The Senate has approved on third and final reading a bill strengthening protections against the detention of patients, their relatives and human remains over unpaid hospital and medical expenses, while retaining legal mechanisms for hospitals to collect outstanding obligations.

Senate Bill No. 1511, which seeks to amend Republic Act No. 9439 prohibiting hospitals and medical clinics from detaining patients unable to pay their bills, was approved with 18 affirmative votes, no negative votes and one abstention.

Under the measure, the prohibition would be expanded to cover patients’ relatives, representatives or caregivers, as well as newborn babies in maternity cases, who may otherwise be detained as a condition for allowing a patient to leave a hospital, clinic or similar facility.

It would also expressly cover unpaid professional fees and medicines and require patients who have fully or partially recovered but are financially incapable of settling their hospitalization expenses to be allowed to leave, subject to payment arrangements provided under the bill.

Despite the expanded protections, principal author and sponsor Sen. Risa Hontiveros said the measure does not cancel patients’ unpaid obligations but requires hospitals to pursue collection without restricting their liberty.

“Hospital sustainability and patient rights are not opposing choices. That is the balance this measure seeks to strike: protecting patients from detention while preserving lawful mechanisms for hospitals to recover legitimate obligations,” Hontiveros said.

For financially incapable patients, the bill allows the execution of a promissory note secured through mechanisms provided under the measure, including a mortgage over real or personal property, a guarantor, an assignment of Social Security System or Government Service Insurance System loan proceeds or benefits, or guarantee letters from government agencies.

Meanwhile, qualified indigent patients would remain subject to assessment and endorsement for government guarantees, while indigent senior citizens endorsed by a hospital’s medical social services office to the Department of Social Welfare and Development would not be required to execute a promissory note.

Upon execution of the required promissory note, patients would also be entitled to the immediate issuance of medical certificates, discharge summaries, prescriptions and other documents needed for their release.

For deceased patients, the measure requires the immediate release of their remains to surviving relatives despite unpaid obligations and the prompt issuance of death certificates and other documents needed for burial, benefit claims or legal proceedings.

In addition, the bill requires hospitals to disclose applicable fees, billing policies and estimated hospitalization costs before or during confinement and prohibits hidden or unauthorized charges.

Violations would carry stiffer penalties, with offending officers or employees of hospitals, clinics or similar facilities facing imprisonment of six months and one day to two years and four months, a fine of P100,000 to P300,000, or both.

If the violation is committed under an established facility policy or management instruction, the responsible director or officer could face four to six years in prison, a fine of P500,000 to P1 million, or both.

Three repeated violations under such a policy or instruction could result in the revocation of the facility’s license to operate.

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