The Philippine Health Insurance Corporation yesterday ordered all accredited hospitals to strictly implement the Outpatient Emergency Care Benefit (OECB).
“All accredited hospitals are hereby reminded to strictly implement the deduction of OECB Package. Hospitals found to be non-compliant…shall be subject to Health Care Provider Performance Assessment System (HCP PAS) Policy,” it warned through an advisory signed by PhilHealth President and Chief Executive Officer Edwin Mercado.
Possible sanctions include administrative cases or breaches of performance commitments.
The new benefit, created under PhilHealth Circular No. 2024-0033, aims to bridge financial coverage gaps for patients seeking urgent or emergent care.
The measure aligns with Republic Act No. 11223, or the Universal Health Care Act, which requires PhilHealth to establish a comprehensive outpatient benefit system.
Under the policy, emergency cases treated in the emergency departments of accredited Level 1, 2, and 3 hospitals are covered by the Facility-based Emergency Benefit.
PhilHealth clarified in Advisory No. 2025-009 that no additional application is required from hospitals to provide the OECB since eligibility is assumed through their Department of Health license.
The OECB is expected to lessen the financial burden of patients who require immediate outpatient emergency medical attention.
The initiative is part of the government’s push to make healthcare more accessible and affordable, particularly for underserved populations.
PhilHealth assured that its regional offices are ready to assist healthcare providers in complying with the new policy.
