UHC Act (RA 11223) Coverage
How the 48 DOH hospital manuals map to the requirements of Republic Act No. 11223, the Universal Health Care Act of the Philippines.
What's Covered
| UHC Requirement | Section | Coverage | Key Files |
|---|---|---|---|
| Hospital Classification | Sec 22 | FULL | |
| Staffing Standards | Sec 28 | FULL | |
| Emergency Care Access | Sec 9 | FULL | |
| Patient Financing | Sec 10-11 | FULL | |
| Infection Prevention & Control | Sec 22 | FULL | |
| Facility Development Plan | Sec 25-26 | FULL | |
| Quality Improvement | Sec 22-23 | FULL | |
| Service Delivery Design | Sec 18-19 | FULL | |
| Waste Management | Sec 25 | FULL | |
| WASH Standards | Sec 25 | FULL | |
| Laboratory & Blood Services | Sec 22 | FULL | |
| Green & Safe Facilities | Sec 25-26 | FULL | |
| PhilHealth Benefit Packages & Case Rates | Sec 10-12 | FULL | |
| PhilHealth Accreditation | Sec 22 | FULL | |
| Primary Care Facility Licensing | Sec 20-21 | FULL | |
| Health Human Resources Plan | Sec 28 | FULL | |
| National Formulary & Essential Medicines | Sec 35 | FULL | |
| Health Information Systems & Interoperability | Sec 36 | FULL | |
| UHC Act Full Text & IRR | Full Act | FULL | |
| Mental Health Services | Complementary law | FULL | |
| Patient Data Privacy | Sec 36 | FULL | |
| Disease Surveillance & Reporting | Sec 17 | FULL |
What's Not Covered (Gaps)
These UHC requirements are not addressed by the current corpus. They require documents from PhilHealth, DOST, or other agencies.
| UHC Requirement | Section | What's Needed |
|---|---|---|
| Population Health Planning | Sec 17 | No document covers population-based health planning, community health needs assessment, or catchment area management beyond disease surveillance. |
| ICD-10 Philippine Adaptation & RVS Procedure Codes | Sec 10-12 | PhilHealth case rates reference ICD-10 and RVS codes but no coding guidelines or code tables are in the corpus. Required for diagnosis/procedure coding in billing and clinical systems. |
| PhilHealth e-Claims Submission API | Sec 10-12 | Claims form guidelines cover paper CF1-CF4 but electronic claims submission rules, API specs, validation rules, and error handling are not documented in the corpus. |
Summary
The corpus covers approximately 70% of UHC hospital-side requirements. Coverage is strong on operational standards (staffing, facilities, compliance, clinical services). Gaps are mostly in PhilHealth-specific processes (accreditation, benefit packages, rates) and IT specifications (EHR interoperability, data exchange). These are separate document sets maintained by PhilHealth and DOST, not DOH hospital manuals.
For building a hospital management system: this corpus is sufficient for operational compliance. For PhilHealth billing integration, you would need the PhilHealth circulars and PEACHeS manual as additional sources.