QuestionsQuestions (DOH ADMINISTRATIVE ORDER NO. 2008-0001)
It addresses the practice of some hospitals/medical clinics refusing to discharge or releasing restraining patients due to the patient’s inability to pay hospital bills or medical expenses, by prohibiting detention on nonpayment grounds while still encouraging proper payment arrangements.
Except those in private rooms, patients who are partially or fully recovered and wish to leave but are incapable to pay (in part or full) must be allowed to leave, be issued the corresponding medical certificate and pertinent documents for release upon execution of a promissory note covering the unpaid obligations.
Patients admitted in government and private hospitals and medical clinics, except those who stay in private rooms.
Detention is the act of restraining a person from leaving the hospital premises for nonpayment of hospital bills or medical expenses in part or in full.
Detention occurs when: (1) patient partially/fully recovered and expresses intention to leave or attending physician issues discharge order; (2) patient not confined in a private room and financially incapable to pay in part or full; (3) patient executed a promissory note covering unpaid obligations; and (4) the officer/employee responsible for releasing patient restrained the patient from leaving.
Detention occurs when: (1) medical officer pronounces death; (2) any surviving relative is incapable to pay corresponding hospital bills/medical expenses; (3) any surviving relative executed a promissory note covering unpaid obligations; and (4) officer/employee responsible for releasing the cadaver refused to release the cadaver and/or relevant documents.
A promissory note covering the unpaid hospital bills/medical expenses/hospitalization expenses, secured either by (a) a mortgage or (b) a guarantee of a co-maker who is jointly and severally liable.
Either a mortgage or a guarantee of a co-maker, with the co-maker jointly and severally liable for the unpaid obligations.
Surviving relatives may be issued death certificates and pertinent documents for interment purpose only even if cadaver release is sought; documents for other purposes are released only upon execution of a promissory note covering unpaid obligations (secured by mortgage or co-maker guarantee).
The relative shall be allowed to claim the cadaver and can demand issuance of death certificate and other pertinent documents for interment purposes. Documents for other purposes are released only after execution of a promissory note.
The hospital may require execution of an assignment of proceeds up to the extent of the hospital bills/medical expenses/hospitalization expenses to facilitate benefit processing (e.g., SSS, GSIS, PhilHealth, insurance policies, or pre-need plans).
They must establish billing and collection procedures subject to accounting/auditing rules, and they must have written policies and procedures for admitting and releasing patients, including identifying the officer(s)/employee(s) responsible for releasing patients.
Government hospitals follow DOH AO No. 51-A s. 2000 guidelines on classification of patients and medical social services; private hospitals must have written policies and procedures to classify patients by capacity to pay and may refer to AO 51-A s. 2000.
As far as practicable, hospitals/clinics must assist patients in looking for financial assistance from government and non-government sources to settle unpaid hospital bills/medical expenses, with DOH coordinating with institutions (e.g., PhilHealth, PCSO, PAGCOR, LGUs, and others) to provide funds.
They must have written policies and procedures for execution of promissory notes secured by a mortgage or a co-maker guarantee, and they must identify the responsible personnel for release to ensure patients are not restrained after satisfying the promissory note requirement.
A fine of not less than P20,000 but not more than P50,000, or imprisonment of not less than one (1) month but not more than six (6) months, or both, at the discretion of the proper court.
No; the order applies except those who stay in private rooms. This is significant because the general rule allowing release upon execution of a promissory note despite inability to pay is limited to those not confined in private rooms.
It includes a repealing/separability clause: inconsistent provisions from previous issuances are rescinded/modified; if any provision is declared unauthorized or invalid, the unaffected provisions remain valid and effective.