PhilHealth adds TB vaccine in its newborn care package

Under its newborn care package in hospital admissions, the Philippine Health Insurance Corporation has included a vaccine against childhood tuberculosis effective this month.

The inclusion of the Bacillus Calmette-Guérin (BCG) vaccine in the NCP was stipulated in Resolution No. 1060 that was approved by the PhilHealth Board of Directors. The amount of the NCP however stays at P1,000.

Effective BCG vaccine provides protection against the more severe types of tuberculosis such as military TB and TB meningitis which are most common in young children.

“We are ensuring that newborn-dependents of members will be able to avail themselves of this benefit regardless of the eligibility of the mother to claim for the Maternity Care Package.”  Lorna Fajardo, acting PhilHealth president and chief executive officer, said.

She also called on accredited health care providers to provide all the required services under the NCP, adding that PhilHealth will not pay for the NCP benefits if the complete services included in the package are not given to the newborn.

“We hope that through this new addition into the NCP, PhilHealth is able to contribute its share in preventing child mortality through the compensability of the BCG vaccine,” she said.

The vaccination is ideally performed after 24 hours of life but not later than three days from complete delivery of the newborn. This will help identify at least five diseases that a newborn may be exposed to, and therefore help to prevent these later in life.

An online press release of PhilHealth stated that the enhanced NCP now includes resuscitation of the newborn, and covers all eligible newborn-dependents delivered in accredited health care facilities including non-hospital maternity health care providers.

To ensure availment of the NBS under the NCP, health care facilities must have Newborn Screening Facility certificates issued by the Department of Health or by the Newborn Screening Reference Center starting January 1, 2008, otherwise claims will not be compensated.

Facilities that are not NSF-certified may refer patients for vaccination to other facilities with NSF certification. In such case, PhilHealth allows reimbursement directly to the member provided that the original official receipt issued by the certified facility is attached to the claim documents.

There are now 600 DOH-certified NSFs out of 1,600 PhilHealth-accredited health care facilities.  To avail of the package, members must submit a duly accomplished PhilHealth Claim Form 1, a clear copy of the Member Data Record (MDR) and the proof of premium payment.  — Jasmin R. Uy/RAE