The Senate overwhelmingly approved a bill Monday seeking to strengthen protections for patients and their families against hospitals that withhold their release over unpaid medical bills.

Eighteen of the 19 senators present voted in favor of Senate Bill 1511, principally authored and sponsored by Senator Risa Hontiveros, on third and final reading.

Senator Panfilo “Ping” Lacson abstained, citing his status as a “founding member of a local hospital in Cavite.” Lacson initially voted for the measure on second reading last week but changed his vote to abstention during the final reading.

The measure seeks to amend Republic Act 9439, which prohibits hospitals and medical clinics from detaining patients or withholding cadavers over unpaid bills.

Lawmakers supporting the bill said RA 9439, which has been in effect for nearly two decades, needs stronger enforcement amid reports of hospitals circumventing the law through a “palit-ulo” scheme, in which a family member is required to remain in the hospital as collateral for unpaid bills.

Hontiveros said hospitals have the right to collect payments to sustain their operations, but this should not come at the expense of patients’ basic rights.

“The answer to unpaid medical debt cannot be to hold a patient, a newborn child, a family member, or the remains of a loved one against their will,” she said. “Debts can be paid, but the dignity and freedom of Filipinos should not be used as collateral.”

Senators Bong Go and Erwin Tulfo likewise said withholding patients over unpaid bills could worsen their financial burden, as prolonged hospital stays only increase their outstanding balances.

“Our fellow Filipinos should not be subjected to this inhumane and humiliating practice,” Senator Mark Villar said.

Senator Raffy Tulfo said his office has received numerous complaints involving hospitals allegedly compelling parents to leave their newborns in the facility until their bills are settled.

SB 1511 would expand RA 9439’s coverage to patients in “any other similar facility” and include unpaid professional fees. It would also require patients with unpaid bills to execute a promissory note secured through mechanisms such as mortgages or government guarantee letters from the Department of Social Welfare and Development or the Department of Health.

Indigent senior citizens endorsed by a hospital’s medical social services office to the DSWD would be exempt from the promissory note requirement.

The bill would also mandate the immediate release of cadavers and the prompt issuance of death certificates and other documents needed for burial, benefit claims, or legal proceedings without requiring payment.

Violators could face up to two years in prison and a fine of P100,000 to P300,000. If the violation is committed under an established hospital or clinic policy or upon management’s 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 could result in the Department of Health revoking the facility’s license to operate.

Similar bills were filed in the House of Representatives during the 19th Congress but remained pending at the committee level. Counterpart measures to SB 1511 have yet to be taken up in committee.