QUEZON CITY, Philippines — The Philippine Health Insurance Corporation (PhilHealth) has updated its rules to cover patients admitted to hospitals for less than 24 hours, as well as those kept in emergency rooms beyond 24 hours.
Bagong Henerasyon Party-list Representative Robert Nazal highlighted the policy adjustments during deliberations on the proposed 2027 budget for the Department of Health (DOH) and its attached agencies. Nazal commended PhilHealth’s new leadership for addressing policy gaps that previously left long-time contributing members without coverage, often burdening them with medical debt.
Bataan 2nd District Representative Albert Garcia, speaking as the sponsor for the DOH budget, confirmed that a new directive governing short-duration admissions took effect on September 18.
Garcia noted that patients who remain in emergency rooms for over 24 hours—frequently due to a shortage of available hospital beds—are also eligible for coverage under the updated system.
During the interpellation, Nazal raised questions regarding patient qualification after prolonged emergency room care:
“So, pag ikaw na-ER at lumagpas ka ng 24 hours, at pinaalis ka na, pwede ka na mag qualify?” Rep. Nazal asked.
Representative Garcia confirmed that such cases are now covered.
In addition to insurance coverage, lawmakers addressed ongoing violations of the Anti-Hospital Deposit and Anti-Hospital Detention Laws. The DOH reported 267 incidents in 2025 where patients were unlawfully detained over unpaid bills before being allowed to leave following government intervention.
The department recorded 26 formal complaints regarding detention and less serious cases, leading to three findings of liability and fines, six pending cases, and 17 dismissals.
To promote strict compliance among healthcare facilities, Nazal recommended implementing an evaluation framework similar to the local government performance ratings.
“Para magkaroon tayo ng rating sa kanila and pag wala sila violation na ganito parang mas maganda ang rating nila and we can recommend them to patients,” Rep. Nazal said.
To further address patient grievances, newly appointed Health Secretary Edwin Mercado plans to launch a dedicated call center to receive immediate reports regarding healthcare provider violations.
Mercado chairs the PhilHealth Board, alongside newly appointed PhilHealth President and Chief Executive Officer Dr. Beverly Lorraine Ho.