REPUBLIC ACTS

SUBJECT: Implementing Rules and Regulations of Republic Act No. 9439, otherwise known as "An Act Prohibiting the Detention of Patients in Hospitals and Medical Clinics on Grounds of Nonpayment of Hospital Bills or Medical Expenses".

I. Rationale:

II. Objective:

III. Scope:

IV. Definition of Terms:

A. Co-Maker - a person, natural or juridical, who binds himself jointly and severally to pay the unpaid hospital bills or medical expenses/hospitalization expenses of the patient.

B. Complaint - a sworn written statement of ultimate facts, filed by the patient, charging the official or employee of the hospital or medical clinic with any violation of R. A.. No. 9439 and its implementing rules and regulations.

C. Detention - an act of restraining a person from leaving the hospital premises for nonpayment of hospital bills or medical expenses in part or in full.

D. Guarantee - an expressed assurance by the co-maker to the hospital or medical clinic that certain facts or conditions are true and/or will happen. The hospital or medical clinic is permitted to rely on that assurance and seek appropriate action if it is not true and/or followed.

E. Hospital - a health facility for the diagnosis, treatment and other forms of health care of individuals suffering from deformity, disease, illness or injury, or in need of surgical, obstetrical, medical or nursing care. It is an institution where there are installed bassinets or beds for 24-hour use or longer by patients in the management of deformities, diseases, injuries, abnormal physical and mental conditions, and maternity cases.

F. Hospital Bills or Medical Expenses/ Hospitalization Expenses - costs of diagnosis, treatment and other forms of health care of patients, which include, but not limited to, doctor's fees, amount owing for clinical and ancillary services rendered, charges for room, meals, medical supplies, drugs and medicines, and payments for use of equipment.

G. Medical Clinic - a health facility that satisfies the above definition of a hospital but uses the phrase "medical clinic" in its business name.

H. Mortgage - a method of using real property (land) or personal property (other physical possessions) as security for the payment of a debt.

I. Officer or Employee of a hospital or medical clinic - a person acting in behalf of a hospital or medical clinic responsible for releasing patients in accordance with written policies and procedures of the hospital or medical clinic.

J. Patient - for the purposes of R. A. No. 9439 and these implementing rules and regulations, a person who is already admitted and availed of health care services in a hospital or medical clinic.

K. Private Room - a single occupancy room or a ward type room divided by either a permanent or semi-permanent partition (except curtains) not to exceed 4 patients per room who are admitted for diagnosis, treatment and other forms of health care maintenance.

L. Promissory Note - an unconditional promise in writing made by the patient and/or his/ her next of kin to the hospital or medical clinic, engaging to pay on demand, or at a fixed or determinable future time, a sum certain in money to order or to bearer.

V. Policies and Guidelines:
A. General Policies:

a) 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 discharge order;

b) The patient is not confined in a private room and is financially incapable to settle in part or in full the corresponding hospital bills or medical expenses/ hospitalization expenses;

c) Patient has executed a promissory note covering the unpaid hospital bills or medical expenses/ hospitalization expenses; and

d) The officer or employee of the hospital or medical clinic responsible for releasing the patient has restrained him from leaving the hospital premises.

a) The medical officer has made the pronouncement of death;

b) Any of the surviving relatives is incapable to pay the corresponding hospital bills or medical expenses/ hospitalization expenses;

c) Any of the surviving relatives has executed a promissory note covering the unpaid hospital bills or medical expenses/hospitalization expenses; and

d) The officer or employee of the hospital or medical clinic responsible for releasing the deceased patient has refused to release the cadaver and/ or relevant documents.

B. Specific Guidelines:

a) Government hospitals or medical clinics shall classify patients in terms of their capacity to pay according to the guidelines set by the DOH in Administrative Order No. 51-A s. 2000: Implementing Guidelines on Classification of Patients and on Availment of Medical Social Services in Government Hospitals, dated October 12, 2001.

b) Private hospitals or medical clinics shall have written policies and procedures to classify patients in terms of their capacity to pay. For this purpose, private hospitals or medical clinics may refer to AO No. 51-A s. 2000.

c) The DOH, government and private hospitals or medical clinics shall, as far as practicable, assist patients in looking for financial assistance from government and non-government sources to settle the unpaid hospital bills or medical expenses/ hospitalization expenses. Toward this end, the DOH shall work closely with financial institutions like, but not limited to, Philippine Health Insurance Corporation, Philippine Charity Sweepstakes Office, Philippine Amusement and Gaming Corporation, Local Government Units, as well as ,Congress, to provide funds for this purpose.

d) All hospitals or medical clinics shall establish billing and collection procedures subject to current accounting and auditing rules and regulations.

e) All hospitals or medical clinics shall have written policies and procedures for admitting and releasing patients, including identifying the officer/s or employee/s responsible for releasing patients.

VI. Repealing/Separability Clause:

VII. Effectivity:

(Signed)
FRANCISCO T. DUQUE, III, M.D. M.Sc.

Secretary of Health

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