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Officials defend Plan Vital expansions, cite provider payments and network adequacy
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Summary
Agency officials told the transition committee Plan Vital expanded services and increased provider payments, while saying network decisions—such as pharmacy participation—must balance federal rules and beneficiary access; investigations into some clinics were described as ongoing.
Agency officials told the transition committee that Plan Vital has expanded both coverage and the range of covered services and that large provider payments were made to retain clinicians and hospitals.
Speaker 3 said the agency served "más de uno punto tres millones de beneficiarios" and that it has "dedicado uno punto dos billones de dólares a pagos a proveedores para retenerlos en la isla." He added the agency had dedicated "más de ciento treinta y cuatro millones de dólares en expansión de servicios" for items such as nonemergency transport and durable medical equipment.
On pharmacy participation and the question of Walgreens entering the Vital network, Speaker 1 said the incoming administration and the plan administrator would make the decision, and stressed legal and federal rules that prioritize beneficiary access over protecting business sectors. "A nivel federal, nosotros no podemos proteger sectores, nosotros lo que podemos hacer es que el beneficiario esté bien servido," he said.
Agency officials said they are available to discuss network analyses with the incoming transition committee and to supply documentation that supports any contracting or network decisions. They also emphasized that major contracts or renewals above $10 million must be reviewed by the Fiscal Oversight Board under PROMESA, a process that can extend timelines for signature and implementation.
The agency noted it will continue reconciliation work with municipalities to ensure federal funds are applied appropriately to services and providers. Officials also said any outstanding transition queries would be answered in writing.
