Puerto Rico Health Department supports project to regulate medical service fees

In a recent meeting of the Puerto Rico House of Representatives, significant discussions centered around a proposed health care bill aimed at addressing critical issues within the island's health system. The bill, known as Cámara 1 3 2, seeks to establish fair billing practices between health care providers and insurers, ensuring that patients are not burdened with excessive charges for services not fully covered by their insurance plans.

The Department of Health emphasized its constitutional responsibility to safeguard the health of all Puerto Ricans. The Secretary of Health highlighted the need for an effective system to provide immediate health services, which is crucial for preserving lives. The proposed legislation responds to a pressing concern: the current insurance reimbursement rates often do not reflect the actual costs of health services, leaving both patients and providers vulnerable.

Key provisions of the bill include a mandate for the Puerto Rico Insurance Commissioner to set reasonable billing limits for providers within 90 days. Additionally, the bill calls for an annual review of these rates to ensure they remain aligned with economic conditions and market realities. This mechanism aims to create a more sustainable and equitable health care environment by allowing providers to charge reasonable fees when insurers do not cover the full cost of services.

The Department of Health expressed strong support for initiatives that prioritize patient welfare and public health. They noted that the introduction of "commercially reasonable" rates is essential to protect patients from excessive charges while also supporting health care providers financially. However, they recommended that the definition of "commercially reasonable" be explicitly included in the bill to avoid ambiguity.

As the legislative process moves forward, the outcomes of this bill could significantly impact the quality and accessibility of health care services for residents of Puerto Rico, fostering a more balanced relationship between insurers and providers while safeguarding patient interests.