(DC file photo)
MANILA – The Philippine Health Insurance Corp. (PhilHealth) has removed the requirement for Yaman ng Kalusugan Program (YAKAP) clinics to provide mammography and breast and liver ultrasound services as a condition for accreditation in 2027.
In an announcement Wednesday, PhilHealth clarified that the diagnostic procedures are covered under a separate cancer screening benefit package with fixed payment rates under Circular No. 2025-0014.
The clarification was issued through Advisory No. 2026-0058, signed by PhilHealth Acting President and CEO Beverly Lorraine Ho on October 22.
“Accordingly, YCs are not required to provide these services directly or through a Memorandum of Agreement (MOA) or Service Level Agreement (SLA) for CY 2027,” the advisory stated.
Under the earlier Circular No. 2024-0013, YAKAP clinics, previously known as Konsulta Package Providers, were supposed to offer mammography and ultrasound services beginning January 1, 2027.
With the updated policy, clinics will no longer need to provide these procedures or secure agreements with other healthcare facilities solely to meet the accreditation requirement.
However, PhilHealth said YAKAP clinics may continue entering into service agreements with other providers for laboratory and diagnostic procedures covered by the program.
The state health insurer also announced plans to issue a separate advisory concerning the transfer of 21 medicines previously covered under YAKAP to the GAMOT benefit package, including implementation arrangements for 2027.
Meanwhile, PhilHealth reiterated that stand-alone cancer screening facilities may apply for accreditation, provided they meet the necessary requirements and have access to the electronic claims or eClaims platform for processing reimbursements.
The changes aim to clarify accreditation requirements for YAKAP providers while maintaining access to diagnostic and cancer screening services through PhilHealth’s separate benefit packages.
