Medical Centres Required By Law To Treat An Emergency. R.a.8344

[wombatphil]

Republic of the Philippines

Congress of the Philippines

Metro Manila

Tenth Congress

Republic Act No. 8344 August 25, 1997

AN ACT PENALIZING THE REFUSAL OF HOSPITALS AND MEDICAL CLINICS TO ADMINISTER APPROPRIATE INITIAL MEDICAL TREATMENT AND SUPPORT IN EMERGENCY OR SERIOUS CASES, AMENDING FOR THE PURPOSE BATAS PAMBANSA BILANG 702, OTHERWISE KNOWN AS "AN ACT PROHIBITING THE DEMAND OF DEPOSITS OR ADVANCE PAYMENTS FOR THE CONFINEMENT OR TREATMENT OF PATIENTS IN HOSPITALS AND MEDICAL CLINICS IN CERTAIN CASES"

Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled::

Section 1. Section 1 of Batas Pambansa Bilang 702 is hereby amended to read as follows:

"SECTION 1. In emergency or serious cases, it shall be unlawful for any proprietor, president, director, manager or any other officer, and/or 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 prerequisite for 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: Provided, That by reason of inadequacy of the medical capabilities of the hospital or medical clinic, the attending physician may transfer the patient to a facility where the appropriate care can 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: Provided, however, That when the patient is unconscious, incapable of giving consent and/or unaccompanied, the physician can transfer the patient even without his consent: Provided, further, 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: Provided, furthermore, That no hospital or clinic, after 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: Provided, finally, That strict compliance with the foregoing procedure on transfer shall not be construed as a refusal made punishable by this Act."

Section 2. Section 2 of Batas Pambansa Bilang 702 is hereby deleted and in place thereof, new sections 2, 3 and 4 are added, to read as follows:

"SEC. 2. For purposes of this Act, the following definitions shall govern:

"(a) '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.

"(b) '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.

"© 'Confinement' - a state of being admitted in a hospital or medical clinic for medical observation, diagnosis, testing, and treatment consistent with the capability and available facilities of the hospital or clinic.

"(d) 'Hospital' - a facility devoted primarily to the diagnosis, treatment and care of individuals suffering from illness, disease, injury or deformity, or in need of obstetrical or other medical and nursing care. It shall also be construed as any institution, building or place where there are facilities and personnel for the continued and prolonged care of patients.

"(e) 'Emergency treatment and support' - any medical or surgical measure within the capability of the hospital or medical clinic that is administered by qualified health care professionals to prevent the death or permanent disability of a patient.

"(f) 'Medical clinic' - a place in which patients can avail of medical consultation or treatment on an outpatient basis.

"(g) 'Permanent disability' - a condition of physical disability as defined under Article 192-C and Article 193-B and C of Presidential Decree No 442; as amended, otherwise known as the Labor Code of the Philippines.

"(h) 'Stabilize' - the provision of necessary care until such time that the patient may be discharged or transferred to another hospital or clinic with a reasonable probability that no physical deterioration would result from or occur during such discharge or transfer.

"SEC. 3. After the hospital or medical clinic mentioned above shall have administered medical treatment and support, it may cause the transfer of the patient to an appropriate hospital consistent with the needs of the patient, preferably to a government hospital, specially in the case of poor or indigent patients.

"SEC. 4. Any official, medical practitioner or employee of the hospital or medical clinic who violates the provisions of this Act shall, 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 Twenty thousand pesos (P20,000.00), but not more than One hundred thousand pesos (P100,000.00) or both, at the discretion of the court: 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 One hundred thousand pesos (P100,000.00), but not more than Five hundred thousand pesos (P500,000.00) or both, at the discretion of the court."

Section 3. Section 3 of Batas Pambansa Bilang 702 is hereby repealed.

Section 4. Section 4 of Batas Pambansa Bilang 702 shall become Section 5 thereof and shall be amended to read as follows:

"SEC. 5. The Department of Health shall promulgate the necessary rules and regulations to carry out the provisions of this Act."

Section 5. This Act shall take effect fifteen (15) days after its publication in two (2) national newspapers of general circulation.

Approved: August 25, 1997

The Lawphil Project - Arellano Law Foundation

IMPLEMENTING RULES AND REGULATIONS OF REPUBLIC ACT NO. 8344,

OTHERWISE KNOWN AS "AN ACT PENALIZING THE REFUSAL OF HOSPITALS AND MEDICAL CLINICS TO ADMINISTER APPROPRIATE INITIAL MEDICAL TREATMENT AND SUPPORT IN EMERGENCY OR SERIOUS CASES, AMENDING FOR THE PURPOSE BATAS PAMBANSA BILANG 702, OTHERWISE KNOWN AS AN ACT PROHIBITING THE DEMAND OF DEPOSITS OR ADVANCE PAYMENTS FOR THE CONFINEMENT OR TREATMENT OF PATIENTS IN HOSPITALS AND MEDICAL CLINICS IN CERTAIN CASES"

WHEREAS, the Tenth Congress of the Republic of the Philippines enacted Republic Act No. 8344 on June 05, 1997;

WHEREAS, the President of the Republic of the Philippines signed into law R.A. 8344 on August 25, 1997;

WHEREAS, under Section 5 of R.A. 8344, the Department of Health (DOH) is mandated to promulgate the necessary rules and regulations to carry out the provisions of the aforementioned law.

NOW THEREFORE, pursuant to the provisions of R.A. 8344 authorizing the Department of Health to promulgate the necessary rules and regulations, the following are hereby issued:

1. Section 1 of said Act provides: "In emergency or serious cases, it shall be unlawful for any proprietor, president, director, manager or any other officer, and/or 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 prerequisite for 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: Provided, That by reason of inadequacy of the medical capabilities of the hospital or medical clinic, the attending physician may transfer the patient to a facility where appropriate care can be given, after the patient or his next of kin consents to said transfer: Provided, however, That when the patient is unconscious, incapable of giving consent and/or unaccompanied, the physician can transfer the patient even without his consent, Provided, further, That such transfer shall be done only after the 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: Provided, finally, That strict compliance with the foregoing procedure on transfer shall not be construed as a refusal made punishable by this Act."

2. For the purpose of implementing the above, the following definitions are provided:

2.1 Emergency - A condition or state of 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.

2.2 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.

2.3 Confinement - a state of being admitted in a hospital or medical clinic for medical observation, diagnosis, testing, and treatment consistent with the capability and available facilities of the hospital or clinic.

2.4 Hospital - a facility devoted primarily to the diagnosis, treatment and care of individuals or other medical and nursing care. It shall also be construed as any institution, building or place where there are facilities and personnel for the continued and prolonged care of patients. The hospital shall be duly licensed by the Bureau of Licensing and Regulation of the DOH.

2.5 Emergency Treatment and Support - any medical or surgical measure within the capability of a hospital or medical clinic that is administer by qualified health care professionals to prevent the death or permanent disability of a patient. (In determining the capability of a hospital or clinic, the standards and the classification of these facilities set by the DOH Bureau of Licensing and Regulation shall be used).

2.6 Medical Clinic - a place in which patients can avail of medical consultation or treatment on an outpatient basis.

2.7 Permanent Disability - a condition of physical disability as defined under Article 192-C and Article 193-B and C of Presidential Decree No. 442, as amended, otherwise known as the Labor Code of the Philippines.

2.8 Stabilize - the provision of necessary care until such time that the patient may be discharged or transferred to another hospital or clinic with a reasonable probability that no physical deterioration would result from or occur during such discharge or transfer.

3. Transfer of Patients - Section 3 of R.A. 8344 provides: "After the hospital or medical clinic mentioned above shall have administered medical treatment and consistent with the needs of the patients preferably to a government hospital, specially in the case of poor or indigent patients."

3.1 The transferring and receiving hospital, shall be as much as practicable, be within ten (10) kilometer radius of each other.

3.2 The transfer of patients contemplated under this Act shall at all times be properly documented.

3.3 Hospitals may require a deposit or advance payment when the patient is no longer under the state of emergency and he/she refuses to be transferred.

4. All hospitals shall use a Uniform Discharge/Transfer Slip for cases covered by RA 8344 which shall include the following information:

4.1 Admission Form of transferring hospital.

4.2 Transfer Form of Transferring Hospital, to include but not necessarily limited to the following information:

4.2.1 Vital signs

4.2.2 Name of Attending Physician

4.2.3 Treatment given to patient

4.2.4 Name of receiving hospital

4.2.5 Name of contact person and approving official at receiving hospital

4.2.6 Consent of the patient or companion. In case of an unaccompanied minor or patient, they may be transferred without consent provided that the provisions of Section 1 of RA 8344 is strictly observed.

The hospital shall endeavor to use all forms of media to contact the next of kin of the unaccompanied minor or patient.

4.2.7 In case of refusal of transfer, the name of the hospital, the name(s) of persons who refused and the reason(s) for the refusal.

A copy of the Uniform Discharge/Transfer Slip is hereto attached as Annex A*.

5. Penal Provisions - any official, medical practitioner or employee of the hospital or medical clinic who violates the provisions of RA 8344 shall, 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 months, or a fine of not less than Twenty Thousand Pesos (P20,000.00) but not more than One Hundred Thousand Pesos (P100,000.00) or both at the discretion of the court: 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 imprisonment of four (4) to six (6) years, or a fine of not less than One Hundred Thousand Pesos (P100,000.00), but not more than Five Hundred Thousand Pesos (P500,000.00) or both, at the discretion of the court.

6. In order to demonstrate compliance with the Act's provisions, all hospitals and medical clinics are instructed to institute the following measures:

6.1 A copy of the law and this implementing rules and regulations should be displayed prominently at hospital emergency rooms, hospital admission, counters and medical clinic premises.

6.2 Hospital and clinic managers shall establish billing and collection procedure for treatment or confinement of emergency and serious cases which shall not commence until the essential appropriate treatment of such cases has been completed.

6.3 Hospital and clinic managers shall instruct their personnel to provide prompt and immediate medical attention to emergency and serious cases without any prior requirements for payment or deposit.

6.4 It is clarified that the law and this administrative order covers only the provision of medical and surgical goods and services, and do not cover the provision of non-medical amenities which have nothing to do with the treatment of the emergency or serious case. The provisions of and payment for these non-medical amenities shall be subject to appropriate institutional business practice.

6.5 Alleged violations of the Act and this Order may be reported to the Bureau of Licensing and Regulations, Office for Standards and Regulations, Department of Health, Sta. Cruz, Manila, or to the nearest Regional Health Office which shall immediately conduct a fact-finding investigation. The findings shall be referred to the appropriate fiscal for criminal prosecution. Persons convicted of violation shall be punished in accordance with the Act.

6.6 At the instance of the Bureau of Licensing and Regulation, Administrative proceedings may also be pursued against erring clinics or hospitals that could lead to either suspension or revocation of appropriate licenses.

These Rules and Regulations shall take effect fifteen (15) days after publication in the Official Gazette or in a newspaper of general circulation.

Adopted: February 18, 1998

(SGD.) CARMENCITA NORIEGA-REODICA, MD

Secretary of Health

* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Q.C.

[Call me bubba]

"(a) '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.

The doctor on duty(or any other doctor) and I(me.you,us) may have a WIDE difference of what would "constitute" an EMERGENCY according the this "definition" under the law

2. this LAW was another "feel good" law(act) that was passed to "win" votes and to ensure

1. that they,the powers to be would be reelected

2.that "you wouldTHINK that you would be treated in an emergency"..

Having a LAW and making sure its FULLY ENFORCED is 2 different things here in the RP.

I have no further comment on political issues/laws that are passed to make others"feel good"

If your in good health you should not have to worry at all. If your concerned about your health in a "emergency" .....PLAN AHEAD...

If your not in Good or Fair health, perhaps you may need to consider that living here may not be the "best" interest for you.

UNLESS you have (good)HEALTH COVERAGE that will treat you no matter what happens

[wombatphil]

The greater percentage of the population here, have a 'head in the sand' attitude when it comes to persons in authority, Govt officials, doctors and etc. They tend to not argue the point and really can be likened to a sheepish attitude in this particular area and can be directed and commanded around with easy compliance, generally...

When it comes to a typical foreigner, these same persons in authority etc, often come up against a brick wall when they try their usual stuff on. The foreigner generally does not lie down and roll over and will push if it is percieved they are being treated unfairly, not correctly and etc.

I've had a little to do with the Law here and have submitted several criminal cases, against 3 persons and an Ombudsman complaint against a very senior Policeman. My finding on it all and the processes is, that if you have the evidence for a case and you submit it to the proper authorities, THEY MUST ACT on the complaint as Prosecutors, no arguement, just do the job coz otherwise, they open themselves up to complaint for corruption and all of the govt people are afraid of the Ombudsman and the power of that office to jail and or dismiss them from service. ...

There is no argument against an enacted Republic Act. It's cast in stone so to speak, it's there for a specific purpose and as far as I'm concerned, you cannot simply sweep this RA under the carpet, nobody can...

[Call me bubba]

The greater percentage of the population here, have a 'head in the sand' attitude when it comes to persons in authority, Govt officials, doctors and etc. They tend to not argue the point and really can be likened to a sheepish attitude in this particular area and can be directed and commanded around with easy compliance, generally...

When it comes to a typical foreigner, these same persons in authority etc, often come up against a brick wall when they try their usual stuff on. The foreigner generally does not lie down and roll over and will push if it is percieved they are being treated unfairly, not correctly and etc.

I've had a little to do with the Law here and have submitted several criminal cases, against 3 persons and an Ombudsman complaint against a very senior Policeman. My finding on it all and the processes is, that if you have the evidence for a case and you submit it to the proper authorities, THEY MUST ACT on the complaint as Prosecutors, no arguement, just do the job coz otherwise, they open themselves up to complaint for corruption and all of the govt people are afraid of the Ombudsman and the power of that office to jail and or dismiss them from service. ...

There is no argument against an enacted Republic Act. It's cast in stone so to speak, it's there for a specific purpose and as far as I'm concerned, you cannot simply sweep this RA under the carpet, nobody can...

........?......

(quote) you cannot simply sweep this RA under the carpet, nobody can..(quote)

Thats so true

BUT the LACK of ENFORCEMENT of this law and so many others are common place,

they have a law(act) yet NO funding(enforcement) or "real teeth" to make it work.

[JJReyes]

The hospital will still give priority services to walk-ins who can demonstrate an ability to pay. The situation is similar to going to a bank for the first time. You want to meet the branch manager and start establishing a relationship. I would also want to visit a nearby hospital and meet with an administrator or someone in accounting. The same with the local police station and fire department.

[MikeB]

Anyone considering not having medical insurance or adequate financial resources to handle a medical emergency because they are "protected" by this law is making a grave mistake, imo.

[earthdome]

Anyone considering not having medical insurance or adequate financial resources to handle a medical emergency because they are "protected" by this law is making a grave mistake, imo.

So true, if you depend on government, in the end you will be sorely disappointed.

It is up to you to do the necessary due diligence to ensure medical services will be available in case of emergency.

[luke]

Anyone considering not having medical insurance or adequate financial resources to handle a medical emergency because they are "protected" by this law is making a grave mistake, imo.

Right! After you're 6 feet under your ghost can take on the government.... :1 (103):

[Okieboy]

insurance is good but will not get you into a hospital in most cases, you need cash money. Phil health is cheap and available to all foreigners, it will get you in untill you can make better use of your funds or insurance, Americans flight to Guam if on Medicare or VA. i have two friends in Guam now getting knee replacements one a retired US Army Captian went thru VA in Manila, the other Phil Health first than to Guam for appointment and now the surgery using his medicare