Stiffer penalties vs. hospital advance payments in effect
posted 6-May-2018  ·  
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Hospitals and clinics refusing to render treatment unless deposits or advance payments are made by patients can now be probed and punished pursuant to Republic Act 10932.

Last Monday, April 23, 2018, the Implementing Rules and Regulations of RA 10932, which strengthened the Anti-Hospital Deposit Law by increasing penalties for the violation, formally took effect 15 days following its publication in a national newspaper.

The IRR states that in emergency or serious cased, it is unlawful for any proprietor, official, medical practitioner or employee of a hospital or medical clinic to “request, solicit, demand or accept any deposit or any other form of advance payment as a pre-requisite for administering basic emergency care to any patient, confinement or medical treatment of a patient in such hospital or medical clinic or to refuse to administer medical treatment and support as dictated by good practice of medicine to prevent death, or permanent disability, or in the case of a pregnant woman, permanent injury or loss of her unborn child, or non-institutional delivery…”

The same rules, however, provide that by reason of inadequacy of the medical capabilities or the hospital or medical clinic, the attending physician may transfer the patient to a facility where the appropriate care may be given, after the patient or his next of kin consents to said transfer and after the receiving hospital or medical clinic agrees to the transfer.

In case the patient is unconscious, incapable of giving consent and/or is unaccompanied, the physician can transfer the patient even without his consent, provided that such transfer shall be done only after necessary emergency treatment and support have been administered to stabilize the patient and after it has been established that such transfer entails less risks than the patient’s continued confinement, the IRR stated.

It also provides that no hospital or clinic, upon being informed of the medical indications for such transfer, shall refuse to receive the patient nor demand from the patient or his next of kin any deposit or advance payment.

In case of transfer of patients, the IRR said, the patients should be transferred to the nearest next higher level facility with proper coordination and documentation, with the hospital or clinic to provide a staff nurse with certification on advanced cardiovascular life support (ACLS) to accompany the patient in the emergency vehicle.

On the other hand, the local government unit (LGU) where the hospital or clinic is located shall allow the free use of its emergency vehicles to transport the patient if there is no available ambulance in the hospital or clinic.

Pursuant to this provision, the LGU is to implement a system to provide such vehicle without delay during emergency, setting up a hotline to receive calls for ambulance 24/7 and entering into a memorandum of agreement with the specific hospital on the free use of its emergency vehicles.

The new IRR states that “a presumption of liability” shall arise against the hospital, clinic, and the official, medical practitioner or employee involved in the denial of a patient’s admission to a health facility based on two requisites.

There requisites are: 1) the denial was pursuant to a policy or practice of demanding deposits or advance payments for confinement or treatment, and, 2) the denial of admission was the proximate cause of the death, permanent disability, or serious impairment of the patient, or permanent injury to a pregnant women or the loss of her unborn child.

The presumption can be overcome by the presentation of evidence that one of the requisites is not present, it added.

Under the amended law, erring officials, employees or medical practitioners may be punished with imprisonment of six months to two years  or a fine of P100,000.00 to P300,000.00 pesos or both

If the violation was committed pursuant to an established policy or upon instruction of management, the director or officer responsible for the formulation and implementation of such policy shall be metered to imprisonment of four to six years, or a fine of P500,000.00 to P1 million, or both, “without prejudice to the damages that may be awarded to the patient-complainant.

The law, however, is not entirely focused on sanctions, as it allows the reimbursement by PhilHealth of the cost of basic emergency care and transportation services incurred by the hospital or clinic for the emergency medical services given to poor and indigent patients.

The Philippine Charity Sweepstakes Office (PCSO) is also mandated to provide medical assistance for such basic emergency care needs of poor and marginalized groups.

Emergency care to such patients which were not reimbursed by PhilHealth or PCSO shall be deductible from gross sales or receipts of the hospital or clinic.

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