Ten days before the Puerto Rico Health Insurance Administration (PRHIA) submits the Reform management contracts to the federal Government for approval, several participating insurance companies have expressed some concerns. The main issue is what will transpire when the Obamacare federal funds that Puerto Rico has received since 2011 run out.
“There are many concerns that affect the negotiation and extension of Mi Salud contracts. The uncertainty over getting additional funds, once the funds under the Patient Protection and Affordable Care Act run out,” recognized Madeline Figueroa, main operations official for Molina Healthcare.
They are also worried about “the implementation of cost-control initiatives that would impact the existing model for the provision of services.”
For Dorelisse Juarbe, senior vice president for the Triple-S Government Healthcare Plan’s business line, there are two great challenges in the contract negotiations: an increase in medication costs, and the cutbacks the Government seeks to impose to comply with the Fiscal Plan.
While acknowledging that the pharmacy costs have exhibited a double-digit increase since July of 2016 in regions managed by Triple-S, Juarbe highlighted that this exceeds the PRHIA’s national tendencies and projections for this fiscal year, which is why the Government has proposed savings initiatives that are currently being evaluated.
“We are sure that our experience and commitment to healthcare services will be a great contribution to guarantee access to the population and maintain outstanding services before the new challenges we are facing as a nation,” said Mayra Rivera, spokesperson for First Medical.
Myriam Aguilú, spokesperson for MMM and PMC, indicated that they would not comment because they are currently undergoing a negotiating process with the PRHIA.
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