In short
Act 35-1994 provides that every hospital, public or private, to whose emergency room a patient comes and requests medical treatment, must give them an adequate medical evaluation to determine whether a medical emergency condition exists or, in the case of a pregnant person with apparent labor symptoms, whether they are in labor, regardless of whether the person can pay for the services. The evaluation and emergency service must be offered regardless of race, color, sex, age, religion, birth, ethnic or national origin or identification, political ideology, physical or mental disability, socioeconomic condition, gender identity, sexual orientation or immigration status. No public or private medical-hospital institution may require any information on the immigration status of its patients or of their parents, guardians and custodians, including vaccination services. If the evaluation reveals an emergency or that the patient is in labor, the hospital must provide, according to available facilities and resources, the treatment necessary to stabilize the condition or assist in the delivery, or arrange a transfer under the law. Anyone denied care or transferred because they cannot pay may file a complaint within one (1) year before the Medical Examining Board or the Auxiliary Secretariat for the Regulation and Accreditation of Health Facilities. Every emergency room must display a sign alerting the public to these rights.
What is it?
It is the law that separates two things hospitals sometimes mix: who pays, and who gets evaluated. The adequate medical evaluation in the emergency room is not conditioned on your ability to pay, your immigration status, or any of the characteristics the law enumerates. What can be charged is the evaluation itself, if it turns out it was not an emergency.
Who can do it?
Anyone who comes to the emergency room of a hospital, public or private, and requests medical treatment. The law defines a medical emergency as a health condition in which, unforeseen, medical assistance or first aid becomes necessary as soon as possible in order to preserve health or reduce the harm or disability that may arise from an automobile or other accident, or from an illness.
Requirements
- Coming to the emergency room of a hospital, public or private, and requesting medical treatment.Verified against the official source
- For the Article 5 complaint: that medical assistance was denied or you were transferred to another hospital because you could not pay, and that the complaint be filed within one (1) year.Verified against the official source
Documents you need
Information pending verification.
Cost
Step by step
Step 1: The evaluation does not depend on your ability to pay
The text says it in a single sentence: an adequate medical evaluation must be performed to determine whether a medical emergency condition exists, “regardless of whether the person can pay for the medical services rendered.” The list of characteristics that likewise cannot condition it expressly includes gender identity, sexual orientation and immigration status.
Step 2: They cannot ask your immigration status
It is a separate prohibition and it reaches beyond the emergency room: no public or private medical-hospital institution may require any information on the immigration status of its patients or of their parents, guardians and custodians, who come seeking medical-hospital services, including vaccination services.
Step 3: If there is an emergency or labor: stabilize, or transfer properly
When the evaluation reveals a medical emergency condition or that the patient is in labor, the hospital must provide, according to available facilities and resources, the treatment necessary to stabilize the condition or assist in the delivery, or arrange a transfer to another institution under the law. And if the condition has not been stabilized, or the woman is in labor, the hospital may not transfer her unless the patient or the legally responsible person requests it, or a physician or other qualified medical personnel certifies in writing that the benefits reasonably expected from treatment at the other institution outweigh the increased risk of the transfer.
Step 4: What makes a transfer proper
The law defines it with three conditions: that the receiving institution have available space and qualified personnel, accept the transfer, and accept providing proper medical treatment; that the transferring hospital provide the receiving institution the medical records or copies of them on the examinations and treatments administered; and that the transfer be carried out by qualified personnel using proper transportation equipment, including appropriate life-support means during the transfer. Also, the physician in charge of the evaluation must make, or ensure that arrangements have been made for, the patient’s acceptance.
Step 5: What can be charged
This has to be said in full for the guide to be genuinely useful: once the patient is evaluated and it is determined that it is not an emergency, the patient must pay for that medical evaluation according to their resources. What the law guarantees without a payment condition is the evaluation and emergency service, not that everything is free.
Step 6: The complaint: one year, and the form is in the room
Every patient with a medical emergency condition and every woman in labor who comes to the emergency room and who, because they cannot pay, is denied medical assistance or transferred to another hospital in violation of this law, may file within one (1) year a complaint before the Medical Examining Board or the Auxiliary Secretariat for the Regulation and Accreditation of Health Facilities, against the person, physician or hospital. The Secretary of Health must design an official form to be available in every emergency, urgent care or stabilization room. The complaint may be filed by the patient or an authorized representative.
Step 7: Look for the sign, and note it if it is missing
Every hospital, public or private, is obligated to place in its emergency, urgent care or stabilization rooms a sign alerting the public to their rights and guarantees under this law. A missing sign is a fact worth noting in the complaint.
Step 8: The penalty for knowingly violating it
Every natural or legal person who knowingly violates this law’s provisions commits a misdemeanor, punished with a fine ranging from five thousand (5,000) to a maximum of twenty-five thousand (25,000) dollars, set at the Court’s discretion. The limitations period for this offense is three (3) years. That period is different from the one year you have for the administrative complaint: do not confuse them.
Where to do it
The law names two forums for the complaint: the Medical Examining Board and the Auxiliary Secretariat for the Regulation and Accreditation of Health Facilities, and charges the Department of Health with investigating; if the investigation indicates a violation, the case shall be referred to the Secretary of Justice to bring the corresponding action. The Office of the Patient Advocate is the other complaint door we cover separately. If the issue is the ambulance bill or a surprise bill, those are their own guides.
How long it takes
What to do if something goes wrong
The limits of what we say here. The duty to stabilize is written “according to available facilities and resources,” and that phrase is the statute’s: the law does not promise that any hospital can give you any treatment. The law also establishes two presumptions in the hospital’s favor: it is presumed to have complied if it offered additional examinations or treatment to stabilize and the patient or the person acting on their behalf refused consent, and it is presumed to have complied if it offered the transfer under the law and consent was refused. What we did not read: the federal statute the compilation mentions in a bracketed note when defining “Anti Dumping Act” — the compiler notes it may refer to EMTALA, 42 U.S.C. 1395dd — we did not read it, so we describe no federal remedy and do not compare it with this one. Nor did we read any Department of Health regulation or the official complaint form, so we publish no fields, internal administrative deadlines or step-by-step investigation procedure. And we publish no costs: the law sets no rates and only says that, if the evaluation determines it was not an emergency, the patient pays according to their resources.
Common mistakes
- Leaving when told they will not see you without insurance: the evaluation does not depend on ability to pay.
- Handing over immigration status information: no medical-hospital institution may require it.
- Accepting an unstabilized transfer without the physician’s written certification.
- Letting the year lapse: the Article 5 complaint is filed within one (1) year.
- Confusing that year with the three-year limitations period for the offense.
- Not asking for the official form: it must be available in every emergency, urgent care or stabilization room.
Frequently asked questions
Can they deny me care for not having insurance?
The adequate medical evaluation must be performed regardless of whether the person can pay for the medical services rendered. If the evaluation reveals an emergency or that the patient is in labor, the hospital must provide, according to available facilities and resources, the treatment necessary to stabilize or assist in the delivery, or arrange the transfer under the law.
Can they ask about my immigration status?
No. No public or private medical-hospital institution may require any information on the immigration status of its patients or of their parents, guardians and custodians, who come seeking medical-hospital services, including vaccination services.
How long do I have to file the complaint?
One (1) year, before the Medical Examining Board or the Auxiliary Secretariat for the Regulation and Accreditation of Health Facilities. The patient or an authorized representative may file it.
Can they charge me if it turned out not to be an emergency?
Yes. The law provides that, once the patient is evaluated and it is determined that it is not an emergency, the patient must pay for that medical evaluation according to their resources.
Official sources
These are the government pages this guide is based on.
- Departamento de Salud de Puerto Rico
Salud
bvirtualogp.pr.gov
- Department of Health
Departamento de Salud
www.salud.pr.gov
Last verified
August 24, 2026
MiPRFácil is an independent informational website and is not affiliated with, endorsed by, or operated by the Government of Puerto Rico or any government agency.
MiPRFácil does not submit applications on your behalf.
Was this guide helpful?
Did you find out-of-date information?
Your rights as a patient: what the Bill of Rights says
Act 194-2000 made plain: emergency access regardless of ability to pay, information before deciding, your medical record, and the right to appeal a denial.
Complaint to the Patient Advocate: health plan, hospital or provider
It covers insurers, mental health organisations and health service providers. It can be filed with a phone call.
9-1-1 ambulance: your plan pays the provider directly
Act 129-2019 requires every basic plan to cover emergency ground ambulance and to pay the provider directly, minus deductibles and copays.
After childbirth: 48 hours of hospital, 96 if it was a C-section
Act 248-1999 requires the plan to cover a minimum 48 hospital hours after an uncomplicated vaginal birth and 96 hours if there was a C-section.
Insurance: 15 days to acknowledge, 90 to resolve, 30 to reconsider
Article 1.120 of the Insurance Code puts dates on your claim and bars treating an unaccepted cheque as a waiver of your claims.
Emergency price freeze: it is automatic and the fine is $10,000
Since Act 52-2019, prices of essential goods freeze automatically when the emergency is declared. Who enforces it and how big the fine is.