Republic of the Philippines Republic of the Philippines Congress of the PhilippinesCongress of the Philippines

RA 9439RA 9439

Presented by:Presented by:Julabar, Marona Ysabel G.Julabar, Marona Ysabel G.

Republic Act No. 9439Republic Act No. 9439AN ACT PROHIBITING THE AN ACT PROHIBITING THE

DETENTION OF PATIENTS IN DETENTION OF PATIENTS IN HOSPITALS AND MEDICAL HOSPITALS AND MEDICAL CLINICS ON GROUNDS OF CLINICS ON GROUNDS OF

NONPAYMENT OF HOSPITAL NONPAYMENT OF HOSPITAL BILLS OR MEDICAL EXPENSESBILLS OR MEDICAL EXPENSES

Approved:Approved:June 7, 2005June 7, 2005

JOSE DE VENECIA JR.JOSE DE VENECIA JR.Speaker of the House of Speaker of the House of

RepresentativesRepresentativesROBERTO P. NAZARENOROBERTO P. NAZARENO

Secretary GeneralSecretary GeneralHouse of RepresentativesHouse of Representatives

Approved:Approved:February 19, 2007February 19, 2007OSCAR G. YABESOSCAR G. YABES

Secretary of the SenateSecretary of the SenateMANNY VILLARMANNY VILLAR

President of the SenatePresident of the Senate

Approved: Approved: April 27, 2007April 27, 2007

GLORIA MACAPAGAL-ARROYOGLORIA MACAPAGAL-ARROYOPresident of the PhilippinesPresident of the Philippines

Section 1 SummarySection 1 Summary• It’s unlawful for It’s unlawful for hospitals to detain hospitals to detain patients for reasons of patients for reasons of nonpayment of hospital nonpayment of hospital bills.bills.

Section 2 SummarySection 2 Summary• Patients who are incapable to pay for the Patients who are incapable to pay for the

medical expenses still have the right to medical expenses still have the right to leave the hospital and ask for pertinent leave the hospital and ask for pertinent papers.papers.

• Promissory notes shall be secured. The Promissory notes shall be secured. The patient and guarantor shall be jointly and patient and guarantor shall be jointly and severely liable for any unpaid obligation. severely liable for any unpaid obligation. Mortgage is also an option.Mortgage is also an option.

• Patients who stayed in private rooms shall Patients who stayed in private rooms shall not be covered by this Act.not be covered by this Act.

Section 3 SummarySection 3 Summary• Officers or employees of the Officers or employees of the

hospital who violates this act shall hospital who violates this act shall be punished by a fine ranging be punished by a fine ranging from P20,000 to P50,000 OR from P20,000 to P50,000 OR imprisonment for 1 month to 6 imprisonment for 1 month to 6 months OR BOTH by discretion of months OR BOTH by discretion of the proper court.the proper court.

Section 4 SummarySection 4 Summary• DOH shall promulgate DOH shall promulgate the rules to carry out the rules to carry out the provisions of this the provisions of this Act.Act.

Section 5 SummarySection 5 Summary• If any of these are If any of these are declared void, those declared void, those that remain shall still be that remain shall still be considered effective.considered effective.

Section 6 SummarySection 6 Summary• Every part of this Act Every part of this Act that is considered that is considered inconsistent are hereby inconsistent are hereby repealed or amended repealed or amended accordingly.accordingly.

Section 7 SummarySection 7 Summary•This Act shall be This Act shall be effective 15 days effective 15 days after publication in 2 after publication in 2 national newspapers.national newspapers.

CASE 1CASE 1An indigent young female patient was An indigent young female patient was

admitted to a government hospital in Manila admitted to a government hospital in Manila because of pus in the head which required because of pus in the head which required

minor surgery. The family availed of the minor surgery. The family availed of the PhilHealth ward because the hospital’s PhilHealth ward because the hospital’s

charity ward was always full and consisted charity ward was always full and consisted of diverse cases. The family would have of diverse cases. The family would have

waited indefinitely in the hall if they waited waited indefinitely in the hall if they waited for a bed in the charity ward.for a bed in the charity ward.

The hospital bill reached almost P40,000 for The hospital bill reached almost P40,000 for the child’s three-week confinement. The the child’s three-week confinement. The

child was not allowed to leave the hospital child was not allowed to leave the hospital until the family has paid 70% partial until the family has paid 70% partial

payment of the hospital bills. The family had payment of the hospital bills. The family had meetings with different heads of different meetings with different heads of different

departments for approval before their departments for approval before their promissory note was approved. Only then promissory note was approved. Only then was the child released from the hospital.was the child released from the hospital.

CASE 2CASE 2A male patient was confined in a private hospital A male patient was confined in a private hospital

because it was the hospital nearest to the patient’s because it was the hospital nearest to the patient’s residence. The patient was admitted at the charity residence. The patient was admitted at the charity

ward only. However, his hospital bills were too ward only. However, his hospital bills were too much for the family to pay immediately. The much for the family to pay immediately. The patient was not discharged from the hospital patient was not discharged from the hospital

because the hospital did not accept the promissory because the hospital did not accept the promissory note for the balance of the patient’s bill. The staff note for the balance of the patient’s bill. The staff told the family that execution of promissory notes told the family that execution of promissory notes

is allowed in government hospitals only. The family is allowed in government hospitals only. The family sought the advice of the Public Attorney’s Office.sought the advice of the Public Attorney’s Office.

Response of Public Attorney’s OfficeResponse of Public Attorney’s Office

Any hospital or medical clinic detaining or indirectly or directly causing the Any hospital or medical clinic detaining or indirectly or directly causing the detention of a patient by reason of non-payment may be penalized in detention of a patient by reason of non-payment may be penalized in accordance with the provisions of the Anti-Hospital Detention Act. For accordance with the provisions of the Anti-Hospital Detention Act. For purposes of this law, detention occurs when all the following are present: 1) purposes of this law, detention occurs when all the following are present: 1) the patient who is partially or fully recovered has expressed his/ her intention the patient who is partially or fully recovered has expressed his/ her intention to leave the hospital or medical clinic, or the attending physician has issued a to leave the hospital or medical clinic, or the attending physician has issued a discharge order; 2) the patient is not confined in a private room and is discharge order; 2) the patient is not confined in a private room and is financially incapable to settle in part or in full the corresponding hospital bills financially incapable to settle in part or in full the corresponding hospital bills or medical expenses/ hospitalization expenses; 3) the patient has executed a or medical expenses/ hospitalization expenses; 3) the patient has executed a promissory note covering the unpaid hospital bills or medical promissory note covering the unpaid hospital bills or medical expenses/hospitalization expenses; and 4) the officer or employee of the expenses/hospitalization expenses; and 4) the officer or employee of the hospital or medical clinic responsible for releasing the patient has restrained hospital or medical clinic responsible for releasing the patient has restrained him from leaving the hospital premises (Rule V, Implementing Rules and him from leaving the hospital premises (Rule V, Implementing Rules and Regulations of R.A. No 9439).Regulations of R.A. No 9439).We hope that we were able to answer your queries. Please be reminded that We hope that we were able to answer your queries. Please be reminded that this advice is based solely on the facts that you have narrated and our this advice is based solely on the facts that you have narrated and our appreciation of the same. Our opinion may vary when other facts are appreciation of the same. Our opinion may vary when other facts are changed or elaborated.changed or elaborated.

CASE 3CASE 3A female 68 y/o patient was admitted to a private A female 68 y/o patient was admitted to a private

hospital because of uncontrolled hypertension. No hospital because of uncontrolled hypertension. No deposit was required upon admission but the deposit was required upon admission but the family deposited a minimal amount within 24 family deposited a minimal amount within 24 hours. The patient’s case was complex which hours. The patient’s case was complex which

necessitated the maintenance of several doctors, necessitated the maintenance of several doctors, which included a cardiologist, pulmonologist, and which included a cardiologist, pulmonologist, and

urologist, among others. The patient was urologist, among others. The patient was eventually transferred to the ICU. A doctor friend eventually transferred to the ICU. A doctor friend

initially vouched for the family. However, the family initially vouched for the family. However, the family had consultations with high hospital officials when had consultations with high hospital officials when the patient’s bill reached more than Php 500,000. the patient’s bill reached more than Php 500,000.

The hospital accepted as mortgage the title of a The hospital accepted as mortgage the title of a small land owned by the family. The parties agreed small land owned by the family. The parties agreed

that the patient would be transferred to a semi-that the patient would be transferred to a semi-private ward while arrangements for a transfer to a private ward while arrangements for a transfer to a

government hospital were on-going. However, government hospital were on-going. However, during the arrangements, the patient became during the arrangements, the patient became

comatose, leading to the patient’s demise in the comatose, leading to the patient’s demise in the ICU after 24 hours. The patient’s hospital bill and ICU after 24 hours. The patient’s hospital bill and professional fees for the almost three months of professional fees for the almost three months of

confinement reached almost PhP 1.5 million. The confinement reached almost PhP 1.5 million. The hospital allowed the family to sign a promissory hospital allowed the family to sign a promissory

note, and the body was released by the hospital. note, and the body was released by the hospital. The family is still paying for the hospital bill.The family is still paying for the hospital bill.

Exhibit 2: STATEMENT OF ACCOUNT OF CASE 3Exhibit 2: STATEMENT OF ACCOUNT OF CASE 3

EEXXHHIIBBIITT

OONNEE

RRAA99443399

SourcesSources• localpatientadvocate.com (background picture)localpatientadvocate.com (background picture)• http://www.lawphil.net/statutes/repacts/http://www.lawphil.net/statutes/repacts/

ra2007/ra_9439_2007.htmlra2007/ra_9439_2007.html• Case 1: Name withheld. Information Case 1: Name withheld. Information

available upon request.available upon request.• Case 2: http://www.manilatimes.net/when-Case 2: http://www.manilatimes.net/when-

hospitals-do-not-discharge-patients/87132/hospitals-do-not-discharge-patients/87132/• Case 3: Name withheld. Information Case 3: Name withheld. Information

available upon request.available upon request.

THANK YOUTHANK YOU