This Tuesday the Superintendency of Health Services, a decentralized body dependent on the Ministry of Health in charge of Carla vizzotti, established a typification in three broad categories for prepaid medicine companies: as indicated by the Resolution 1950/2021 published in the Official Gazette.
The different private health entities will be classified as Type A, B or C based on economic-financial, demographic and administrative information that these must provide to the national State in a term of 90 days in a row starting this Tuesday.
Prepaid worried and alert for the surprise resolution of the government
With this measure, the Government now requires from prepaid medicine companies updated information regarding “all of their full coverage plans and partial, booklets, user padrn, fees received and average fee, balance, etc”.
Through the presentation of this information, the prepaid must request their inclusion in the different categories. All entities that are currently registered in the National Registry of Prepaid Medicine Entities (RNEMP), either way definitive or provisional.
In case of not complying with the requirements, the Superintendency of Health Services provisionally classify to the different companies based on the information previously presented.
In addition, as indicated by Resolution 1950, in the absence of data on the part of prepaid companies, the body that acts in the orbit of the Ministry of Health “will be empowered to intimate the presentation of any missing information, arrange to carry out comprehensive audits, Start summary proceedings for the purposes of determining the appropriateness of applying sanctions and, even, proceed to deregister the defaulting entity in case of not correcting its breach “.
Medicines: Government and laboratories agreed to freeze the price of all medicines until January
Prepaid: due to the increases, the contracting of low-cost health plans grows
THE DIFFERENT CLASSIFICATIONS
Based on the different structures of prepaid medicine companies, the Government established three large groups for typing:
- The Type A It is made up of entities that meet the following requirements:
- Provide at least a comprehensive coverage plan (not partial) based on the provisions of Law 26,682, which proposes a regulatory framework for prepaid medicine;
- Count on more than 50,000 users; and
- Have a average capita per user equal to or greater than $ 4000. This last value “will be updated in the same proportion and opportunities in which the quota increases of the benefit plans are made effective.”
- The Type B It will be integrated by entities that have at least one comprehensive coverage plan based on the provisions of Law 26.682 but that do not meet the other requirements of Type A
- The Type C It is made up of companies that do not comply with none of the requirements previously raised.
To the entities of Type A “Trustees, auditors and / or supervisors will be appointed” to analyze what is presented and, if additional information is required, they will have the power to request it and / or “promote the necessary corrections or adjustments”.
For their part, the companies of Type B will also be verified by the same individuals but these will be designated rotationally depending on the case, the availability and based on “criteria of analysis of risk or merit, opportunity and convenience”. Finally, what was presented by the prepaid Type C to be verified only in case of suspicion or whistleblowing.
Based on these permits, the Superintendency of Health Services is empowered to require all necessary additional information whether demographic, epidemiological, benefits, economic, financial or of any other type that is pertinent.
Medical consultations change: now they are by cell phone and without “real” doctors
POINT BY POINT, ALL THE INFORMATION TO BE PRESENTED
Entities registered in the National Registry of Prepaid Medicine Entities (RNEMP) must submit the following information:
- its updated user pad (until December 31 of this year);
- Details of current plans that market to the general public, with their updated valuess for each age group and family group;
- Balance sheet year-end with the opinion of an independent public accountant, duly certified;
- Interim Statements with Professional Report, or report that contains the income received, expenditures made and that accounts for the assets assigned to the activity and the debts generated by it.