RA 10932 And RA 9439 | Anti-Hospital Deposit Law And Hospital Detention Law

Have you ever been in a situation where you or your loved one has been refused to be admitted in a hospital? Or have you seen a person being refused to be admitted because they do not have the money to pay the initial deposit? Sounds like something that will only happen in the movies, right? However, the reality is different. Right at this very moment, someone whom you do not know, who needs immediate care, is being refused at hospital doors just because they do not have the money to pay.

As the number of cases of virus-ridden people go up, so does the number of patients that need to be admitted in the hospital. Hospitals are now becoming close to full capacity; hence, resources will sooner be scarce.

Patient bed occupancy rates are nearing full capacity, as well. Hospital queues are much longer and even non-covid cases have been greatly affected. In the end, hospitals have been continuing to refuse admission of patients regardless of their health and emergency status.

Every person has a right to access health and medical care and be given appropriate medical attention or analysis regardless of his status and his capacity to pay, most especially emergency patients who need immediate medical treatment.

Likewise, a patient cannot be detained due to non-payment of medical expenses or hospital bills. These acts are punishable by special penal laws that will be discussed in the next paragraphs.

It is important to know your rights as a patient when it comes to hospital admissions. There may come a time when you or a loved one may need to be admitted to a hospital. Consequently, it pays to be informed of your rights beforehand.

What is the Anti-Hospital Deposit Law?

Republic Act No. 10932¹ is a legislative act enacted last 2017 which penalizes the refusal of hospitals or medical clinics to give immediate care or attention to patients owing to lack of advance payment.

It also makes the hospitals and employees liable for the patients’ death and injuries who cannot be admitted because they cannot pay an advance deposit.

The said law increases the penalties to be imposed on the hospital and its employees who shall still require payment from patients before basic emergency care is given.

What is the importance of R.A 10932?

Republic Act No. 10932² or the Anti-Hospital Deposit law aims to curb the common practice of hospitals and medical clinics who still reject patients for admission to provide basic medical care or attention to them in emergency cases, without an advance payment of initial deposit.

This is truly beneficial, especially those who are at a disadvantaged or people from indigent communities having no means to pay money in advance during emergency cases.

There is no doubt that everyday there is patient out there who visits a hospital to seek proper medical treatment. Just imagine, a person, who attends to his doctor’s appointment seeking only basic treatment finds out that he is diagnosed with an acute or chronic disease that might result to permanent disability, is being refused to be admitted as an in-patient or be given immediate medical treatment due to non-payment of an advance deposit.

Now, this will not be the common practice anymore in the medical field since the anti-hospital deposit law prohibits such act and protects the rights of an individual to be admitted to any hospital and be given basic emergency care without being asked to hand over an advance payment outright.

Can a hospital refuse to admit a person suffering from illness, whether emergency or not?

Hospitals and medical clinics cannot reject a person suffering from an illness to be admitted, whether it is an emergency case or not.

Doctors took the Hippocratic oath wherein they pledged to help the sick in the best of their ability and knowledge. Hospitals, in general, are duty-bound to provide care and treatment to those who are injured or suffering.

Section 1 of R.A. 10932, expressly provides that:

“in emergency or serious cases, it shall be unlawful for any hospital or medical clinic to request, solicit, demand or accept any deposit or any other form of advance payment as prerequisite for administering basic emergency care, for confinement or medical treatment, or to refuse to administer medical treatment and support to any patient. x x x x. . . .”³

Simply put, hospitals or medical clinics are prohibited to refuse patients who are in need of any medical treatment just because they have no money for down payment.

What do you mean by “emergency”, “serious case”, “basic emergency care”, and “noninstitutional delivery”?

Section 2 of R.A. 10932 provides the definitions of the terms above mentioned.

1. Emergency – a condition or state of a patient wherein based on the objective findings of a prudent medical officer on duty for the day there is immediate danger and where delay in initial support and treatment may cause loss of life or cause permanent disability to the patient, or in the case of a pregnant woman, permanent injury or loss of her unborn child, or would result in a noninstitutional delivery.⁴
2. Serious case – refers to a condition of a patient characterized by gravity or danger wherein based on the objective findings of a prudent medical officer on duty for the day when left unattended to, may cause loss of life or cause permanent disability to the patient, or in the case of a pregnant woman, permanent injury or loss of her unborn child.⁵
3. Basic emergency care – the response to a situation where there is urgently required medical care and attention, and shall include procedures required for initial diagnosis, use of equipment and supplies in sufficiently addressing the emergency situation, considering the welfare of the patient. It also includes the necessary medical procedures and treatment administered to a woman in active labor to ensure the safe delivery of the newborn.⁶
4. Noninstitutional delivery – the delivery of a newborn while in transit, outside of a health facility, after an initial consultation was done with a health facility.⁷

Policies and Procedures on Anti-Hospital Deposit Law

Section 1 of R.A. 10932 lists down the policies and procedures to be observed in emergency or serious cases. The policies laid down are as follows:⁸

1. In emergency or serious cases, any hospital staff or employee or medical practitioner is prohibited to solicit or demand any deposit or advance payment in any form, as a requirement, from patients before basic emergency care is administered.
2. In the event that the hospital or medical clinic is inadequate to treat the patient, the attending physician may transfer such patient to another medical facility who can give the appropriate care needed, provided that consent is given by the patient or his next of kin and the receiving hospital has agreed to the transfer.
3. Should the patient be unconscious or incapable to give his consent, the attending physician can transfer him without his consent.
4. The transfer can only be done after basic emergency care was provided and it was established that such transfer poses less risks than the patient’s continued confinement.
5. The receiving hospital or medical clinic shall not refuse to admit the patient after being informed of the said transfer and shall refuse to demand any form of deposit or advance payment.
6. In cases wherein no ambulance is available for the emergency transfer of the patient, the local government unit, where the hospital is located, must allow the free use of its emergency vehicle for such A staff nurse with advanced cardiovascular life support (ACLS) certification must accompany the patient in the emergency vehicle.⁹

Who may be held liable and what are the penalties to be imposed?

Section 4 of R.A 10932 provides that:

“any official, medical practitioner or employee of the hospital or medical clinic who violates the provisions of this Act shall be held liable upon conviction by final judgment, be punished by imprisonment of not less than six (6) months and one (1) day but not more than two (2) years and four (4) months, or a fine of not less than One hundred thousand pesos (₱100,000.00), but not more than Three hundred thousand pesos (₱300,000.00) or both, at the discretion of the court:¹⁰

“Provided, however, That if such violation was committed pursuant to an established policy of the hospital or clinic or upon instruction of its management, the director or officer of such hospital or clinic responsible for the formulation and implementation of such policy shall, upon conviction by final judgment, suffer imprisonment of four (4) to six (6) years, or a fine of not less than Five hundred thousand pesos (₱500,000.00), but not more than One million pesos (₱1,000,000.00) or both, at the discretion of the court, without prejudice to damages that may be awarded  to  the  patient- complainant:¹¹

“Provided, further, That upon three (3) repeated violations committed pursuant to an established policy of the hospital or clinic or upon the instruction of its management, the health facility’s license to operate shall be revoked by the DOH. The president, chairman, board of directors, or trustees, and other officers of the health facility shall be solidarily liable for damages that may be awarded by the court to the patient-complainant.”¹¹

What is Republic Act No. 9439?

As the old saying goes, health is wealth. A year into this pandemic, as the surge of covid cases keeps on increasing per day, getting sick nowadays is indeed a luxury we cannot afford. When a person gets sick, immediate medical attention is needed, necessitating confinement.

Confinement which involves expensive medical treatments, medicines, surgeries, doctor’s fees among others. For a person who is under-privileged, this is a burden that they cannot afford. In effect, patients who cannot afford to pay their medical expenses are illegally detained.

Republic Act No. 9439,¹² also known as the Hospital Detention Law, aims to curb this situation.

Signed into law last April 27, 2007, this Act prohibits the detention of patients who have fully or partially recovered or may have died, in hospitals and medical clinics due to non-payment of hospital bills.¹³

Importance of Republic Act No. 9439

This Act is a big help to patients who do not have the capacity to pay in full their hospital bills. Now people, especially the under-privileged and indigent, can seek confinement or immediate medical care without thinking that they will be deprived of their right to seek health care.

Also, under the law, any hospital or medical clinic is prohibited to detain such patient, for non-payment, and shall be punished with a hefty fine and imprisonment.

Can a hospital refuse to release a patient?

Under the law, it is illegal to detain any patient, who has fully recovered or partially recovered or who may have died, against his will because of due to non payment of hospital bills.

Patients are now allowed to leave the hospital upon accomplishment of a promissory note, except patients who stayed in private rooms.¹⁴

Is it illegal to leave a hospital without being discharged?

Every patient has a right to leave the hospital, provided that he or she has been discharged properly by his attending physician. What is considered illegal is detaining a patient against his will simply because they don not have enough money to pay the hospital charges or medical expenses they incurred.

How is RA 9439 violated? Who may be held liable and what are the penalties imposed?

Any hospital or medical clinic in the country, who illegally detains a person, who have fully or partially recovered, or have been adequately attended to or who may have died, without financial capacity to pay his hospital expenses, is held liable of violating the provisions of the said Act.

Section 3 of this Act provides that:

“any officer or employee of the hospital or medical clinic responsible for releasing patients, who violates the provisions of this Act shall be punished by a fine of not less than Twenty thousand pesos (P20,000.00), but not more than Fifty thousand pesos (P50,000.00), or imprisonment of not less than one month, but not more than six months, or both such fine and imprisonment, at the discretion of the proper court.”¹⁵

Who are not covered by this law?

Along with strict proscriptions, there is also an exception. Therefore, patients who have stayed in private rooms are not covered in this Act.¹⁴

Can one go to jail for not paying hospital bills in the Philippines?

The Bill of Rights, specifically under Article 3, Section 20, provides that no one can be imprisoned for non-payment of debt. Citing the case of Ganaway vs. Quillen,¹⁶

“x x x x . . . .

“the ‘debt’ intended to be covered by the constitutional guaranty has a well-defined meaning.¹⁷

“Organic provisions relieving from imprisonment for debt, were intended to prevent commitment of debtors to prison for liabilities arising from actions ex contractu.¹⁷

“The inhibition was never meant to include damages arising in actions ex delicto, for the reason that damages recoverable therein do not arise from any contract entered into between the parties but are imposed upon the defendant for the wrong he has done and are considered as punishment, nor to fines and penalties imposed by the courts in criminal proceedings as punishments for crime.¹⁷

“x x x x . . . .”

Related Jurisprudence

Several cases have been decided by the Supreme Court when it comes to violations of RA 10932 and RA 9439. Both legislative acts offer protection to patients who needs immediate medical care and cannot do so because of financial constraints.

Additionally, R.A. No. 10932, aims to make sure that private hospitals do not turn down patients who could not afford to give advance payment during emergency cases, and should first and foremost fulfill their duty to save lives.

In the case of PHAPI vs. Executive Secretary Medialdea¹⁸ which upheld the constitutionality of R.A. No. 10932, the Court ruled that “the challenged law also enjoys the presumption of constitutionality, which the Court, at the first instance, cannot disturb in the absence of a prima facie showing of grave abuse of discretion and, upon delving into the merits, in the absence of a clearest showing that there was indeed an infraction of the Constitution.

If the Court were to invalidate the questioned law on the basis of conjectures and suppositions, then it would be unduly treading questions of policy and wisdom not only of the legislature that passed it, but also of the executive which approved it.

Final thoughts

You have probably seen or heard news and stories where patients are being turned away by several hospitals due to their inability to pay a deposit which results to either further medical complications like permanent disability or untimely death of the patient.

Additionally, there are also news on patients being detained as well as hospital’s holding a patient’s dead body due to non-payment of hospital bills.

With the enactment of these laws, underprivileged citizens can now have a much easier access to proper health care which is a right enshrined under the constitution. Their health will not be compromised just because of their lack of money for payment.

In general, human lives are more important than the profits of some people or businesses. However, we cannot turn a blind eye that hospitals are also businesses that need money to operate and secure resources. Necessarily, it may not still be far-fetched that the above-mentioned laws are still subject to abuse.

Harsher punishments must be in placed to make sure that these Acts are not susceptible to abuse by hospitals and patients alike.

Here is a gentle reminder to each Filipino citizen: each of us has equal rights no matter what our social status is. Never be afraid to fight for your right specially in this time of pandemic where everything is open to abuse.

1. An Act Strengthening the Anti-Hospital Deposit Law by Increasing the Penalties for the Refusal of Hospitals and Medical Clinics to Administer Appropriate Initial Medical Treatment and Support in Emergency or Serious Cases[↩]
2. Supra.[↩]
3. Sec 1, R.A. 10932[↩]
4. Sec 2(a), R.A 10932[↩]
5. Sec 2(b), R.A 10932[↩]
6. Sec 2(c), R.A 10932[↩]
7. Sec 2(d), R.A 10932[↩]
8. Section 1, R.A. 10932[↩]
9. Section 3, R.A. 10932[↩]
10. Section 4 of R.A 10932[↩]
11. Ibid.[↩][↩]
12. An Act Prohibiting The Detention Of Patients In Hospitals And Medical Clinics On Grounds Of Nonpayment Of Hospital Bills Or Medical Expenses[↩]
13. Section 1, R.A. No. 9439[↩]
14. Section 2, R.A. No. 9439[↩][↩]
15. Section 3, Hospital Detention Law, R.A. No. 9439[↩]
16. G.R. No. 18619 February 20, 1922[↩]
17. Ibid.[↩][↩][↩]
18. G.R. No. 234448, November 06, 2018[↩]