Officers
FUNCTIONAL
NAME ACTUAL OFFICE CONTACT NO.
DESIGNATION

BGEN. RICARDO President and Chief Office of the President (02) 637-6294; 637-6177
C. MORALES, AFP Executive Officer and Chief Executive
(RET) FICD (CEO) Officer

BASA, RUBEN Executive Vice Office of the Executive (02) 637-6448

JOHN A. President and Chief Vice President and
Operating Officer Chief Operating Officer

Enabling Laws
RA 11223
(Universal Health Care Act)
Quasi-Judicial Provisions Of The Revised Implementing Rules And Regulations Of
R.A.10606
The Revised Implementing Rules And Regulations Of The
National Health Insurance Act Of 2013 (RA 7875 As Amended By RA 9241 And 10606)
R.A. 10606
R.A. 9241 And Its Implementing Rules And Regulations
R.A. 7875 And Its Implementing Rules And Regulations

Privacy Notice for Members and

Health Care Professionals
In carrying out its mandate under Republic Act (RA) No. 7875, as amended by RAs 9241
and 10606, which relates to the administration of the National Health Insurance
Program (NHIP), the Philippine Health Insurance Corporation (“PhilHealth or “We”)
collects and processes personal data. It does so in a manner that is consistent with the
provisions of RA 10173, also known as the Data Privacy Act of 2012 (DPA).
PhilHealth commits to secure and keep confidential all its collected data. It also aims to
uphold the fundamental right to privacy of all individuals they pertain to, especially
PhilHealth members and their dependents and health care professionals.
Personal Data We Collect
We collect data that are necessary to fulfill our functions and activities relative to the
implementation of the NHIP when you:
1. fill out any of our forms, either electronically or manually;
2. register in and use our online services;
3. avail PhilHealth benefits; and
4. contact us via phone, email or any other means.
They include, but are not limited to, member’s name, age, sex, date of birth, email
address, contact details, health information, employment details, government-issued ID
numbers, signature, and details about his or her dependents (spouse, children, and
parents). Additional information are collected from health care professionals in relation
to their residency training and medical affiliations. CCTV camera footages of both
PhilHealth personnel and visitors are also recorded within our office premises.
You may visit https://www.philhealth.gov.ph/privacy/ to read the Privacy Notice,
specific to our website.
How We Use Personal Data
In accordance with our mandate to implement the NHIP, we may use and process
collected personal data for any or all of the following purposes:
1. to process member registration;
2. to process accreditation registration;
3. to process the payment of premiums;
4. to process reimbursement of benefit and claims;
5. to establish and maintain PhilHealth database and records;
6. to investigate incidents that involve PhilHealth-accredited health care professionals
or facilities;
7. to compile and generate reports for statistical and research purposes;
8. to relay or communicate queries, clarifications and official announcements; and
9. to accomplish other compatible purposes allowed by law.
We will not, under any circumstances, subject your personal data to any automated
decision-making process without your prior consent or any authority granted by law.
Security of Personal Data
We have established necessary and appropriate physical, technical and organizational
security measures to protect the personal data we collect and process. These
safeguards are regularly reviewed and updated to ensure that they are constantly at
par with international and industry standards. Access to your personal data is limited to
authorized PhilHealth personnel and, on occasion, third-party service providers who are
required to implement security measures that are similar to or better than our own.
How We Share or Disclose Personal Data
To the extent permitted or required by law, we may also share or disclose your personal
data to other persons or organizations in order to uphold your interests and pursue ours
when administering the NHIP. Among those reasons we share personal data are, as
follows:
1. to provide 24/7 call center service when addressing issues and concerns of members,
health care professional, and health care providers;
2. to facilitate the remittance of premiums through Accredited Collecting Agents, like
banks;
3. to conduct research or surveys for purposes of institutional development;
4. to report and/or disclose information to the National Privacy Commission (NPC) and
other government agencies, when so required or allowed by law; and
5. to comply with court orders, subpoenas, and or other legal obligations.
How We Retain and Dispose the Personal Data
As a general rule, we dispose of or delete collected data in accordance with the
period prescribed by applicable laws, or on occasion, PhilHealth policy. Sometimes, we
retain relevant personal data for historical and statistical purposes.
Rights of Data Subjects
Individuals whose personal data we collect are accorded rights by the DPA as data
subjects. They may invoke such rights at any time, in accordance with the provisions of
the law.
On the other hand, if there are inaccuracies in their records that need to be corrected
or updated, members must notify PhilHealth immediately through any of its Local Health
Insurance Offices or Branches.
Changes to this Notice
This Privacy Notice becomes effective on March 29, 2019 until subsequently amended.
Revisions become effective immediately after being posted in areas visible to
applicants and members, including PhilHealth’s website. PhiHealth shall also avail of
other opportunities to communicate such changes.

Privacy Notice for Suppliers and Consultants

In carrying out its mandate under Republic Act (RA) No. 7875, as amended by RAs 9241
and 10606, which relates to the administration of the National Health Insurance
Program (NHIP), the Philippine Health Insurance Corporation (herein referred to as
“PhilHealth or “We”) collects and processes personal data. It does so in a manner that is
consistent with the provisions of RA 10173, also known as the Data Privacy Act of 2012
(DPA).
PhilHealth commits to secure and keep confidential all its collected data. It also aims to
uphold the fundamental right to privacy of all individuals they pertain to, especially
suppliers and consultants, as applicable.
Personal Data We Collect
We collect, acquire or generate your personal data in many forms. They may consist of
written records, photographic and video images, digital material. Examples include:
1. Information you provide prior to your engagement. When you bid for a certain
project, we ask for your personal data through the Request for Quotation, Bid Forms,
Statement of all Ongoing Government and Private Contracts including Contracts
awarded but not yet started, Statement of Single Largest Completed Contract, resume
of consultants or personnel involved in the implementation of certain projects,
DTI/SEC/CDA Registration, valid and current Mayor’s Permit/Business License, Tax
Clearance Certificate issued by BIR and Certificate of PhilGEPS registration.

2. Information we collect or generate upon commencement of your

engagement. Once you agree to the terms of engagement, we will collect another set
of information, but not limited to the following: (1) Performance record of the supplier in
providing goods, civil works or consulting services to government, i.e., if the
supplier/contractor/consultant is currently suspended or blacklisted; (2) Relationship by
consanguinity or affinity between supplier and PhilHealth officers, as revealed in articles
of incorporation; (3) Compliance of the supplier to professional and labor laws and
standards as may be revealed upon generation of data from: PhilHealth, Social Security
System, Home Development Mutual Fund, Department of Labor and Employment (as
may be applicable) and the Professional Regulation Commission (4) Performance
Security Bond; and (5) Non Disclosure Agreement.

3. Information we collect or generate during the engagement with PhilHealth. After you
engage with PhilHealth, we may also collect additional information about you when
we will acquire other forms of data like pictures or videos of activities you participate in,
via official documentation of such activities, or through recordings from closed-circuit
security television cameras installed within PhilHealth premises.
If you supply us with personal data of other individuals (e.g., person to contact in the
event of an emergency), we will request you to certify that you have obtained the
consent of such individuals before providing us with their personal data.
How We Use Personal Data
To the extent permitted or required by law, we use your personal data to pursue our
legitimate interests as a health insurance corporation, employer, and/or contracting
party, including a variety of administrative, research, historical and statistical purposes.
For example, we may use the information we collect for purposes such as:
1. Identifying bidders and processing their respective bids;
2. Assessing the suitability in providing goods or services;
3. Verifying the provided or submitted information;
4. Evaluating qualifications;
5. Administering remuneration and payment for goods or services rendered;
6. Compiling statistics and conducting surveys and research for internal and statutory
reporting purposes; and
7. Perform such other processing or disclosure permitted or required by law.
We will not, under any circumstances, subject your personal data to any automated
decision-making process without your prior consent or any authority granted by law.
Security of Personal Data
We have established necessary and appropriate physical, technical and organizational
security measures to protect the personal data we collect and process. These
safeguards are regularly reviewed and updated to ensure that they are constantly at
par with international and industry standards. Access to your personal data is limited to
authorized PhilHealth personnel and, on occasion, third-party service providers who are
required to implement security measures that are similar to or better than our own.
How We Share or Disclose Personal Data
To the extent permitted or required by law, we may also share or disclose your personal
data to other persons or organizations in order to uphold your interests and pursue ours
when administering the NHIP. Among those reasons we share personal data are, as
follows:
1. Submission of information to government agencies such as PhilGEPS for transparency
of bids and award notices and Bureau of Internal Revenue for taxes remittance; and
2. Other purposes, when necessary and under circumstances permitted or required by
law.
How We Retain and Dispose the Personal Data
As a general rule, we dispose of or delete collected data in accordance with the
period prescribed by applicable laws, or on occasion, PhilHealth Policy.
Rights of Data Subjects
Individuals whose personal data we collect are accorded rights by the DPA as data
subjects. They may invoke such rights at any time, in accordance with the provisions of
the law.
Changes to this Policy
This Privacy Notice becomes effective beginning on March 29, 2019 until subsequently
amended. Revisions become effective immediately after being posted in areas visible
to suppliers and including PhilHealth’s website. PhiHealth shall also avail of other
opportunities to communicate such changes.
Contact Information
If you have feedback, questions, complaints or other concerns regarding this Privacy
Notice or PhilHealth’s data processing operations, you may relay them to us via our
Data Protection Officer using the information below:
DATA PROTECTION OFFICER
(02) 441-7444 local 7493
Email: privacy.dpo@philhealth.gov.ph