The health of the most vulnerable Puerto Ricans should not be at the mercy of disproportionate considerations such as those that seem to emerge with a cut in Puerto Rico Medicaid funds for fiscal years 2020 and 2021.
A reduction to the $ 12 billion package, previously recommended by Congress to fund four years of Medicaid services on the island, tightens the budget for health care services for the poorest population. The White House set a cap of $ 5,742 billion for just two fiscal years and strict conditions for additional Medicaid program items.
By alluding to waste and irresponsibility in the use of federal funds, the federal administration has tried to ensure that Puerto Rico receives fewer funds during the only two years approved. As a result, uncertainty remains over the long-term funding of the Vital plan, primarily funded by Medicaid.
Among other conditions, Puerto Rico has to adopt a plan to reform the hiring process for the health program in 12 months, in order to avoid losing 2.5 percent of the annual federal contribution. This would represent $ 175 million less over the fiscal years mentioned above.
In Puerto Rico, Medicaid funds are even more crucial at this historic moment, since recovery from the severe impact of Hurricane Maria is still an ongoing process, partly due to the delay in releasing federal allocations.
Insufficient health care funds could affect Medicaid patient care and boost an exodus of health professionals.
In no way do we condone improper actions in the use of federal funds, including alleged violations of law in the Health Insurance Administration still to be resolved in court. It is the responsibility of the Puerto Rican government to ensure there will be no mismanagement of federal or state public resources.
The Puerto Rican government must undoubtedly comply with the new federal rules established to access Medicaid funding, including the appointment of an external resource to ensure the integrity of the program’s operations. The government should lead efforts to enforce controls seeking to avoid payment errors while promoting the continuity of quality services.
However, assuming that Puerto Rico is incapable of taking actions seeking to correct these problems, and punishing the island´s most vulnerable population under that premise, looks like an extreme measure.
The Puerto Rico False Claims Act-2018 created a Medicaid fraud control unit. The statute provides for the prosecution of criminal and civil actions and includes penalties for recovery and/or restitution for loss or damage.
Besides Medicaid.pr.gov also makes it easy to confidentially report irregular or fraudulent situations. The website includes recommendations for patients to avoid exposing themselves to misuse of their health cards and to protect themselves from improper practices by any service provider or unscrupulous individuals.
It is urgent to seek that federal authorities reconsider this crucial issue, directly related to the wellbeing of the poorest patients, whose fundamental right to health must be respected. Any effort in this regard by the medical community and other health professionals who provide services to 1.25 million patients in Medicaid on the island is also very valuable.
Puerto Rico should eloquently demonstrate that it can handle federal and state resources with fiscal responsibility. Likewise, the U.S. government must fulfill its commitment to U.S. citizens in Puerto Rico, regardless of political considerations. Approving adequate Medicaid funding is an important step in that task.