Republic of the Philippines Congress of the Philippines Republic Act No. 9439 An act prohibiting the detention of patients in hospitals and medical clinics on grounds of nonpayment of hospital bills or medical expenses. Approved by President Gloria Macapagal-Arroyo

1. Republic of the PhilippinesRepublic 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.

2. Republic Act No. 9439Republic Act No. 9439
AN ACT PROHIBITING THEAN ACT PROHIBITING THE
DETENTION OF PATIENTS INDETENTION OF PATIENTS IN
HOSPITALS AND MEDICALHOSPITALS AND MEDICAL
CLINICS ON GROUNDS OFCLINICS ON GROUNDS OF
NONPAYMENT OF HOSPITALNONPAYMENT OF HOSPITAL
BILLS OR MEDICAL EXPENSESBILLS OR MEDICAL EXPENSES

3. Approved:Approved:
June 7, 2005June 7, 2005
JOSE DE VENECIA JR.JOSE DE VENECIA JR.
Speaker of the House ofSpeaker of the House of
RepresentativesRepresentatives
ROBERTO P. NAZARENOROBERTO P. NAZARENO
Secretary GeneralSecretary General
House of RepresentativesHouse of Representatives

4. Approved:Approved:
February 19, 2007February 19, 2007
OSCAR G. YABESOSCAR G. YABES
Secretary of the SenateSecretary of the Senate
MANNY VILLARMANNY VILLAR
President of the SenatePresident of the Senate

5. Approved:Approved:
April 27, 2007April 27, 2007
GLORIA MACAPAGAL-ARROYOGLORIA MACAPAGAL-ARROYO
President of the PhilippinesPresident of the Philippines

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

7. Section 2 SummarySection 2 Summary
• Patients who are incapable to pay for thePatients who are incapable to pay for the
medical expenses still have the right tomedical expenses still have the right to
leave the hospital and ask for pertinentleave the hospital and ask for pertinent
papers.papers.
• Promissory notes shall be secured. ThePromissory notes shall be secured. The
patient and guarantor shall be jointly andpatient 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 shallPatients who stayed in private rooms shall
not be covered by this Act.not be covered by this Act.

8. Section 3 SummarySection 3 Summary
• Officers or employees of theOfficers or employees of the
hospital who violates this act shallhospital who violates this act shall
be punished by a fine rangingbe punished by a fine ranging
from P20,000 to P50,000 ORfrom P20,000 to P50,000 OR
imprisonment for 1 month to 6imprisonment for 1 month to 6
months OR BOTH by discretion ofmonths OR BOTH by discretion of
the proper court.the proper court.

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

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

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

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

13. CASE 1CASE 1
An indigent young female patient wasAn indigent young female patient was
admitted to a government hospital in Manilaadmitted to a government hospital in Manila
because of pus in the head which requiredbecause of pus in the head which required
minor surgery. The family availed of theminor surgery. The family availed of the
PhilHealth ward because the hospital’sPhilHealth ward because the hospital’s
charity ward was always full and consistedcharity ward was always full and consisted
of diverse cases. The family would haveof diverse cases. The family would have
waited indefinitely in the hall if they waitedwaited indefinitely in the hall if they waited
for a bed in the charity ward.for a bed in the charity ward.

14. The hospital bill reached almost P40,000The hospital bill reached almost P40,000
for the child’s three-week confinement. Thefor the child’s three-week confinement. The
child was not allowed to leave the hospitalchild was not allowed to leave the hospital
until the family has paid 70% partialuntil the family has paid 70% partial
payment of the hospital bills. The family hadpayment of the hospital bills. The family had
meetings with different heads of differentmeetings with different heads of different
departments for approval before theirdepartments for approval before their
promissory note was approved. Only thenpromissory note was approved. Only then
was the child released from the hospital.was the child released from the hospital.

15. CASE 2CASE 2
A male patient was confined in a private hospitalA male patient was confined in a private hospital
because it was the hospital nearest to the patient’sbecause it was the hospital nearest to the patient’s
residence. The patient was admitted at the charityresidence. The patient was admitted at the charity
ward only. However, his hospital bills were tooward only. However, his hospital bills were too
much for the family to pay immediately. Themuch for the family to pay immediately. The
patient was not discharged from the hospitalpatient was not discharged from the hospital
because the hospital did not accept the promissorybecause the hospital did not accept the promissory
note for the balance of the patient’s bill. The staffnote for the balance of the patient’s bill. The staff
told the family that execution of promissory notestold the family that execution of promissory notes
is allowed in government hospitals only. The familyis 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.

16. Response of Public Attorney’s OfficeResponse of Public Attorney’s Office
Any hospital or medical clinic detaining or indirectly or directly causing theAny hospital or medical clinic detaining or indirectly or directly causing the
detention of a patient by reason of non-payment may be penalized indetention of a patient by reason of non-payment may be penalized in
accordance with the provisions of the Anti-Hospital Detention Act. Foraccordance 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 intentionthe 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 ato 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 isdischarge 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 billsfinancially incapable to settle in part or in full the corresponding hospital bills
or medical expenses/ hospitalization expenses; 3) the patient has executed aor medical expenses/ hospitalization expenses; 3) the patient has executed a
promissory note covering the unpaid hospital bills or medicalpromissory note covering the unpaid hospital bills or medical
expenses/hospitalization expenses; and 4) the officer or employee of theexpenses/hospitalization expenses; and 4) the officer or employee of the
hospital or medical clinic responsible for releasing the patient has restrainedhospital or medical clinic responsible for releasing the patient has restrained
him from leaving the hospital premises (Rule V, Implementing Rules andhim 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 thatWe 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 ourthis advice is based solely on the facts that you have narrated and our
appreciation of the same. Our opinion may vary when other facts areappreciation of the same. Our opinion may vary when other facts are
changed or elaborated.changed or elaborated.

17. CASE 3CASE 3
A female 68 y/o patient was admitted to a privateA female 68 y/o patient was admitted to a private
hospital because of uncontrolled hypertension. Nohospital because of uncontrolled hypertension. No
deposit was required upon admission but thedeposit was required upon admission but the
family deposited a minimal amount within 24family deposited a minimal amount within 24
hours. The patient’s case was complex whichhours. The patient’s case was complex which
necessitated the maintenance of several doctors,necessitated the maintenance of several doctors,
which included a cardiologist, pulmonologist, andwhich included a cardiologist, pulmonologist, and
urologist, among others. The patient wasurologist, among others. The patient was
eventually transferred to the ICU. A doctor friendeventually transferred to the ICU. A doctor friend
initially vouched for the family. However, the familyinitially vouched for the family. However, the family
had consultations with high hospital officials whenhad 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.

18. The hospital accepted as mortgage the title of aThe hospital accepted as mortgage the title of a
small land owned by the family. The parties agreedsmall 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 aprivate 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 becameduring the arrangements, the patient became
comatose, leading to the patient’s demise in thecomatose, leading to the patient’s demise in the
ICU after 24 hours. The patient’s hospital bill andICU after 24 hours. The patient’s hospital bill and
professional fees for the almost three months ofprofessional fees for the almost three months of
confinement reached almost PhP 1.5 million. Theconfinement reached almost PhP 1.5 million. The
hospital allowed the family to sign a promissoryhospital 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.

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

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21. SourcesSources
• localpatientadvocate.com (background picture)localpatientadvocate.com (background picture)
• http://www.lawphil.net/statutes/repacts/ra2http://www.lawphil.net/statutes/repacts/ra2
007/ra_9439_2007.html007/ra_9439_2007.html
• Case 1: Name withheld. InformationCase 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-hospitals-do-not-discharge-
patients/87132/patients/87132/
• Case 3: Name withheld. InformationCase 3: Name withheld. Information
available upon request.available upon request.

22. THANK YOUTHANK YOU