HOSPITAL HOLIDAY ACT (REPUBLIC ACT NO.

9439)
April 27, 2007
AN ACT PROHIBITING THE DETENTION OF
PATIENTS IN HOSPITALS AND MEDICAL
CLINICS ON GROUNDS OF NONPAYMENT OF
HOSPITAL BILLS OR MEDICAL EXPENSES
FRAMED BY SEN. PIA CAYETANO
SECTION 1. It shall be 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
nonpayment in part or in full of hospital bills or
medical expenses.
SEC. 2. Patients who have fully or partially
recovered and who already wish to leave the
hospital or medical clinic but are financially
incapable to settle, in part or in full, their
hospitalization expenses, including professional
fees and medicines, shall be allowed to leave the
hospital or medical clinic, with a right to demand
the issuance of the corresponding medical
certificate and other pertinent papers required for
the release of the patient from the hospital or
medical clinic upon the execution of a promissory
note covering the unpaid obligation.
SEC. 3. 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.
SEC. 4. The Department of Health shall
promulgate the necessary rules and regulations
to carry out the provisions of this Act.
SEC. 5. If any provision of this Act is declared
void and unconstitutional the remaining
provisions hereof not affected thereby shall
remain in full force and effect.
SEC. 6. All laws, decrees, orders, rules and
regulations or part thereof inconsistent with this
Act are hereby repealed or amended accordingly.
SEC. 7. This Act shall take effect fifteen (15) days
after its publication in two national newspapers of
general circulation.This Act which originated in
the House of Representatives was finally passed
by the House of Representatives and the Senate
on June 7, 2005 and February 19, 2007,
respectively.
IMPLEMENTING RULES AND REGULATIONS
REPUBLIC ACT NO. 9439
ADMINISTRATIVE ORDER NO. 2008 - 0001
January 7, 2008
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".
Rationale:The passage of Republic Act (R.A.) 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", addresses the problem
involving some hospitals and medical clinics that
refuse to discharge patients due to the latter's
inability to pay their hospital bills or medical
expenses by encouraging them to employ
appropriate payment schemes. It also
emphasizes the responsibility of patients to honor
their obligation with the hospital or medical clinic
to pay their bills. Sec. 4 of R. A. No. 9439
authorizes the Department of Health (DOH) to
promulgate the necessary rules and regulations.
II. Objective:This Administrative Order sets the
implementing rules and regulations to carry out
the provisions of R. A. 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".
Scope: This Administrative Order applies to
patients admitted in government and private
hospitals and medical clinics, except those who
stay in private rooms.
DEFINITION OF TERMS:
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 comaker 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
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.
Detention occurs when all of the following are
present:
B. Specific Guidelines:
1. Classification, Admission and Discharge of
Patients
2. Execution of Promissory Note
3. Penalty
DISSECTING THE HOSPITAL DETENTION
LAW/HOSPITAL HOLIDAY ACT.
ISSUES REGARDING HOSPITAL HOLIDAY ACT
Profits vs Public Service
As the Hospital Detention Law gained
praise for its pro-poor principles, its passage
threatened hospital owners as well as doctors and
nurses.
The Private Hospitals Association of the
Philippines (PHAP) argued that without the
payments from hospital fees, the funds of
hospitals will not suffice for medicine and
equipment expenses as well as the salaries of
hospital employees.
The group added that the hospitals lack of
fund sources will lead to closures of hospitals and
will further drive health professionals to work

abroad wherein better compensation and benefit

packages awaits them.
Only one out of 10 of them honored the
promissory agreements. Meanwhile in their
desperation, other patients resort to providing
fictitious names and addresses to avoid their
unpaid obligations.
HOSPITAL HOLIDAY- PHAP member
hospitals will close down two to three times a
month except for the emergency ward. The
Hospital Holiday will continue until 2008 or until
the law is amended or a reasonable
Implementing Rules and Regulations
(IRR) are formulated.
hospital holiday, - the deliberate slowing and
cutting of hospital services if the Department of
Health (DOH) cant come up with acceptable
terms of IRRthe implementing rules and
regulations for the new law.
HOSPITAL DETENTION ACT: PRO-POOR,
ANTI-HEALTHCARE?
The PHAP is blurry and pessimistic about
signed payment pledges. Even when guaranteed
by mortgage or co-maker, the group believes
promissory notes will not work because many
patients pull back in their financial obligations.
OnlY 10% pays payment pledges; others give
wrong addresses and claim penury to escape
payment liability.
Nicholas Gonzales, a private citizen, expressed
his displeasure to RA9439 when he half-jokingly
and half-seriously asked, Will we allow hungry
people to eat at any restaurant and submit
promissory notes?
It places the blame on private hospitals
instead of establishing an accessible healthcare
system by allotting sufficient funds for public
hospitals, echoed Dr. Eleanor Jara, the director of
Health Education Training and Services Council
for Health Development (CHD).
The constitution assigns the government
the responsibility of healthcare for its citizens,
said Dr. Santiago A. del Rosario, a former
president of the Philippine Medical Association
(PMA). He points out that More than half of our
hospitals have ceased to operate. Dr. Santiago
blamed the closures to absconding patients,
taxes, expensive facilities, and high maintenance
and labor costs. With the new law, we run the
risk of breeding patients who have little ability
and incentive to pay. Hard pressed with the fight
for survival, our hospitals will doubly labor on
debt collection if we dont instill fiscal
responsibility to ourselves.