EN BANC
G.R. No. 234448, November 06, 2018
PRIVATE HOSPITALS ASSOCIATION OF THE PHILIPPINES, INC. (PHAPI) REPRESENTED BY ITS PRESIDENT, DR. RUSTICO JIMENEZ, Petitioner, v. HON. SALVADOR MEDIALDEA, EXECUTIVE SECRETARY, AND THE ACTING SECRETARY OF DEPARTMENT OF HEALTH, Respondents.
D E C I S I O N
TIJAM, J.:
On grounds of denial of substantive due process, repugnancy to the constitutional presumption of innocence, violation of the equal protection and involuntary servitude clauses, petitioner Private Hospitals Association of the Philippines, Inc., (PHAPi) - an organization of privately-owned clinics, hospitals, and other health facilities - seeks to declare as unconstitutional and void the duty imposed upon hospitals, medical practitioners and employees to prevent actual death or injury under Section 1; the penal provisions under Section 4; the presumption of liability clause under Section 5; and the reimbursement and tax deduction clause under Sections 7 and 8, all of Republic Act (R.A.) No. 109321 otherwise known as an Act Strengthening the Anti-Hospital Deposit Law.
(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.R.A. No. 8344 also increased the penalties prescribed under BP 702 to imprisonment of not less than six months and one day but not more than two years and four months, or a fine of not less than twenty thousand pesos, but not more than one hundred thousand pesos, or both at the discretion of the court. However, if the violation was committed pursuant to an established hospital or clinic policy or upon the instruction of its management, the director or officer responsible for the formulation and implementation of such policy shall suffer imprisonment of four to six years, or a fine of not less than one hundred thousand pesos, but not more than five hundred thousand pesos, or both, at the court's discretion.8
(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.
(c) 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.
With respect to the Court, however, the remedies of certiorari and prohibition are necessarily broader in scope and reach, and the writ of certiorari or prohibition may be issued to correct errors of jurisdiction committed not only by a tribunal, corporation, board or officer exercising judicial, quasi-judicial or ministerial functions but also to set right, undo and restrain any act of grave abuse of discretion amounting to lack or excess of jurisdiction by any branch or instrumentality of the Government, even if the latter does not exercise judicial, quasi-judicial or ministerial functions. This application is expressly authorized by the text of the second paragraph of Section 1, supra.Accordingly, we held as proper remedies the writs of certiorari and prohibition in Samahan ng mga Progresibong Kabataan (SPARK), et al. v. Quezon City, as represented by Mayor Herbert Bautista, et al.,55 assailing the constitutionality of curfew ordinances and in Agcaoili questioning the contempt powers of the Congress in the exercise of its power of inquiry in aid of legislation. Following this trend in jurisprudence, petitioner therefore correctly availed of certiorari and prohibition under Rule 65 of the Rules of Court to assail the constitutionality of R.A. No. 10932 and enjoin its enforcement, notwithstanding that these governmental actions do not involve the exercise of judicial, quasi-judicial or ministerial functions.
Thus, petitions for certiorari and prohibition are appropriate remedies to raise constitutional issues and to review and/or prohibit or nullify the acts of legislative and executive officials.54 (Citation omitted and emphasis ours)
(1) an actual case or controversy calling for the exercise of judicial power; (2) the person challenging the act must have standing to challenge; he must have a personal and substantial interest in the case such that he has sustained, or will sustain, direct injury as a result of its enforcement; (3) the question of constitutionality must be raised at the earliest possible opportunity; and (4) the issue of constitutionality must be the very lis mota of the case.73Arguing the absence of the first and second requisites, respondents seek an outright dismissal of the instant petition. We agree.
| Very truly yours, |
(SGD) | |
EDGAR O. ARICHETA | |
Clerk of Court |
Endnotes:
1 AN ACT STRENGTHENING THE ANTI-HOSPITAL DEPOSIT LAW BY INCREASING THE PENALTIES FOR 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", AS AMENDED BY REPUBLIC ACT NO. 8344, AND FOR OTHER PURPOSES. Approved August 3, 2017.
2See Explanatory Note of House Bill No. 6341.
3Section 1. It shall be unlawful for any director, manager or any other officer of a hospital or medical clinic to demand any deposit or any other form of advance payment for confinement or treatment in such hospital or medical clinic in emergency or serious cases.
4Section 2. Any director, manager or any other officer of a hospital or medical clinic who violates Section 1 of this Act shall be punished by a fine of not less than one thousand pesos but not more than two thousand pesos or imprisonment for not less than fifteen days but not more than thirty days, or both such fine and imprisonment.
Section 3. Any person convicted under this Act shall not be entitled to probation under the provisions of Presidential Decree No. 968, as amended, otherwise known as the Probation Law of 1976.
5 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."
6Section 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.
7Section 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:x x x x8Section 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. 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.x x x x9 AN ACT STRENGTHENING THE PROVISION OF EMERGENCY HEALTH CARE SERVICE TO PATIENTS, FURTHER AMENDING FOR THE PURPOSE BATAS PAMBANSA BILANG 702, AS AMENDED, ENTITLED "AN ACT PROHIBITING THE DEMAND OF DEPOSITS OR ADVANCED PAYMENTS FOR THE CONFINEMENT OR TREATMENT OF PATIENTS IN HOSPITALS AND MEDICAL CLINICS IN CERTAIN CASES."
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.
10See Fact Sheet of House Bill No. 5159.
11 AN ACT INCREASING THE PENALTIES FOR 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" AS AMENDED BY REPUBLIC ACT NO. 8344, AND FOR OTHER PURPOSES.
12 Section 1. Section 1 of Batas Pambansa Bilang 702, as amended, is hereby further amended to read as follows:
ChanRoblesVirtualawlibrarySec. 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 administering basic emergency care to any patient, 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, or in the case of a pregnant woman, permanent injury or loss of her unborn child, or noninstitutional delivery: 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.13 Section 2. Section 2 of the same Act, as amended, is hereby further amended to read as follows:
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"Sec. 2. For purposes of this Act, the following definitions shall govern:
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"x x x x
"(i) 'Basic emergency care' - the response to a situation where there is urgently required medical care and attention, and shall include procedures required for initial diagnosis, use of equipment and supplies in sufficiently addressing the emergency situation, considering the welfare of the patient. It also includes the necessary medical procedures and treatment administered to a woman in active labor to ensure the safe delivery of the newborn.
"(j) 'Noninstitutional delivery' - the delivery of a newborn while in transit, outside of a health facility, after an initial consultation was done with a health facility."
14 SEC. 3. Section 3 of the same Act, as amended, is hereby further amended to read as follows:
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"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, especially in the case of poor or indigent patients.
Where there is no ambulance available for use by the hospital or medical clinic for the emergency transfer of the patient to a facility where the appropriate care shall be given, the local government unit (LGU) where the hospital or medical clinic is located must allow the free use of its emergency vehicle to transport the patient to the hospital or medical clinic where a continuation of care shall be given. The hospital or medical clinic must provide a staff nurse with advanced cardiovascular life support (ACLS) certification or its equivalent to accompany the patient in the emergency vehicle.
All hospitals are required to post at their entrance a notice indicating the classification level of the hospital as licensed by the Department of Health (DOH) and the list of medical services that the hospital is authorized to perform."
15 SEC. 5. New Sections 5, 6, 7 and 8 shall be inserted after Section 4 of Batas Pambansa bilang 702, as amended, to read as follows:
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x x x x
SEC. 6. Health Facilities Oversight Board. - All complaints for violations of this Act against health facilities shall be filed initially with the Health Facilities Oversight Board under the Health Facilities and Services Regulatory Bureau (HFSRB) of the [DOH]. The Board shall be composed of a DOH representative with a minimum rank of director to serve as Chair, a representative from the Philippine Health Insurance Corporation (PhilHealth), a representative from the Philippine Medical Association (PMA), a representative from private health institutions and three (3) representatives from non-government organizations (NGOs) advocating for patient's rights and public health, one of whom should be a licensed physician.
The Board shall investigate the claim of the patient and after adjudication, impose administrative sanctions in accordance with this Act including the revocation of the health facility's license. On the basis of its own findings, the Board shall also facilitate the filing of the criminal case in the proper courts. This is without prejudice to the right of the patient-complainant to directly institute criminal proceedings in the courts.
16 SEC. 4. section 4 of the same Act, as amended, is hereby further amended to read as follows:
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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 One hundred thousand pesos (P100,000.00), but not more than Three hundred thousand pesos (P300,000.00 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 Five hundred thousand pesos (P500,000.00), but not more than One million pesos (P1,000,000.00) or both, at the discretion of the court, without prejudice to damages that may be awarded to the patient-complainant: Provided, further, That upon three (3) repeated violations committed pursuant to an established policy of the hospital or clinic or upon the instruction of its management, the health facility's license to operate shall be revoked by the DOH. The president, chairman, board of directors. or trustees, and other officers of the health facility shall be solidarily liable for damages that may be awarded by the court to the patient-complainant.
17 Id.
18 SEC. 5. New Sections 5, 6, 7 and 8 shall be inserted after section 4 of Batas Pambansa bilang 702, as amended, to read as follows:
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SEC. 5. Presumption of Liability. - In the event of death, permanent disability, serious impairment of the health condition of the patient-complainant, or in the case of a pregnant woman, permanent injury or loss of her unborn child, proceeding from the denial of his or her admission to a health facility pursuant to a policy or practice of demanding deposits or advance payments for confinement or treatment, a presumption of liability shall arise against the hospital, medical clinic, and the official, medical practitioner, or employee involved.
19 SEC. 5. New Sections 5, 6, 7 and 8 shall be inse1ted after section 4 of Batas Pambansa bilang 702, as amended, to read as follows:
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x x x x
SEC. 7. PhilHealth Reimbursement of Basic Emergency Care. - PhilHealth shall reimburse the cost of basic emergency care and transportation services incurred by the hospital or medical clinic for the emergency medical services given to poor and indigent patients. Furthermore, the Philippine Charity Sweepstakes Office (PCSO) shall provide medical assistance for the basic emergency care needs of the poor and marginalized groups.
20Rollo, p. 8.
21 Id.
22 Id. at 10.
23 Id. at 10-11.
24 Id. at 11.
25 Id. at 13-14.
26 Id. at 14.
27 604 Phil. 98 (2009).
28 Id. at 125.
29Rollo, p. 16.
30 Id.
31 Id. at 18.
32 Id. at 20.
33 Id.
34 Id.
35 Id. at 22.
36 Id.
37 Id. at 55.
38 Id. at 56.
39 Id. at 58-59.
40 Id. at 61.
41 Id. at 68.
42 Id. at 71.
43 Id. at 72.
44 Id. at 73-74.
45Hon. Ermita v. Hon. Aldecoa-Delorino, 666 Phil. 122, 132 (2011).
46Ocampo, et al. v. Rear Admiral Enriquez, et al., 798 Phil. 227, 294 (2016).
47Francisco, Jr., et al. v. Toll Regulatory Board, et al., 648 Phil. 54, 86 (2010).
48 Section 1. The judicial power shall be vested in the Supreme Court and in such lower courts as may be established by law.
Judicial power includes the duty of the courts of justice to settle actual controversies involving rights which are legally demandable and enforceable, and to determine whether or not there has been a grave abuse of discretion amounting to lack or excess of jurisdiction on the part of any branch or instrumentality of the Government.
49See Francisco, Jr. v. The House of Representatives, 460 Phil. 830, 883, 909-910 (2003).
50Association of Medical Clinics for Overseas Workers, Inc. (AMCOW) v. GCC Approved Medical Centers Association, Inc., et al., 802 Phil. 116, 139 (2016).
51Araullo, et al. v. President Benigno S.C. Aquino III, et al., 737 Phil. 457, 531 (2014).
52 G.R. No. 232395, July 3, 2018.
53 757 Phil. 534 (2015).
54 Id. at 544, citing Araullo, et al. v. President Benigno S.C. Aquino III, et al., supra at 531.
55 G.R. No. 225442, August 8, 2017.
56 Section 4 of Rule 65 provides:
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SEC. 4. When and where petition filed. - The petition shall be filed not later than sixty (60) days from notice of the judgment, order or resolution. In case a motion for reconsideration or new trial is timely filed, whether such motion is required or not, the sixty (60) day period shall be counted from notice of the denial of the said motion.
The petition shall be filed in the Supreme Court or, if it relates to the acts or omissions of a lower court or of a corporation, board, officer or person, in the Regional Trial Court exercising jurisdiction over the territorial area as defined by the Supreme Court. It may also be filed in the Court of Appeals whether or not the same is in aid of its appellate jurisdiction, or in the Sandiganbayan if it is in aid of its appellate jurisdiction. If it involves the acts or missions of a quasi-judicial agency, unless otherwise provided by law or these rules, the petition shall be filed in and cognizable only by the Court of Appeals.
No extension of time to file the petition shall be granted except for compelling reason and in no case exceeding fifteen (15) days.
57Chamber of Real Estate and Builders Assn., Inc. (CREBA) v. Sec. of Agrarian Reform, 635 Phil. 283, 300 (2010), citing Heirs of Bertuldo Hinog v. Hon. Melicor, 495 Phil. 422, 432 (2005).
58Arroyo v. DOJ, et al., 695 Phil. 302, 334 (2012).
59Dy v. Judge Bibat-Palamos, et al., 717 Phil. 776, 782 (2013).
60 751 Phil. 301 (2015).
61 Id. at 330-331.
62 Supra note 60.
63 Id. at 331.
64 Id. at 332.
65 Id.
66 Id. at 333.
67 Id.
68 Id. at 334.
69 Id.
70 Id. at 334-335.
71Congressman Garcia v. The Executive Secretary, et al., 602 Phil. 64, 73 (2009).
72 602 Phil. 64 (2009).
73 Id. at 73.
74Hon. Exec. Sec. Belgica, et al. v. Ochoa, Jr., et al., 721 Phil. 416, 519 (2013).
75Samahan ng mga Progresibong Kabataan (SPARK), et al., v. Quezon City, as represented by Mayor Herbert Bautista, et al., supra note 55.
76 Id.
77 G.R. No. 231671, July 25, 2017.
78Lawyers Against Monopoly and Poverty (LAMP), et al. v. The Secretary of Budget and Management, et al., 686 Phil. 357, 369 (2012).
79Philippine Constitution Association (PHILCONSA) v. Philippine Government (GPH), G.R. No. 218406, November 29, 2016, 811 SCRA 284, 297.
80 589 Phil. 387 (2008).
81 Id. at 486.
82See Hon. Drilon v. Mayor Lim, 305 Phil. 146, 150 (1994).
83ABAKADA GURO Party List (formerly AASJS), et al. v. Hon Purisima, et al., 584 Phil. 246, 268 (2008).
84Anak Mindanao Party-List Group v. Exec. Sec. Ermita, 558 Phil. 338, 350 (2007).
85Tolentino v. Commission on Elections, 465 Phil. 385, 402 (2004).
86 SECTION 1. Who may be parties; plaintiff and defendant. - Only natural or juridical persons, or entities authorized by law may be parties in a civil action. The term "plaintiff" may refer to the claiming party, the counter-claimant, the cross-claimant, or the third (fourth, etc.) - party plaintiff. The term "defendant" may refer to the original defending party, the defendant in a counterclaim, the cross-defendant, or the third (fourth, etc.) - party defendant.
87 Art. 44. The following are juridical persons:
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(1) The State and its political subdivisions;
(2) Other corporations, institutions and entities for public interest or purpose, created by law; their personality begins as soon as they have been constituted according to law;
(3) Corporations, partnerships and associations for private interest or purpose to which the law grants a juridical personality, separate and distinct from that of each shareholder, partner or member.
88 Sec. 4. Capacity. - Facts showing the capacity of a party to sue or be sued or the authority of a party to sue or be sued in a representative capacity or the legal existence of an organized association of person that is made a party, must be averred. A party desiring to raise an issue as to the legal existence of any party or the capacity of any party to sue or be sued in a representative capacity, shall do so by specific denial, which shall include such supporting particulars as are peculiarly within the pleader's knowledge.
89White Light Corp., et al. v. City of Manila, 596 Phil. 444, 456 (2009).
90Pharmaceutical and Health Care Assoc. of the Phils. v. Health Sec. Duque III, 561 Phil. 386, 396 (2007).
91Rollo, pp. 4-5.
92 Id. at 33-34 and 36-37.
93 Id. at 35.
PERLAS-BERNABE, J.:
I concur.
The present Petition for Certiorari and Prohibition filed by petitioner Private Hospitals Association of the Philippines, Inc. (PHAPi) should be dismissed due to its lack of legal standing, and the absence of an actual case or controversy.
The power of judicial review is the power of the courts to test the validity of the executive and legislative acts if they conform to the Constitution. Through such power, the judiciary enforces and upholds the supremacy of the Constitution. However, for a court to exercise this power, certain requirements must first be met, namely:
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In this case, PHAPi is not a hospital or medical clinic, but only an association of - as its name denotes - private hospitals. As such, PHAPi is not directly subject to the provisions of Republic Act No. (RA) 10932,2 and consequently, does not stand to suffer a real and apparent threat or injury so as to demonstrate its locus standi to file this petition. To be sure, while it claims that it represents the interests of its member hospitals, records are bereft of any showing that it was specifically authorized to file this case on their behalf. Hence, PHAPi's conveyed interests, through the distinct manner of argumentation in the petition, can only be attributed as its own.
(1) an actual case or controversy calling for the exercise of judicial power; (2) the person challenging the act must have "standing" to challenge; he must have a personal and substantial interest in the case such that he has sustained, or will sustain, direct injury as a result of its enforcement; (3) the question of constitutionality must be raised at the earliest possible opportunity; and (4) the issue of constitutionality must be the very lis mota of the case.1
Endnotes:
1Garcia v. Executive Secretary, 602 Phil. 64,73 (2009).
2 Entitled "AN ACT STRENGTHENING THE ANTI-HOSPITAL DEPOSIT LAW BY INCREASING THE PENALTIES FOR 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,' AS AMENDED BY REPUBLIC ACT NO. 8344, AND FOR OTHER PURPOSES," approved on August 3, 2017.
3 See Philippine Constitution Association v. Philippine Government, G.R. Nos. 218406, 218761, 204355, 318407, and 204354, November 29, 2016, 811 SCRA 284, 296-297.
LEONEN, J.:
I concur with the ponencia and add the following observations.
In this Petition for Certiorari and Prohibition under Rule 65 of the Rules of Court, petitioner Private Hospitals Association of the Philippines, Inc. (PHAPi), represented by its President, Dr. Rustico Jimenez, seeks to question the constitutionality of particular provisions of Republic Act No. 10932, otherwise known as the Act Strengthening the Anti-Hospital Deposit Law by Increasing Penalties for Refusal of Hospitals and Clinics to Administer Medical Treatment in Emergency or Serious Cases.
Petitioner asserts that the case is ripe for adjudication considering that there is an imminent threat that unconstitutional obligations and sanctions will be imposed on its members because of the impending approval of the implementing rules of Republic Act No. 10932.1 It also claims that it has the required locus standi because it stands to be directly injured by the implementation of Republic Act No. 10932, considering that its members' management and staff are placed at the risk of administrative, civil, and criminal liabilities.2 It further argues that in any case, the absence of a direct injury should not bar this Court from taking cognizance of this case as it raises issues that are of transcendental importance, particularly on denial of due process, equal protection of laws, and presumption of innocence.3
The ponencia notes that the requisites for this Court's exercise of the power of judicial review is not present in this case.4 It found that there is no actual case or controversy, and that petitioner does not have the required locus standi to file the petition.
It discusses that the requirement of an actual case or controversy is satisfied upon a prima facie showing of grave abuse of discretion in the governmental act. Likewise, a case is ripe for adjudication if there is an act of the government and an immediate or threatened injury to petitioner as a result of the act.5
The ponencia found that petitioner failed to meet the requirement. It notes that there is no allegation that petitioner or its members have suffered an actual or direct injury from any grave abuse of discretion. It found that the absence of the injury will render this Court's opinion as merely advisory.6
The ponencia further points out that the law is presumed constitutional and this cannot be overturned in the absence of any showing of grave abuse of discretion or any infraction of the Constitution.7 It posits that it would be delving into questions of policy and wisdom of the executive and legislative departments if it invalidated the law based on conjectures and suppositions.8
As to locus standi, the ponencia notes that Republic Act No. 10932 covers hospitals, medical facilities, medical practitioners, and employees, but not associations.9 Thus, in this case, the association is not the one who will be held liable for any violation of Republic Act No. 10932.10
Furthermore, while an association has the capacity to sue or be sued, it must still show a substantial interest such that it has sustained or will sustain a direct injury.11 While third-party standing may be invoked as an exception to the rule, the ponencia notes that petitioner failed to demonstrate that it had been authorized by its members to file the instant case.12
Thus, it did not take cognizance of the present petition.
I concur. This case is indeed not ripe for judicial review.
Canonical for the exercise of judicial review when the constitutionality of a law is being questioned are these requirements: first, there must be an actual case or controversy involving legal rights that are capable of judicial determination; second, the parties raising the issue must have locus standi; third, the constitutionality of the law must be raised at the earliest opportunity; and fourth, resolving the issue on constitutionality must be essential to the disposition of the case.13
Section 1. The judicial power shall be vested in one Supreme Court and in such lower courts as may be established by law.An actual case or controversy means that there are conflicting legal rights, such that the legal claim of one party is opposed to the legal claim of another, and it is capable of being resolved by the courts.14 It is necessary that the conflicting legal rights must be real and concrete, not merely hypothetical or conjectural.15
Judicial power includes the duty of the courts of justice to settle actual controversies involving rights which are legally demandabie and enforceable, and to determine whether or not there has been a grave abuse of discretion amounting to lack or excess of jurisdiction on the part of any branch or instrumentality of the Government. (Emphasis supplied)
It is well-established in this jurisdiction that . . . for a court to exercise its power of adjudication, there must be an actual case or controversy — one which involves a conflict of legal rights, an assertion of opposite legal claims susceptible of judicial resolution; . . . In other words, the pleadings must show an active antagonistic assertion of a legal right, on the one hand, and a denial thereof on the other; that is, it must concern a real and not a merely theoretical question or issue. There ought to be an actual and substantial controversy admitting of specific relief through a decree conclusive in nature, as distinguished from an opinion advising what the law would be upon a hypothetical state of facts.16 (Citations omitted)Thus, there must first be a real and material act affecting another, which one party asserts is done within the bounds allowed by law, but which another contends is injurious to his or her right. If there is yet no such act, or when such acts are merely conjecture, there is no actual case or controversy. In case of a governmental act, the party asserting its unconstitutionality must allege the actual act performed by the government that caused it the injury.
An aspect of the "case-or-controversy" requirement is the requisite of "ripeness". In the United States, courts are centrally concerned with whether a case involves uncertain contingent future events that may not occur as anticipated, or indeed may not occur at all. Another approach is the evaluation of the twofold aspect of ripeness: first, the fitness of the issues for judicial decision; and second, the hardship to the parties entailed by withholding court consideration. In our jurisdiction, the issue of ripeness is generally treated in terms of actual injury to the plaintiff. Hence, a question is ripe for adjudication when the act being challenged has had a direct adverse effect on the individual challenging it. An alternative road to review similarly taken would be to determine whether an action has already been accomplished or performed by a branch of government before the courts may step in.18 (Emphasis supplied, citations omitted)The requirement of an actual case or controversy is rooted on the respect for the separation of powers of the three branches of the government. Courts cannot supplant the discretionary acts of the legislative or the executive branch on the premise that they know of a wiser, more just, or expedient policy or course of action.19 They may only act in case the other branches acted outside the bounds of their powers or with grave abuse of discretion amounting to lack or excess of jurisdiction.
Basic in litigation raising constitutional issues is the requirement that there must be an actual case or controversy. This Court cannot render an advisory opinion. We assume that the Constitution binds all other constitutional departments, instrumentalities, and organs. We are aware that in the exercise of their various powers, they do interpret the text of the Constitution in the light of contemporary needs that they should address. A policy that reduces this Court to an adviser for official acts by the other departments that have not yet been done would unnecessarily tax our resources. It is inconsistent with our role as final arbiter and adjudicator and weakens the entire system of the Rule of Law. Our power of judicial review is a duty to make a final and binding construction of law. This power should generally be reserved when the departments have exhausted any and all acts that would remedy any perceived violation of right. The rationale that defines the extent of our doctrines laying down exceptions to our rules on justiciability are clear: Not only should the pleadings show a convincing violation of a right, but the impact should be shown to be so grave, imminent, and irreparable that any delayed exercise of judicial review or deference would undermine fundamental principles that should be enjoyed by the party complaining or the constituents that they legitimately represent.Moreover, hypothetical or conjectural situations illicitly widen the courts' discretion such that future parties who present claims on the law being interpreted may be unduly affected by the limitations set, without affording them the opportunity to be heard, thus:24
The requirement of an "actual case," thus, means that the case before this Court "involves a conflict of legal rights, an assertion of opposite legal claims susceptible of judicial resolution; the case must not be moot or academic based on extra-legal or other similar considerations not cognizable by a court of justice." Furthermore, "the controversy needs to be definite and concrete, bearing upon the legal relations of parties who are pitted against each other due to their adverse legal interests." Thus, the adverse position of the parties must be sufficient enough for the case to be pleaded and for this Court to be able to provide the parties the proper relief/s prayed for.
The requirement of an 'actual case' will ensure that this Court will not issue advisory opinions. It prevents us from using the immense power of judicial review absent a party that can sufficiently argue from a standpoint with real and substantial interests.23 (Citations omitted)
An advisory opinion is one where the factual setting is conjectural or hypothetical. In such cases, the conflict will not have sufficient concreteness or adversariness so as to constrain the discretion of this Court. After all, legal arguments from concretely lived facts are chosen narrowly by the parties. Those who bring theoretical cases will have no such limits. They can argue up to the level of absurdity. They will bind the future parties who may have more motives to choose specific legal arguments. In other words, for there to be a real conflict between the parties, there must exist actual facts from which courts can properly determine whether there has been a breach of constitutional text.25 (Emphasis in the original)Thus, in cases where the constitutionality of a law is being questioned, it is not enough that the law or the regulation has been passed or is in effect. To rule on the constitutionality of provisions in the law without an actual case is to decide only the basis of the mere enactment of the statute. This amounts to a ruling on the wisdom of the policy imposed by the Congress on the subject matter of the law.
Legal standing or locus standi is the "right of appearance in a court of justice on a given question." To possess legal standing, parties must show "a personal and substantial interest in the case such that [they have] sustained or will sustain direct injury as a result of the governmental act that is being challenged." The requirement of direct injury guarantees that the party who brings suit has such personal stake in the outcome of the controversy and, in effect, assures "that concrete adverseness which sharpens the presentation of issues upon which the court depends for illumination of difficult constitutional questions."The party filing must show that it has a substantial interest in the case such that it was or will be directly affected or injured by the challenged governmental act.
. . . .
Whether a suit is public or private, the parties must have "a present substantial interest," not a "mere expectancy or a future, contingent, subordinate, or consequential interest." Those who bring the suit must possess their own right to the relief sought.31 (Citations omitted)
This [modern] view fuses the legal identity of an association with that of its members. An association has standing to file suit for its workers despite its lack of direct interest if its members are affected by the action. An organization has standing to assert the concerns of its constituents.However, associations must sufficiently establish who their members are, that their members authorized them to sue on their behalf, and that they would be directly injured by the challenged governmental acts.38
. . . .
. . . We note that, under its Articles of Incorporation, the respondent was organized . . . to act as the representative of any individual, company, entity or association on matters related to the manpower recruitment industry, and to perform other acts and activities necessary to accomplish the purposes embodied therein. The respondent is, thus, the appropriate party to assert the rights of its members, because it and its members are in every practical sense identical . . . The respondent [association] is but the medium through which its individual members seek to make more effective the expression of their voices and the redress of their grievances.37 (Citation omitted)
The associations in Pharmaceutical and Health Care Association of the Philippines, Holy Spirit Homeowners Association, Inc., and The Executive Secretary were allowed to sue on behalf of their members because they sufficiently established who their members were, that their members authorized the associations to sue on their behalf, and that the members would be directly injured by the challenged governmental acts.In Executive Secretary v. The Hon. Court of Appeals,41 the Asian Recruitment Council Philippine Chapter, Inc. was found to have standing to file the petition for declaratory relief on behalf of its member recruitment agencies because it proved through board resolutions that it was authorized to sue on the behalf of its members. It was able to show that it was the medium used by the members to effectively communicate their grievances.
The liberality of this Court to grant standing for associations or corporations whose members are those who suffer direct and substantial injury depends on a few factors.
In all these cases, there must be an actual controversy. Furthermore, there should also be a clear and convincing demonstration of special reasons why the truly injured parties may not be able to sue.
Alternatively, there must be a similarly clear and convincing demonstration that the representation of the association is more efficient for the petitioners to bring. They must further show that it is more efficient for this Court to hear only one voice from the association.
In other words, the association should show special reasons for bringing the action themselves rather than as a class suit, allowed when the subject matter of the controversy is one of common or general interest to many persons. In a class suit, a number of the members of the class are permitted to sue and to defend for the benefit of all the members so long as they are sufficiently numerous and representative of the class to which they belong.
In some circumstances similar to those in White Light, the third parties represented by the petitioner would have special and legitimate reasons why they may not bring the action themselves. Understandably, the cost to patrons in the White Light case to bring the action themselves—i.e., the amount they would pay for the lease of the motels—will be too small compared with the cost of the suit. But viewed in another way, whoever among the patrons files the case even for its transcendental interest endows benefits on a substantial number of interested parties without recovering their costs. This is the free rider problem in economics. It is a negative externality which operates as a disincentive to sue and assert a transcendental right.40
There being no doctrinal definition of transcendental importance, the following determinants formulated by former Supreme Court Justice Florentino P. Feliciano are instructive: (1) the character of the funds or other assets involved in the case; (2) the presence of a clear case of disregard of a constitutional or statutory prohibition by the public respondent agency or instrumentality of the government; and (3) the lack of any other party with a more direct and specific interest in raising the questions being raised.43 (Citations omitted)Moreover, there must also be a showing of a "clear or imminent threat to fundamental rights" and of "proper parties suffering real, actual or more imminent injury,"44 thus:
In addition to an actual controversy, special reasons to represent, and disincentives for the injured party to bring the suit themselves, there must be a showing of the transcendent nature of the right involved.The petitioner was unable to prove that it was authorized by its members to file the instant case through board resolutions or through its articles of incorporation; I find, thus, that petitioner does not have the required standing to file the petition.
Only constitutional rights shared by many and requiring a grounded level of urgency can be transcendent. For instance, in The Association of Small Landowners in the Philippines, Inc. v. Secretary of Agrarian Reform, the association was allowed to file on behalf of its members considering the importance of the issue involved, i.e., the constitutionality of agrarian reform measures, specifically, of then newly enacted Comprehensive Agrarian Reform Law.
This Court is not a forum to appeal political and policy choices made by the Executive, Legislative, and other constitutional agencies and organs. This Court dilutes its role in a democracy if it is asked to substitute its political wisdom for the wisdom of accountable and representative bodies where there is no unmistakable democratic deficit. It cannot lose this place in the constitutional order. Petitioners' invocation of our jurisdiction and the justiciability of their claims must be presented with rigor. Transcendental interest is not a talisman to blur the lines of authority drawn by our most fundamental law.
. . . .
Again, the reasons cited—the "far-reaching consequences" and "wide area of coverage and extent of effect" of Department Order No. 118-12 and Memorandum Circular No. 2012-001—are reasons not transcendent considering that most administrative issuances of the national government are of wide coverage. These reasons are not special reasons for this Court to brush aside the requirement of legal standing.45 (Citations omitted)
Endnotes:
1Ponencia, p. 7.
2 Id.
3 Id.
4 Id. at 14.
5 Id. at 15.
6 Id.
7 Id.
8 Id. at 16.
9 Id.
10 Id. at 17.
11 Id. at 16-17.
12 Id. at 17.
13Levy Macasiano v. National Housing Authority, 296 Phil. 56, 63-64 (1993) [Per C.J. Davide, Jr., En Banc].
14Information Technology Foundation of the Philippines v. COMELEC, 499 Phil. 281, 304 (2005) [Per C.J. Panganiban, En Banc].
15 Id. See also Southern Hemisphere Engagement Network v. Anti-Terrorism Council, 646 Phil. 452, 479 (2010) [Per J. Carpio-Morales, En Banc].
16Information Technology Foundation of the Philippines v. COMELEC, 499 Phil. 281, 304 (2005) [Per C.J. Panganiban, En Banc].
17 607 Phil. 334 (2009) [Per C.J. Puno, En Banc].
18 Id. at 341.
19See Angara v. Electoral Commission, 63 Phil. 139 (1936) [Per J. Laurel, En Banc]; Garcia v. Executive Secretary, 602 Phil. 64 (2009) [Per J. Brion, En Banc].
20 Concurring Opinion of J. Leonen in Belgica v. Ochoa, 721 Phil. 416, 661 (2013) [Per J. Perlas-Bernabe, En Banc].
21 CIVIL CODE, art. 8.
22 721 Phil. 416 (2013) [Per J. Perlas-Bernabe, En Banc].
23 Id. at 661-662.
24Philippine Bus Operators Association of the Philippines, et al. vs. Department of Labor and Employment, G.R. No. 202275, July 17, 2018 [Per J. Leonen, En Banc].
25 Id. at 25.
26 646 Phil. 452 (2010) [Per J. Carpio-Morales].
27 718 Phil. 294 (2013) [Per J. Perlas-Bernabe, En Banc].
28 G.R. No. 202275, July 17, 2018 [Per J. Leonen, En Banc].
29Philippine Press Institute, Inc. v. Commission on Elections, 314 Phil. 131 (1995) [Per J. Feliciano, En Banc].
30See Dissenting Opinion of J. Leonen in Spouses Imbong v. Ochoa, Jr., 732 Phil. 1, 554-666 (2014) [Per J. Mendoza, En Banc].
31Philippine Bus Operators Association of the Philippines, et al. vs. Department of Labor and Employment, G.R. No. 202275, July 17, 2018 27-28 [Per J. Leonen, En Banc].
32Funa v. Villar, 686 Phil. 571, 585 (2012) [Per J. Velasco, Jr., En Banc].
33 See Funa v. Villar, 686 Phil. 571 (2012) [Per J. Velasco, Jr., En Banc].
34White Light Corp., et al. v. City of Manila, 596 Phil. 444, 456 (2009) [Per J. Tinga, En Banc].
35 561 Phil. 386 (2007) [Per J. Austria-Martinez, En Banc].
36 Id. at 396.
37 Id. at 395-396.
38Philippine Bus Operators Association of the Philippines, et al. vs. Department of Labor and Employment, G.R. No. 202275, July 17, 2018 32 [Per J. Leonen, En Banc].
39 G.R. No. 202275, July 17, 2018 [Per J. Leonen, En Banc].
40 Id. at 32-33.
41 473 Phil. 27 (2004) [Per J. Callejo, Sr., Second Division].
42 460 Phil. 830 (2003) [Per J. Carpio-Morales, En Banc].
43 Id. at 899.
44In Re Supreme Court Judicial Independence v. Judiciary Development Fund, 751 Phil. 30, 44 (2015) [Per J. Leonen, En Banc].
45Philippine Bus Operators Association of the Philippines, et al. vs. Department of Labor and Employment, G.R. No. 202275, July 17, 2018 33-34 [Per J. Leonen, En Banc].
CAGUIOA, J.:
The instant Petition for Certiorari (Petition) filed by Private Hospitals Association of the Philippines, Inc. (PHAPi) assails the constitutionality of select provisions of Republic Act No. 109321 (RA 10932), or the Act Strengthening the Anti-Hospital Deposit Law, i.e., Sections 1, 4, 5, 7, and 8 of the said law.
I concur with the ponencia that the instant Petition should be dismissed at the first instance because it does not present an actual case or controversy calling for the exercise of judicial power, and the petitioner has no personal and substantial interest in the case such that it has sustained, or will sustain, direct injury as a result of its enforcement.
In asking the Court to declare certain provisions of RA 10932 as unconstitutional for supposedly contravening the Constitution, the petitioner invokes the Court's power of judicial review under Section 4(2), Article VIII of the Constitution.2 The power of judicial review refers to the power of the courts to test the validity of executive and legislative acts for their conformity with the Constitution.3 Through such power, the judiciary enforces and upholds the supremacy of the Constitution.4 For the Court to exercise this power, it is indispensable that certain requirements must first be met, namely:
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The Petition here fails the first two (2) requisites.
(1) an actual case or controversy calling for the exercise of judicial power; (2) the person challenging the act must have standing to challenge; he must have a personal and substantial interest in the case such that he has sustained, or will sustain, direct injury as a result of its enforcement; (3) the question of constitutionality must be raised at the earliest possible opportunity; and (4) the issue of constitutionality must be the very lis mota of the case.5
SEC. 5. Presumption of Liability. — In the event of death, permanent disability, serious impairment of the health condition of the patient-complainant, or in the case of a pregnant woman, permanent injury or loss of her unborn child, proceeding from the denial of his or her admission to a health facility pursuant to a policy or practice of demanding deposits or advance payments for confinement or treatment, a presumption of liability shall arise against the hospital, medical clinic, and the official, medical practitioner, or employee involved.The petitioner finds Section 5, which makes the erring medical institution and/or practitioner prima facie liable for medical malpractice, unconstitutional on the notion that, in medical malpractice cases, the plaintiff must prove that the medical practitioner failed to do what a reasonably prudent doctor would have done or did what a reasonably prudent doctor would not have done. The petitioner adds that medical malpractice must be proven with reasonable medical probability based on competent expert testimony and that proximate cause of injury/death must be established.
"x x x [I]f the very injury has happened which was intended to be prevented by the statute, it has been held that violation of the statute will be deemed to be the proximate cause of the injury." x x xOtherwise stated, when a statute is created in order to prevent a certain injury, and such injury occurs when the statute is violated, then the violation of the statute will be deemed to be the proximate cause of the injury.
"The generally accepted view is that violation of a statutory duty constitutes negligence, negligence as a matter of law, or, according to the decisions on the question, negligence per se, for the reason that non-observance of what the legislature has prescribed as a suitable precaution is failure to observe that care which an ordinarily prudent man would observe, and, when the state regards certain acts as so liable to injure others as to justify their absolute prohibition, doing the forbidden act is a breach of duty with respect to those who may be injured thereby; or, as it has been otherwise expressed, when the standard of care is fixed by law, failure to conform to such standard is negligence, negligence per se or negligence in and of itself, in the absence of a legal excuse. According to this view it is immaterial, where a statute has been violated, whether the act or omission constituting such violation would have been regarded as negligence in the absence of any statute on the subject or whether there was, as a matter of fact, any reason to anticipate that injury would result from such violation. x x x"24 (Italics in the original omitted; emphasis, italics and underscoring supplied)
There is, of course, no constitutional objection to a law providing that the presumption of innocence may be overcome by a contrary presumption founded upon the experience of human conduct, and enacting what evidence shall be sufficient to overcome such presumption of innocence. The legislature may provide for prima facie evidence of guilt of the accused and shift the burden of proof provided there be a rational connection between the facts proved and the ultimate fact presumed so that the inference of the one from proof of the others is not unreasonable and arbitrary because of lack of connection between the two in common experience.31 (Emphasis and underscoring supplied)Applying the foregoing to the Presumption of Liability Clause, considering that it envisions a situation wherein a person who is in extremely urgent need of medical attention is denied treatment by a medical institution/practitioner due to an illegal policy or practice of demanding deposits/advance payments for confinement or treatment, and such person dies or is seriously injured immediately thereafter, there is undoubtedly a reasonable connection between the illegal act committed and the ultimate fact presumed, i.e., liability for the death or injury of the emergency patient.
Endnotes:
1 AN ACT STRENGTHENING THE ANTI-HOSPITAL DEPOSIT LAW BY INCREASING THE PENALTIES FOR 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 BLLANG 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", AS AMENDED BY REPUBLIC ACT NO. 8344, AND FOR OTHER PURPOSES.
2 See Garcia v. The Executive Secretary, 602 Phil. 64, 73 (2009).
3 Id. at 73.
4 Id.
5Francisco, Jr. v. The House of Representatives, 460 Phil. 830, 892 (2003).
6Ocampo v. Enriquez, 798 Phil. 227, 288 (2016).
7 Id. at 288.
8 Id.
9Board ofOptometry v. Colet, 328 Phil. 1187, 1206 (1996).
10Ocampo v. Enriquez, supra note 6, at 289-290.
11 Id. at 290.
12 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 administering basic emergency care to any patient, 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, or in the case of a pregnant woman, permanent injury or loss of her unborn child, or noninstitutional delivery: 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.
13 See Lucas v. Tuaño, 604 Phil. 98, 125 (2009).
14 RA 10932, Sec. 1.
15 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 One hundred thousand pesos (P100,000.00), but not more than Three hundred thousand pesos (P300,000.00) 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 Five hundred thousand pesos (P500,000.00), but not more than One million pesos (P1,000,000.00) or both, at the discretion of the court, without prejudice to damages that may be awarded to the patient-complainant: Provided, further, That upon three (3) repeated violations committed pursuant to an established policy of the hospital or clinic or upon the instruction of its management, the health facility's license to operate shall be revoked by the DOH. The president, chairman, board of directors, or trustees, and other officers of the health facility shall be solidarily liable for damages that may be awarded by the court to the patient-complainant.
16People v. Millora, 252 Phil. 105, 122 (1989).
17 23 Phil. 279, 289 (1912).
18 1987 CONSTITUTION, Art. II, Sec. 15.
19 See Añonuevo v. Court of Appeals, 483 Phil. 756, 766-767 (2004).
20 247-A Phil. 51, 56 (1988).
21 331 Phil. 1019 (1996).
22 Id. at 1027.
23 151-A Phil. 648 (1973).
24 Id. at 652.
25Spouses Africa v. Caltex (Phil.), Inc., 123 Phil. 272, 281-282 (1966).
26 See Ramos v. Cho Chun Chac, 54 Phil. 713, 715 (1930).
27Teague v. Fernandez, supra note 23, at 652.
28Añonuevo v. Court of Appeals, supra note 19.
29 271 Phil. 886 (1991).
30 92 Phil. 856, 858-859 (1953).
31Bañares v. Court of Appeals, supra note 29, at 897.
32 SEC. 7. PhilHealth Reimbursement of Basic Emergency Care. — PhilHealth shall reimburse the cost of basic emergency care and transportation services incurred by the hospital or medical clinic for the emergency medical services given to poor and indigent patients. Furthermore, the Philippine Charity Sweepstakes Office (PCSO) shall provide medical assistance for the basic emergency care needs of the poor and marginalized groups.
SEC. 8. Tax Deductions. — Other expenses incurred by the hospital or medical clinic in providing basic emergency care to poor and indigent patients not reimbursed by PhilHealth shall be tax deductible.
33Biraogo v. The Philippine Truth Commission of 2010, 651 Phil. 374, 459 (2010).
34 Id. at 459.
35 1987 CONSTITUTION, Art. XIII, Sec. 11.