ARS will have to return money to affiliates
SD. The superintendent of Health and Labor Risks (Sisalril) said that the conflict between the otorhinolaryngologists (ENTs) and several Health Risk Administrators (ARS) is unacceptable. It has left the affiliates of the Family Health Insurance (SFS) without the specialized service and they have increased the collection of fees from patients in a unilateral and un-advised fashion. Pedro Luis Castellanos said that he cannot conceive that such a damaging conflict situation for the affiliates can continue, without advancing negotiations by part of the ARS and the health service providers involved and that these actions increase the social inequality and put at risk the health of the people.
Castellanos met last week and yesterday with the president of the Dominican Society of Otorhinolaryngology, William Aude, and with the representatives of the Dominican Association of Health Risk Administrators (Adars), in an attempt to find a solution to the differences which they have, because the doctors want to have increases in their fees for operations from RD$25,000 and RD$30,004 per procedure to RD$50,000.
“Provisionally, while the conflict persists, the ARS will have to repay the affiliates the expenses in which they incur, according to the current fee structure,” warned Castellanos.
“We have given a reasonable time frame (he did not specify how much time) in order that they do away with the actions which prejudice the patients and achieve agreements between the service providers and the ARS; to the contrary, Sisalril will adopt the decisions which correspond to the safeguarding of the population, which could include establishing the tariffs that will be enforced until the new PBS (Basic Health Plan) is approved by the Council,” said Castellanos.
The executive director of ADARS, José Manuel Vargas, rejected this last position by Castellanos, because he feels that this is a power of the CNSS, and therefore it should be eliminated in his statements. “We do not have resources to revise the fee structure, that is until they do not update the per capita fees,” Vargas noted.
For her part, Nelsida Marmolejos, the head of the Directorate of Information and Defense of the Affiliates of Social Security (DIDA), said that the suspension of medical services by the DNT’s violates the Constitution and Law 87 – 01, which establishes that health is a obligatory public service to be granted in the case of need.
July 9, 2015
Category: DR News |