implementing rules and regulations of republic act no. 8344

IMPLEMENTING RULES ANDREGULATIONSOFREPUBLIC ACT NO. 8344“AN ACT PENALIZING THE REFUSAL OFHOSPITALS AND MEDICAL CLINICS TOADMINISTER APPROPRIATE INITIAL MEDICALTREATMENT AND SUPPORT IN EMERGENCYOR SERIOUS CASES, AMENDING FOR THEPURPOSE BATAS PAMBANSA BILANG 702,OTHERWISE KNOWN AS AN ACT PROHIBITINGTHE DEMAND OF DEPOSITS OR ADVANCEPAYMENTS FOR THE CONFINEMENT ORTREATMENT OF PATIENTS IN HOSPITALS ANDMEDICAL CLINICS IN CERTAIN CASES” BATAS PAMBANSA BLG. 702 DEPARTMENT OF HEALTH (DOH) ADMINISTRATIVEORDER NO. 89 – IMPLEMENTING RULES ANDREGULATIONS OF BATAS PAMBANSA BLG. 702 REPUBLIC ACT NO. 8344WHEREAS, the Tenth Congress of the Republic of the Philippinesenacted Republic Act No. 8344 on June 05, 1997; chanroblespublishingcompanyWHEREAS, the President of the Republic of the Philippines signedinto law R.A. 8344 on August 25, 1997; chanroblespublishingcompany

WHEREAS, under Section 5 of R.A. 8344, the Department of Health(DOH) is mandated to promulgate the necessary rules andregulations to carry out the provisions of the aforementioned law.NOW THEREFORE, pursuant to the provisions of R.A. 8344authorizing the Department of Health to promulgate the necessaryrules and regulations, the following are hereby issued: chanroblespublishingcompany1. Section 1 of said Act provides: “In emergency or seriouscases, it shall be unlawful for any proprietor, president,director, manager or any other officer, and/or medicalpractitioner or employee of a hospital or medical clinic torequest, solicit, demand or accept any deposit or any otherform of advance payment as a prerequisite for confinementor medical treatment of a patient in such hospital ormedical clinic or to refuse to administer medical treatmentand support as dictated by good practice of medicine toprevent death or permanent disability: Provided, That byreason of inadequacy of the medical capabilities of thehospital or medical clinic, the attending physician maytransfer the patient to a facility where appropriate care canbe given, after the patient or his next of kin consents to saidtransfer: Provided, however, That when the patient isunconscious, incapable of giving consent and/orunaccompanied, the physician can transfer the patient evenwithout his consent, Provided, further, That such transfershall be done only after the necessary emergency treatmentand support have been administered to stabilize the patientand after it has been established that such transfer entailsless risks than the patient’s continued confinement:Provided, finally, That strict compliance with the foregoingprocedure on transfer shall not be construed as a refusalmade punishable by this Act.” chanroblespublishingcompany2. For the purpose of implementing the above, the followingdefinitions are provided:2.1 Emergency — A condition or state of patient whereinbased on the objective findings of a prudent medicalofficer on duty for the day there is immediate danger

and where delay in initial support and treatment maycause loss of life or cause permanent disability to thepatient. chanroblespublishingcompany2.2 Serious Case — refers to a condition of a patientcharacterized by gravity or danger wherein based onthe objective findings of a prudent medical officer onduty for the day when left unattended to, may causeloss of life or cause permanent disability to thepatient.2.3 Confinement — a state of being admitted in a hospitalor medical clinic for medical observation, diagnosis,testing, and treatment consistent with the capabilityand available facilities of the hospital or clinic. chanroblespublishingcompany2.4 Hospital — a facility devoted primarily to thediagnosis, treatment and care of individuals or othermedical and nursing care. It shall also be construedas any institution, building or place where there arefacilities and personnel for the continued andprolonged care of patients. The hospital shall be dulylicensed by the Bureau of Licensing and Regulation ofthe DOH. chanroblespublishingcompany2.5 Emergency Treatment and Support — any medical orsurgical measure within the capability of a hospital ormedical clinic that is administer by qualified healthcare professionals to prevent the death or permanentdisability of a patient. (In determining the capabilityof a hospital or clinic, the standards and theclassification of these facilities set by the DOHBureau of Licensing and Regulation shall be used).chanroblespublishingcompany2.6 Medical Clinic — a place in which patients can avail ofmedical consultation or treatment on an outpatientbasis.2.7 Permanent Disability — a condition of physicaldisability as defined under Article 192-C and Article

193-B and C of Presidential Decree No. 442, asamended, otherwise known as the Labor Code of thePhilippines. chanroblespublishingcompany2.8 Stabilize — the provision of necessary care until suchtime that the patient may be discharged ortransferred to another hospital or clinic with areasonable probability that no physical deteriorationwould result from or occur during such discharge ortransfer. chanroblespublishingcompany3. Transfer of Patients — Section 3 of R.A. 8344 provides:“After the hospital or medical clinic mentioned above shallhave administered medical treatment and consistent withthe needs of the patients preferably to a governmenthospital, specially in the case of poor or indigent patients.”chanroblespublishingcompany3.1 The transferring and receiving hospital, shall be asmuch as practicable, be within ten (10) kilometerradius of each other. chanroblespublishingcompany3.2 The transfer of patients contemplated under this Actshall at all times be properly documented. chanroblespublishingcompany3.3 Hospitals may require a deposit or advance paymentwhen the patient is no longer under the state ofemergency and he/she refuses to be transferred. chanroblespublishingcompany4. All hospitals shall use a Uniform Discharge/Transfer Slipfor cases covered by RA 8344 which shall include thefollowing information:4.1 Admission Form of transferring hospital.4.2 Transfer Form of Transferring Hospital, to includebut not necessarily limited to the followinginformation: chanroblespublishingcompany4.2.1 Vital signs

4.2.2 Name of Attending Physician4.2.3 Treatment given to patient4.2.4 Name of receiving hospital4.2.5 Name of contact person and approvingofficial at receiving hospital4.2.6 Consent of the patient or companion. In caseof an unaccompanied minor or patient, theymay be transferred without consent providedthat the provisions of Section 1 of RA 8344 isstrictly observed. chanroblespublishingcompanyThe hospital shall endeavor to use all forms ofmedia to contact the next of kin of theunaccompanied minor or patient.4.2.7 In case of refusal of transfer, the name of thehospital, the name(s) of persons who refusedand the reason(s) for the refusal.A copy of the Uniform Discharge/Transfer Slip ishereto attached as Annex A. [*] chanroblespublishingcompany5. Penal Provisions — any official, medical practitioner oremployee of the hospital or medical clinic who violates theprovisions of RA 8344 shall, upon conviction by finaljudgment, be punished by imprisonment of not less thansix (6) months and one (1) day but not more than two (2)years and four months, or a fine of not less than TwentyThousand Pesos (P20,000.00) but not more than OneHundred Thousand Pesos (P100,000.00) or both at thediscretion of the court: Provided, however, That if suchviolation was committed pursuant to an established policyof the hospital or clinic or upon instruction of itsmanagement, the director or officer of such hospital orclinic responsible for the formulation and imprisonment offour (4) to six (6) years, or a fine of not less than One

Hundred Thousand Pesos (P100,000.00), but not morethan Five Hundred Thousand Pesos (P500,000.00) orboth, at the discretion of the court.chanroblespublishingcompany6. In order to demonstrate compliance with the Act’sprovisions, all hospitals and medical clinics are instructedto institute the following measures:6.1 A copy of the law and this implementing rules andregulations should be displayed prominently athospital emergency rooms, hospital admission,counters and medical clinic premises.6.2 Hospital and clinic managers shall establish billingand collection procedure for treatment orconfinement of emergency and serious cases whichshall not commence until the essential appropriatetreatment of such cases has been completed.6.3 Hospital and clinic managers shall instruct theirpersonnel to provide prompt and immediate medicalattention to emergency and serious cases without anyprior requirements for payment or deposit.6.4 It is clarified that the law and this administrativeorder covers only the provision of medical andsurgical goods and services, and do not cover theprovision of non-medical amenities which havenothing to do with the treatment of the emergency orserious case. The provisions of and payment for thesenon-medical amenities shall be subject to appropriateinstitutional business practice. chanroblespublishingcompany6.5 Alleged violations of the Act and this Order may bereported to the Bureau of Licensing and Regulations,Office for Standards and Regulations, Department ofHealth, Sta. Cruz, Manila, or to the nearest RegionalHealth Office which shall immediately conduct a factfindinginvestigation. The findings shall be referred tothe appropriate fiscal for criminal prosecution.

Persons convicted of violation shall be punished inaccordance with the Act. chanroblespublishingcompany6.6 At the instance of the Bureau of Licensing andRegulation, Administrative proceedings may also bepursued against erring clinics or hospitals that couldlead to either suspension or revocation of appropriatelicenses. chanroblespublishingcompanyThese Rules and Regulations shall take effect fifteen (15) days afterpublication in the Official Gazette or in a newspaper of generalcirculation.Adopted: February 18, 1998(SGD.)CARMENCITA NORIEGA-REODICA, MDSecretary of Health[*] A copy of the Uniform Discharge/Transfer Slip was attached as Annex “A”and is available at the Office of The National Administrative Register, U.P.Law Complex, Diliman, Quezon City, Metro Manila.chanroblespublishingcompany