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When can hospital detention be valid?

Dear PAO,

My friend went to the hospital for a check-up, complaining of chest pains. She, however, ended up
having a surgery as her condition worsened when she got to the hospital. Fortunately, she received
adequate medical attention and has recovered. But since her family was not prepared for the situation,
they are unable to pay for the hospital bills. My friend’s doctors have cleared her for discharge but the
hospital refuses to let her go without first settling her bill. It has been two days.

Can the hospital detain her like this? I believe there is an anti-hospital detention law. Can that law be
invoked in her situation? Thank you, in advance, for your advice.

Marcus

Dear Marcus,

Republic Act (RA) 9439 or an Act Prohibiting the Detention of Patients in Hospitals and Medical Clinics
on Grounds of Non-payment of Hospital Bills or Medical Expenses” declares it “unlawful for any hospital
or medical clinic in the country to detain or to otherwise cause, directly or indirectly, the detention of
patients who have fully or partially recovered or have been adequately attended to or who may have
died, for reasons of non-payment in part or in full of hospital bills or medical expenses” (Section 1, Id.).

But in order to conclude that there is illegal detention of patients and for which reason the provisions of
RA 9439 may be invoked, the following conditions must be present, to wit: (1) the patients who are
confined in a hospital or medical clinic have fully or partially recovered, or have been adequately
attended to or may have died; (2) they must have signified their desire to leave the hospital or medical
clinic and/or the issuance of the corresponding medical certificate and other pertinent papers, or for
deceased patients, their surviving relatives have signified their desire for the release of the cadaver and/
or relevant documents, but are financially incapable to settle, in part or in full, their hospitalization
expenses, including professional fees and medicines; (3) the patients (or their representatives, in case of
demised patients) have executed a promissory note covering the unpaid obligation; (4) such promissory
note is secured by either a mortgage or by a guarantee of a co-maker, who will be jointly and severally
liable with the patient for the unpaid obligation; and (5) the patients stayed, during their confinement,
in a non-private room (Section 1 in relation to Section 2, Id.).
In the situation which you have shared with us, we submit that it will not be enough to say that there is
hospital detention only because your friend was cleared by her physicians for hospital discharge, that
she is unable to settle her hospital bill and that the hospital refuses to let her go without first settling the
same. Equally important for her to establish, in order to seamlessly invoke the provisions of RA 9439, are
the facts that she has already manifested her desire to leave the hospital, she has already executed a
promissory note that covers her unpaid obligation with the hospital and the same is secured by either a
mortgage or by a guarantee of a co-maker, who will be jointly and severally liable with the patient for
the unpaid obligation, and that she is staying in a non-private room as patients who stayed in private
rooms are not be covered by RA 9439 (Section 2, Id.). The term “non-private room” refers to a room the
occupancy of which exceeds 4 patients who are admitted for diagnosis, treatment and other forms of
health care maintenance whether it is divided by either a permanent or semi-permanent partition
(except curtains), considering that, a contrario, the term “private room” means “x x x 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. x x x” (Part III (K), Implementing Rules and Regulations of RA 9439).