Tiong Bi, Inc. vs. Philippine Health Insurance Corporation

SECOND DIVISION

February 20, 2019

G.R. No. 229106

TIONG BI, INC. [Owner of Bacolod Our Lady of Mercy Specialty Hospital], Petitioner vs. PHILIPPINE HEALTH INSURANCE CORPORATION, Respondent

DECISION

REYES, J. JR., J.:

Before us is a petition for review on certiorari1 under Rule 45 of the Rules of Court, assailing the Resolutions dated August 10, 20162 and January 12, 20173 of the Court of Appeals (CA) in CA-G.R. SP No. 144704, denying Tiong Bi, Inc.'s (petitioner) Extremely Urgent Motion for Immediate Issuance of Temporary Restraining Order.

The instant petition is rooted from charges of "Padding of Claims" and "Misrepresentation by Furnishing False and Incorrect Information" against petitioner before respondent Philippine Health Insurance Corporation (PhilHealth). These charges, in turn, stemmed from similar charges against two PhilHealth-accredited eye surgeons, who used petitioner's facilities and the services of its staff to attend to the needs of said physicians.4

Briefly, the charges of fraudulent benefit claims include padding of prescriptions and recommending of medicines and supplies such as oxygen and intravenous fluids not needed by the patients nor actually provided by the hospital or the doctors.5

In a Decision dated August 1, 2008, PhilHealth's Arbitration Department dismissed the charges against the two doctors for lack of merit. This Decision was affirmed by the PhilHealth Board.6

On the other hand, in PhilHealth Board Resolution No. 2040, S. 2016 dated February 24, 2016, PhilHealth affirmed with modification the July 30, 2010 Decision of Arbiter Darwin G. De Leon, finding petitioner guilty, for the second time, of a fraudulent offense. In accordance with the Revised Internal Rules of the PhilHealth Board on Appealed Administrative Cases, the reduced penalty of six months and one day suspension of accreditation and a fine of P10,000.00 for each count of Padding of Claims for a total of PI 70,000.00 were imposed upon petitioner. It was further ordered that the restitution for any payment made by PhilHealth for the claim/s subject of the case be made by petitioner or be charged and deducted from the proceeds of any pending or future claims of petitioner with PhilHealth. Lastly, petitioner was sternly warned that a repetition of the same or similar offense shall be dealt with more severely.7

Aggrieved, petitioner appealed the said PhilHealth Resolution before the CA through a petition for certiorari under Rule 43 of the Rules of Court. Petitioner likewise filed therein an Extremely Urgent Motion for Immediate Issuance of Temporary Restraining Order (TRO). Petitioner basically argues that the PhilHealth Resolution was erroneous for allegedly being based on a wrong case, which was said to be heard by a different arbiter. Also, petitioner insists that the charges against the two doctors were dismissed for lack of merit, the charges against it which were grounded upon the same set of facts should likewise be dismissed.8

As for the motion for issuance of TRO, petitioner cited the general concepts of public interest, public health, and safety to support its claim of irreparable injury and urgency. Specifically, petitioner averred that it is one of the biggest health providers in Negros and the threatened closure of its hospital by virtue of the subject PhilHealth Resolution would impede the health measures it can provide to contain certain epidemic in the country. According to petitioner, the flawed PhilHealth Resolution put in grave peril the safety, life and health of the patients confined in its hospital.9

In its August 10, 2016 Resolution,10 the CA denied petitioner's motion for issuance of TRO, finding no actual existing right to be protected on the part of the petitioner nor the possibility of irreparable injury.

In its January 12, 2017 Resolution,11 the CA likewise denied petitioner's motion for reconsideration of the August 10, 2016 Resolution.

Notably, the main case remains to be pending with the CA for resolution.

Petitioner now comes before this Court through the instant petition for review on certiorari under Rule 45 of the Rules of Court on the pretext that it is grounded on pure questions of law. Specifically, petitioner contends that the CA erred in refusing to issue an injunctive writ, endangering, thus, public safety and exposing the public to the hazard and risk of a health crisis. Reiterating its argument in its pending appeals before the CA, petitioner argues that the threatened closure of its hospital would put the safety, life, and health of its confined patients to grave peril. Further, petitioner avers that closing a major health service provider such as petitioner's hospital, in a region with few hospitals, would create a crisis.

Petitioner also assails in the instant petition the subject PhilHealth Resolution, pointing out that it was based on a wrong case; that it has no factual and legal bases; and that it was based merely on surmises, guesswork, and assumptions, among others.

We resolve.

At the outset, it should be pointed out that the petitioner resorted to an improper remedy before this Court. Section 1(c), Rule 41 of the same Rules expressly provides that no appeal may be taken from an interlocutory order. An interlocutory order, as opposed to a final judgment or order, is one that does not dispose of the case completely but leaves something to be decided upon. Petitioner resorted to a petition for review on certiorari under Rule 45 of the Rules of Court to question the denial of its motion for issuance of an injunctive relief. An order granting or denying an application for a TRO or a preliminary injunction is interlocutory in nature and, thus, unappealable. The proper remedy is to file a petition for certiorari and/or prohibition under Rule 65 of the same Rules.12

Furthermore, a close reading of the arguments raised by the petitioner would readily show that they are factual in nature. While petitioner is ascribing grave abuse of discretion on the part of the CA in denying its motion for TRO, it basically seeks to enjoin the implementation of the PhilHealth Resolution questioned before the CA for allegedly being unfounded and erroneous. Undoubtedly, such endeavor would require an examination of evidence. Petitioner is questioning before this Court the exact same PhilHealth Resolution being questioned before the CA at present and on the same grounds raised therein. It is basic that a petition for review under Rule 45 of the Rules of Court may raise only questions of law. This Court is not a trier of facts and we are not duty-bound to re-examine evidence especially when the court a quo had not yet even ruled on the merits of the main case.13 To rule otherwise would effectively preempt the proceedings before the CA.

The present petition may, thus, be dismissed outright for being an improper remedy.14

At any rate, even if we treat this case as a petition under Rule 65, it shall still fail for lack of merit.

The grant or denial of a TRO or an injunctive writ rests on the sound discretion of the court taking cognizance of the case, since the assessment and evaluation of evidence towards that end involves findings of facts left to the said court for its conclusive determination. Verily, the exercise of judicial discretion by a court in injunctive matters must not be interfered with, unless there is grave abuse of discretion.15

The only issue, therefore, that confronts us is limited to the matter of whether the CA's denial of petitioner's motion for issuance of TRO was tainted with grave abuse of discretion.

In the issuance or denial of an injunctive writ, grave abuse of discretion implies a capricious and whimsical exercise of judgment equivalent to lack of jurisdiction; or the exercise of power in an arbitrary or despotic manner by reason of passion, prejudice or personal aversion amounting to an evasion of positive duty or to a virtual refusal to perform the duty enjoined or to act at all in contemplation of law.16

In this case, the Court finds no grave abuse of discretion on the part of the CA in denying the issuance of a TRO.1'шphi1

To be entitled to the injunctive writ, petitioner must show that (1) there exists a clear and unmistakable right to be protected; (2) this right is directly threatened by an act sought to be enjoined; (3) the invasion of the right is material and substantial; and (4) there is an urgent and paramount necessity for the writ to prevent serious and irreparable damage.17

As correctly ruled by the CA, essential for the grant of the injunctive relief is the existence of an urgent necessity to prevent serious damage. A TRO is issued only if the matter is of such extreme urgency that grave injustice and irreparable injury will arise unless it is issued immediately. Parenthetically, the burden is on the petitioner to show in the application that there is meritorious ground for the issuance of the TRO in its favor.18 In this case, we are one with the CA in finding that the petitioner failed to discharge such burden.

To support its claim of urgency and irreparable injury, petitioner sweepingly concluded that-the penalty imposed by the subject PhilHealth Resolution would prejudice not only its current patients but also the public in general as they will be deprived of one of the few health providers in the region if the penalty will be implemented.

This argument deserves scant consideration.

As stated, petitioner is not the only health service provider in the region. Hence, the suspension of its PhilHealth accreditation and the imposition of fine against it will not, in any way, hamper the delivery of health care services to the public, contrary to what the petitioner would want to impress to this Court. More importantly, it should be stressed that the subject PhilHealth Resolution merely imposes a fine and the suspension of the hospital's PhilHealth accreditation not the closure of the hospital. Hence, neither will petitioner's health care services be forestalled by the implementation of the penalty sought to be restrained. If at all, it is merely the members' benefits which may temporarily be hampered when the penalty is implemented. Such damage, if any, is easily quantifiable and, as such, cannot be considered as "grave and irreparable injury" as contemplated under the law. The Court in Heirs of Melencio Yu v. Court of Appeals,19 citing Social Security Commission v. Bayona20 explained the concept of irreparable damage or injury as follows:

Damages are irreparable within the meaning of the rule relative to the issuance of injunction where there is no standard by which their amount can be measured with reasonable accuracy. "An irreparable injury which a court of equity will enjoin includes that degree of wrong of a repeated and continuing kind which produce hurt, inconvenience, or damage that can be estimated only by conjecture, and not by any accurate standard of measurement." x x x

Here, the only possible injury which may be perceived is easily subject to mathematical computation.

In sum, this Court finds no reversible error, much less, grave abuse of discretion, on the part of the CA in denying the motion for the issuance of the TRO. What is more, the prevailing rule is that the courts should avoid resorting to interlocutory injunctive reliefs that would in effect preempt the resolution of the main case.

WHEREFORE, premises considered, the instant petition is DENIED. The Resolutions dated August 10, 2016 and January 12, 2017 of the Court of Appeals in CA-G.R. SP No. 144704 are AFFIRMED. The Court of Appeals is DIRECTED to resolve CA-G.R. SP No. 144704 with dispatch.

SO ORDERED.

Carpio, Senior Associate Justice, (Chairperson), Perlas-Bernabe, Caguioa, and Hernando,* JJ., concur.

Footnotes

*Additional Member per S.O. No. 2630 dated December 18, 2018.

1 Rollo, pp. 11-78.

2 Penned by Associate Justice Japar B. Dimaampao, with Associate Justices Franchito N. Diamante and Zenaida T. Galapate-Laguilles, concurring; id. at 102-104.

3 Id. at 123-124.

4 Id. at 16.

5 Id. at 23.

6 Id. at 19-20.

7 Id. at 26-30.

8 Id. at 30-31.

9 Id.

10 Supra note 2.

11 Supra note 3.

12 Australian Professional Realty, Inc. v. Municipality of Padre Garcia, Batangas, 684 Phil. 283, 291 (2012).

13 See Department of Public Works and Highways v. City Advertising Ventures Corp., 799 Phil. 47, 58-59 (2016).

14 Ortega v. Social Security Commission, 578 Phil. 338, 346 (2008).

15 Barbieto v. Court of Appeals, 619 Phil. 819, 835 (2009).

16 AMA Land, Inc. v. Wack Wack Residents' Association, Inc., G.R. No. 202342, July 19, 2017.

17 Australian Professional Realty, Inc. v. Municipality of Padre Garcia, Batangas, supra note 12, at 292.

18 Brizuela v. Dingle, 576 Phil. 611, 622 (2008).

19 717 Phil. 284, 301 (2013).

20 115 Phil. 106, 110-111 (1962).