(No. 9) (Approved February 12, 2007) AN ACT

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1 (H.B. 3040) (No. 9) (Approved February 12, 2007) AN ACT To amend subsection (j) of Section 2 of Act No. 194 of August 25, 2000, as amended, better known as the Bill of Rights and Responsibilities of the Patient, in order to clarify and adjust the definition of Patient pursuant to the Code of Laws now in effect. STATEMENT OF MOTIVES In seeking to visibly contribute to the formation of a better informed, more conscious, responsible and healthy public which would foster the most efficient use of the resources available, Act No. 149 of August 25, 2000, as amended, better known as the Bill of Rights and Responsibilities of the Patient, was approved. Besides the continuous search for solutions to the changes brought about by the implementation of Act No. 72 of September 7, 1993, better known as the Puerto Rico Health Insurance Administration Act, and Act No. 194, supra, Act No. 11 of April 11, 2001, as amended, was approved To create the Office and position of the Advocate for Patients Beneficiaries of the Health Reform. Section 3 of Act No. 11, supra, establishes the responsibility of the Advocate for Patients for guaranteeing to the patients compliance with the rights consigned in the Bill of Rights and Responsibilities of the Patient and for coordinating, handling, and solving the problems, needs, and claims

2 of said patients, users and consumers of medical-hospital health services in Puerto Rico. However, when the Office of the Advocate for Patients was created, Section 2 of Act No. 194, supra, was not amended, since its subsection (j) limits the definition of the term Patient, to all subscribers under a Health Care Plan. From the outset, this definition is incomplete and erroneous since having a health plan is not what defines a person as patient. The same is not a wholly proper definition of what a patient is according to the present Code of Laws. A patient is not only a subscriber to a health care plan but also that person who is or shall be subject to treatment for a physical or mental condition. A patient is that person who for the sole purpose of obtaining medical treatment, or a preliminary diagnosis for said treatment, consults a physician or subjects him/herself to an examination conducted by the latter. Compare with Rule 26 of the Rules of Evidence, according to Ortíz García v. Meléndez, 2005 T.S.P.R. 19. In fact, we believe that the amendment to be considered has to include the definition herein proposed as part of the definition already contained in the Bill of Rights and Responsibilities of the Patient. Furthermore, an interpretation of the statute would lead to the conclusion that those who do not have a health plan would not be covered under the rights set forth in the Bill of Rights and Responsibilities of the Patient, establishing from the outset discrimination because of their economic resources for obtaining a health plan. To this, it must be added that the Constitution of the Commonwealth of Puerto Rico in its Art. II, sec. 2 provides that no discrimination whatsoever may be established because of origin or social condition, among others. In providing that, no discrimination whatsoever may be established because of origin or social condition, the Supreme Court

3 of Puerto Rico has construed that this refers to discrimination or ranking on the basis of the economic or social position or situation a persons holds in society. The constitutional value that inspires this construction is based on the premise that there should be no ranking, favoritism, or prejudice against a person due to his/her socioeconomic position. Pérez Vega v. Procuradora Especial de Relaciones de Familia, 148 D.P.R. 201 (1999), see also the concurrent opinion in Molina v. C.R.U.V., 114 D.P.R. 295 (1983). In other words, if discrimination is incurred against a person who is kept in social and economic isolation and is thus put in a situation of juridical inferiority because of said social condition, said discrimination would presumably be unconstitutional. Such discrimination is precisely contradictory to the equal access and treatment general objectives of the legal system in effect in relation to the rights of the patient. The impropriety of discrimination may be alleged because if there is no health plan there is no access to the representation and assistance that can be provided by the Office of the Advocate for Patients when faced with conduct harmful to the rights of the latter exhibited by both public and private entities. This Legislature believes that this is a better legal definition for the Bill of Rights and Responsibilities of the Patient. BE IT ENACTED BY THE LEGISLATURE OF PUERTO RICO: Section 1.-Subsection (j) of Section 2 of Act No. 194 of August 25, 2000, as amended, is hereby amended to read as follows: Section 2.-Definitions For the purposes of this Act, the following terms shall have the meaning indicated below: (a)

4 (b) (j) Patient : refers to those persons who are or shall be subject to treatment for their health, be it because of a physical or mental condition, and who consult a health professional or submit themselves to an examination by the latter for the purpose of obtaining information for staying in good health, obtaining a diagnosis of their state of health or for the treatment of an illness or injury affecting their health, including preventive diagnoses or treatments for the early detection of possible illnesses or complications of those already diagnosed and for prolonging the life and improving the quality of life of those with existing complications, regardless of whether they are or are not subscribers or beneficiaries of a public or private Health Care Plan. (k) Section 2.-This Act shall take effect one hundred and eighty (180) days after its approval.

5 CERTIFICATION I hereby certify to the Secretary of State that the following Act No. 9 (H.B. 3040) of the 5 th Session of the 15 th Legislature of Puerto Rico: AN ACT to amend subsection (j) of Section 2 of Act No. 194 of August 25, 2000, as amended, better known as the Bill of Rights and Responsibilities of the Patient, in order to clarify and adjust the definition of Patient pursuant to the Code of Laws now in effect, has been translated from Spanish to English and that the English version is correct. In San Juan, Puerto Rico, today 17 th of April of Francisco J. Domenech Director

(No. 277) (Approved December 12, 2002) AN ACT

(H.B. 2175) (No. 277) (Approved December 12, 2002) AN ACT To amend the first paragraph of subsection (d) of Section 37(a) of Act No. 55 of May 12, 1933, as amended, known as the Banking Act of Puerto Rico,