上诉法院已指示位于碧瑶市的圣母查特尔医院（Notre Dame de Chartres Hospital）向近十年前被拒绝给予强制性折扣的老年患者退还908,116比索。6月18日的裁决还将罚款金额从770万比索减至70,000比索。
上诉法院第11特别分庭确认了该医院根据第7875号共和国法案应承担的行政责任，因为该院未落实法定的12%增值税豁免和20%老年人折扣。针对该设施的投诉于2018年提出，导致菲律宾健康保险公司（PhilHealth）早先做出裁定，基于77项独立指控处以770万比索的罚款。
在判决书中，法院明确了扣除的正确顺序：首先是增值税豁免，其次是老年人折扣，最后是任何PhilHealth福利。该医院曾辩称其账单不适用销项增值税，但法官们认为这一解释缺乏法律依据。
该裁决要求医院向受影响的患者进行全额赔偿，同时在处罚方面将这些违规行为视为单一违规事件。圣母查特尔医院由圣保罗查特尔天主教修女会运营，目前仍是PhilHealth的认证服务提供商。
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