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UHC Exam (2024/2025) | Actual Questions and Answers Latest Updated 2024/2025 (Graded A+), Exams of Insurance law

what filipinos can expect from the universal health care law? - ✔✔all filipinos will be granted health coverage but not everything will be free universal health care law - ✔✔- all Filipinos are covered - it is not completely free - PhilHealth will become the "national purchaser" of health goods and services - DOH will still be in charge of "population-based" health services - health systems will become city-wide and province-wide - A "Health Technology and Assessment Council" (HTAC) will be created - health information will be collected UHCL by NEDA - ✔✔policy issue 1: limited coverage of the national health insurance program 2: overlapping of functions of govt agencies

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2023/2024

Available from 08/29/2024

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Download UHC Exam (2024/2025) | Actual Questions and Answers Latest Updated 2024/2025 (Graded A+) and more Exams Insurance law in PDF only on Docsity! UHC Exam (2024/2025) | Actual Questions and Answers Latest Updated 2024/2025 (Graded A+) what filipinos can expect from the universal health care law? - ✔✔all filipinos will be granted health coverage but not everything will be free universal health care law - ✔✔- all Filipinos are covered - it is not completely free - PhilHealth will become the "national purchaser" of health goods and services - DOH will still be in charge of "population-based" health services - health systems will become city-wide and province-wide - A "Health Technology and Assessment Council" (HTAC) will be created - health information will be collected UHCL by NEDA - ✔✔policy issue 1: limited coverage of the national health insurance program 2: overlapping of functions of govt agencies policy issue 1 - ✔✔- limited coverage of the national health insurance program --- in 2017, about 54.5% of total health payment came from Filipinos' own pocket, with medicines and drugs as the main contributors. Lack of PhilHealth coverage of medicines for outpatients and the high cost of drugs and medicines in the country push the out-of-pocket expenditure up. policy issue 2 - ✔✔- overlapping of functions of govt agencies --- the Philippine health system has been operating on a devolved set-up. The Department of Health supervises specialty, DOH-retained, and regional hospitals. The Department of National Defense runs military hospitals. And local government units operate their respective health facilities. clarified roles under the universal health care law - ✔✔- department of health and local government units - philhealth population based health services - ✔✔refers to interventions, such as health promotion, disease surveillance, and vector control, that address population-wide concerns. individual based health services - ✔✔refers to services that can be accessed within a health facility or remotely, and can be definitively traced back to one recipient Socioeconomic Planning Secretary - ✔✔Ernesto M. Pernia Republic Act. No 11223 - ✔✔Universal Health Care Act Universal Health Care Act - ✔✔it is the policy of the state to protect and promote the right to health of all Filipinos and instill health consciousness among them Universal Health Care Act - ✔✔An integrated and comprehensive approach to ensure that all Filipinos are health literate, provided with healthy living conditions, and protected from hazards and risks that could affect their health Universal Health Care Act - ✔✔A health care model that provides all Filipinos access to a comprehensive set of quality and cost-effective, promotive, preventive, curative, rehabilitative and palliative health services without causing financial hardship,, and prioritizes the needs of the population who cannot afford such services Universal Health Care Act - ✔✔A framework that fosters a whole-of-system, whole-of-government, and whole-ofsociety approach in the development, implementation, monitoring, and evaluation of health policies, programs and plans -- 5 ex officio members -- 3 expert panel members with expertise in publich health -- 5 sectoral panel members -- ex officio members - ✔✔- Secretary of Health - Secretary of Social Welfare and Development - Secretary of Finance -Secretary of Labor and Employment expert panel members with expertise in public health - ✔✔- management - finance - health economics sectoral panel members - ✔✔- representing the direct contributors, indirect contributors, employers group, health care providers to be endorsed by their national associations of health care institutions and health care professionals, and representative of the elected local chief executives to be endorsed by the League of Provinces of the Philippines, League of Cities of the Philippines and League of Municipalities of the Philippines: provided that at least one of the expert panel members and at least two of the sectoral panel members are women ex officio member - ✔✔is a member of a body (notably a board, committee, council) who is part of it by virtue of holding another office ex officio - ✔✔is Latin, meaning literally 'from the office', and the sense intended is 'by right of office' expert panel members must - ✔✔- be of recognized probity and independence and must have distinguished themselves professionally in public, civic or academic service - be in the active practice of their professions for at least seven years - not be appointed within one year after losing in the immediately preceding elections, whether regular or special secretary of health - ✔✔shall be an ex officio nonvoting Chairperson of the Board appointive members of the Board - ✔✔shall be required to undergo training in health care financing, health systems, costing health services and Health Technology Assessment prior to the start of their term. Noncompliance shall be a ground for dismissal additional powers and functions of philhealth - ✔✔To fix the reasonable compensation, allowances and other benefits of all positions, including its President and CEO, based on a comprehensive job analysis and audit of actual duties and responsibilities, subject to the approval of the President of the Philippines. additional powers and functions of philhealth - ✔✔To establish the organizational structure and staffing pattern of PhilHealth's central and regional offices to cover as many provinces, cities and legislative districts, including foreign countries, whenever and wherever it may be expedient, necessary and feasible and to inspect or cause to be inspected periodically such offices, subject to the approval by the Board; additional powers and functions of philhealth - ✔✔to maintain a Provident Fund which consists of contributions made by both PhilHealth and its officials and employees and earnings thereon, for the payment of benefits to such officials and employees or their dependents or heirs under such terms and conditions as may be prescribed by the Board, subject to the approval of the President of the Philippines additional powers and functions of philhealth - ✔✔To adopt or approve the annual and supplemental budget of receipts and expenditures including salaries, allowances and early retirement of PhilHealth personnel and to authorize such capital and operating expenditures and disbursements as may be necessary and proper for the effective management and operation of PhilHealth health services delivery - ✔✔- population-based health services - individual-based health services population-based health services - ✔✔the DOH shall endeavor to contract province-wide and city-wide health systems for the delivery of population-based health services. population-based health services - ✔✔Province-wide and city-wide health systems shall have the minimum components -- primary care provider network with patient records accessible throughout the health system -- accurate, sensitive, and timely epidemiologic surveillance systems -- proactive and effective health promotion programs or campaigns individual-based health services - ✔✔PhilHealth shall endeavor to contract public, private, or mixed health care provider networks for the delivery of individual-based health services: individual-based health services - ✔✔PhilHealth shall endeavor to shift to paying providers using performance-driven, close-end, prospective payments based on disease or diagnosis related groupings and validated costing methodologies and without differentiating facility and professional fees; population-based health services - ✔✔ additional powers and functions of philhealth - ✔✔To adopt or approve the annual and supplemental budget of receipts and expenditures including salaries, allowances and early retirement of PhilHealth personnel and to authorize such capital and operating expenditures and disbursements as may be necessary and proper for the effective management and operation of PhilHealth