By Charissa Luci-Atienza The House committee on appropriations has approved a substitute measure seeking to modernize the regulation of health facilities and services. House of the Representatives (Manila Bulletin File Photo) The House panel, chaired by Davao City Rep. Isidro Ungab, passed on Wednesday the unnumbered substitute bill, which is a consolidation of five measures. "We approved the bill yesterday, Feb.5," Ungab told the Manila Bulletin in a text message Quezon Rep. Angelina Tan has been seeking the final passage of the bill, which aims to repeal Republic Act 4226, otherwise known as the Hospital Licensure Act. She is the chairman of the House committee on health that approved the substitute bill on December 17, 2019. Tan, one of the principal authors of the bill, said a number of health facilities in the country no longer qualify under the existing regulatory mandate of the Department of Health (DOH) through the Bureau of Health Facilities and Services (BHFS) because of the emergence and development of their variety of forms and structures following the "globalization" of health services. "The measure provides for the upgrading of critical technical guidelines and infrastructure to enable the DOH to cope with the challenges of globalization. Thus, aside from competitiveness, the high quality of health facilities and services are ensured," the House leader said. She said the bill also addresses the increasing cost of health services, particularly hospital care. "By regulating the costs of health services in health facilities especially through a strengthened Bureau of Health Facilities and Services, these services will be made more accessible financially to the population, especially those who belong to the lowest income group," Tan said. Bill coverage Bohol Rep. Alexie Tutor, chairman of the technical working group (TWG) that consolidated the five measures, said the measure will complement the Universal Health Care Act as it expands the scope of health facilities and health services to be regulated by BHFS to include stand-alone health facilities and other modes of health service provision. Covered by the bill are health facilities that provide any of the following services: diagnostic, therapeutic, rehabilitative, and other health care services except medical radiation facilities and hospital or stand-alone pharmacies. Also covered are services that may be preventive, diagnostic, therapeutic, rehabilitative, or palliative, among others that are provided by non-health related establishments or entities such as ambulance services and other emerging services. BHFS functions, tasks Under the substitute bill, the Health Facilities and Services Regulatory Bureau (HFSRB) shall be renamed the Bureau of Health Facilities and Services (BHFS), which shall be created in the DOH. The Bureau, which shall be under the Office of the DOH Secretary, is mandated to promulgate, establish, and prescribe rules, regulations, standards, requirements, and specifications in the construction and operation of health facilities and impose penalties for violations. The BHFS is also expected to inspect all health facilities and services, and monitor and conduct surveillance of health facilities and services. Under the bill, the Bureau is also mandated to review and approve construction designs and plans for all health facilities and to determine levy, assess, and collect the appropriate permit, registration, and license fees and surcharges pertinent to the operation of facilities and services. The bill authorizes the BHFS to investigate, hear, and decide administrative cases initiated by the Bureau or filed by any person against a health facility or health service establishment violating any provision of the proposed Act. The Bureau shall also exercise contempt powers and impose appropriate penalties, it said. The proposed Health Facilities and Services Regulation Act provides that all health facilities shall be licensed by the Bureau, in accordance with Republic Act No. 11032 or the Ease of Doing Business Act before such facilities are allowed to operate or be opened to the public. The initial license to operate and maintain a health facility or other related facility shall be valid for a period of three years from its date of issuance, and shall be renewed regularly, subject to the rules and regulations to be issued by the Bureau. Penalties for violation of Act The Bureau, after conducting an administrative hearing, may suspend or revoke the license to operate and maintain a health facility or service of any person, partnership, corporation or association. Any person, partnership, association, or corporation that establishes, operates, conducts, manages, or maintains a health facility or other related facility without first obtaining a license or violates any provision of the proposed Act or its implementing rules and regulations shall pay a fine ranging from P50,000 to P100,000 for the first offense; P100,000 to P500,000 for the second offense; P500,000 to P1 million for the third and subsequent offenses. After the third offense, the license of the hospital shall be revoked. Under the bill, the Bureau may summarily order the closure of any health facility or other related facility found operating without a license or revoke the license to operate (LTO) of any health facility or other related facility after due process. Facilities may only re-apply for a new LTO one year after the revocation of its license. Funding, review, IRR The current appropriations of the DOH under the General Appropriations Act shall be used to carry out the initial implementation of the proposed Act. Thereafter, such sums as maybe necessary for the continued implementation of the proposed Act shall be included in the succeeding GAA. The bill tasks Congress to undertake a mandatory review of the proposed Act at least once every five years and as often as it may deem necessary. The bill mandates the Secretary of Health to issue the implementing rules and regulations of the proposed Act within 90 days from its effectivity.