HIMA STROKE CENTER IN DANGER DUE TO BILLING AND HEALTHCARE PLAN PROBLEMS

According to the article published in the newspaper El Nuevo Día on November 4, 2016, titled “Peligran servicios a pacientes de derrames cerebrales”  by Marga Parés Arroyo, the Primary Stroke Center located at Hospital HIMA San Pablo Caguas is in danger due to problems with its billing and to problems with the healthcare plans, private and from the government. The Primary Stroke Center is the only center in Puerto Rico dedicated in treating stroke patients and since June 9, 2016 it has ceases operations temporarily due to the two neurologists in charge quitting. Doctor María Mercedes Toledo, endovascular neurosurgeon, stated that the fact that the treatment of these patients is so high (the first 6 hours of treatment costs between $20,000 to $24,000 per patient), it makes it difficult for the healthcare plans to refund the costs, which threatens the specialized service that the center provides. According to Dr. Iván del Toro, HIMA San Pablo Caguas’ Medical Director, Molina Healthcare denies a lot of the hospital’s invoices and presently owes the hospital 27 million dollars. Likewise, HIMA San Pablo Caguas’ has confronted problems with the healthcare plans and presently some of the hospital’s personnel have filed complaints against Molina Healthcare requesting the payment of 3 million dollars for services provided. On another note, according to Mr. Irving Jiménez, Director of “Servicios Médicos de la Adminsitración de Servicios Médicos” (ASEM), the Primary Stroke Center at Hospital HIMA San Pablo Caguas will be resuming its operation during the next two weeks, since they have contracted the services of a specialist part-time.

To read the complete article, please access the following link http://www.elnuevodia.com/noticias/locales/nota/peligranserviciosapacientesdederramescerebrales-2258589/

THE GOVERNMENT HEALTHCARE PLAN, MEDICARE AND THE FISCAL CONTROL BOARD

According the newspaper article “Piden a la Junta Fiscal prioridad para la salud”, published on September 6, 2016 on El Nuevo Día, the College of Administrators of Health Services of Puerto Rico (CASS) has requested an analysis of the country’s health system. Ramón Alejandro Pabón, President of CASS, stated that there are is reliable data that present the reality of the health industry in Puerto Rico and that impedes the implementation of a public policy, therefore he proposes the creation of a commission independent from the health system, that within its powers, has the faculty to gather trustworthy data, eliminate the health system’s bureaucracy and established a real picture of Puerto Rico’s actual situation. Pabón believes that the help from the Fiscal Control Board is necessary in order to achieve a parity of funds and access to other forms of income that guaranty better services for patients. He also believes that health must have a higher priority.

Pabón also express his concerns over the access to resources by patients from the health reform due to the differences between the Medicare tables that apply to Puerto Rico. He believes that around 150,000 patients could found themselves without the health reform if the Fiscal Control Board demands that the reform be limited to the tables established by Medicare, having said patients then to go to the emergency rooms in order to be treated.

Pabón also proposes a Medicare “vouchers” plan or program, through which patients would be buying a healthcare plan according to an established amount in those vouchers, creating then competitiveness between healthcare providers which in turn would cause them to offer better services that covers the patients necessities, better options among hospitals, economic increase, decrease among the people who leave the country and hospitals would not be forced to close down floors.

The CASS has also demanded the need that Medicare treats Puerto Rico the same as the rest of the states. According to the article, contrary to the states, in Puerto Rico Medicare is limited by the limits established by the Federal Government and the necessary funds to cover the Medicare program’s necessities, which exceed the limits, come from the local funds, contributing to the deficit which the country is going through.

The article also expresses that recently it has been rumored the possibility of decreasing the federal funds budget regarding the Medicare and Medicaid programs for the year 2017 to the amount of $1,200,000.00. According to the healthcare representatives, if the Fiscal Control Board were to accept said action, Puerto Rico’s health system could collapse

To read the complete article, access the following link: http://elcovero.com/piden-a-la-junta-fiscal-prioridad-para-la-salud/  

EXODUS FROM PUERTO RICO BY DOCTORS ATTRIBUTED TO INSURANCE COMPANIES

According to the article of July 28th, 2016 of the newspaper El Nuevo Dia by Marga Parés Arroyo, doctors attribute insurance companies as the reason of their exodus from Puerto Rico. Doctor David Bragin, who was interviewed for this article, indicated that he refuses to lower the quality of the treatment to patients. Said doctor indicates that he considers it to be a sad situation that insurance companies are the ones who determine the time that a doctor takes examining a patient. This was one of the reasons why Dr. Bragin decided to move to the State of Washington with his family. The article indicates that from the 14,000 doctor practicing in Puerto Rico by 2006, only 9,000 remain active. The article also includes as the reasons attributed to the exodus of doctors from Puerto Rico the following: 1) lower rates by the insurance companies; 2) delay in payments by insurance companies and denial of the services provided; 3) delay and denial of insurance companies in the concession of number of providers to doctors recently graduated; 4) few residencies in Puerto Rico; 5) increase in the medical malpractice premiums due to frivolous lawsuits; 6) lower payments to Medicare and Medicaid Puerto Rico and 7) the expulsion of Medicare providers without reason.

To read the complete article, access the following link:  http://www.elnuevodia.com/noticias/locales/nota/merehusoabajarlacalidad-2224944/.

TAX EXEMPTION FOR DOCTORS AND MEDICAL MALPRACTICE SPECIALIZED COURTROOMS 

According to the newspaper article titled “Exención contributive para evitar el éxodo de los medicos” published in El Vocero de Puerto Rico on September 7, 2016, the candidate for governor for the “Partido Nuevo Progresista” (PNP), Ricardo Roselló, has proposed extending a tax exemption to doctors that would last between 15 to 20 years. Said proposal origins as a method to avoid and decrease the exodus of doctors from the Island. According to Roselló’s exemption plan, doctors would be allowed to have a tax rate of 4%, while doctors must reside and work as doctors in Puerto Rico in order to receive the exemption.  The exemption plan would also establish a 2 year term for doctors to accept the tax benefit.

Said candidate also proposes the creation of an arbitrage model, based on the Florida and Georgia models, through which specialized courtrooms would be created in order to attend medical malpractice suits. Under the arbitrage model proposed by Roselló, the judges in charge of these courtrooms would have a legal and medical expertise, every case would be given a medical consideration since the courtrooms would be specialized and setting limits in this type of cases would not be needed.

To read the complete article access the following link: http://elvocero.com/exencion-contributiva-para-evitar-el-exodo-de-medicos/

HEALTH CRISIS  IN PUERTO RICO

“Health Services in Jeopardy in the Island” was the title of the article published by newspaper “El Nuevo Día” on April 29, 2016, where the crisis in the country is undergoing due to the hospitals decision to close departments and floors and the exodus of doctors from Puerto Rico.

You can access the article at the following electronic address. http://www.elnuevodia.com/noticias/locales/nota/peligranlosserviciosdesaludenlaisla-2193022/

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