The bill also grants another $200 million annually over two years if the government of Puerto Rico allocates at least 70 percent of Medicaid funds to pay for outpatient services providers. (Archive)

The U.S. Senate voted yesterday to advance the spending bill including the up to $5.742 billion in Medicaid funds for Puerto Rico over two federal fiscal years and that, along with another measure will prevent a partial federal government shutdown at midnight tonight and amid the Christmas holidays.

Although the packaged negotiated in Congress was reduced by half, the allocation for fiscal years 2020 and 2021 will represent, on average, the largest amount of annual Medicaid funds for the island.

President Donald Trump must sign the bill approved Tuesday in the Senate in the next few hours.

The measure increases from 55 percent to 76 percent the federal contribution for Medicaid services on the island and directly allocates $2.623 billion during federal fiscal year 2020, which began in October, and $2.719 billion in 2021.

The bill also grants another $200 million annually over two years if the government of Puerto Rico allocates at least 70 percent of Medicaid funds to pay for outpatient services providers.

After last summer's corruption scandal involving the Health Insurance Administration (PRHIA), the legislation requests a reform of the hiring process for the Puerto Rican government's health plan, which will now depend more than ever on Medicaid funds.

To avoid losing up to 2.5 percent of the Federal Medical Assistance Percentage (FMAP), the government must submit a plan in 12 months to reform the hiring process for the health plan, appoint an official to ensure the integrity of the program in six month, and in an 18-month period and in coordination with the Centers for Medicaid and Medicare Services (CMS), comply with the regulations seeking to prevent errors in payments and establish quality controls on program eligibility.

Wanda Vázquez Garced had already anticipated that the Puerto Rican government would run out of Medicaid funds as of February.

"The $5.7 billion over two years (represents, on average,) the largest allocation of Medicaid funds achieved for our island and takes us out of any fiscal concerns with health funds over the next few years," said Washington Resident Commissioner Jenniffer González.

Originally, the U.S. Senate leadership and the U.S. House sought to allocate nearly $12 billion to Puerto Rico over four federal fiscal years with more oversight measures on the island's government.

However, the White House Office Office of Management and Budget –the agency that stopped emergency relief funds after Hurricane María- indicated they blocked the funding deal for the island –and reduced Medicaid funds from about $12 billion to $5.7 billion- because of the history of corruption they attribute to the island´s government.

"This administration remainscommitted to properly prioritizing U.S. taxpayer dollars," said Wednesday Chase Jennings, a spokesperson for the White House Office of Management and Budget to a request of information from El Nuevo Día. "With the historical waste we have faced in Puerto Rico, additional funding was not needed or fiscally responsible," he added.

In messages to Congress, the Puerto Rican government committed to using the increase in Medicaid funds to ensure that more funds go to paying suppliers and hospitals, financing medicines for hepatitis C patients, covering the cost for "dual" Medicare plan B patients (those who buy a Medicare Advantage plan) and to raise the minimum income require to access Medicaid.

Elliot Pacheco, vice president of Empresarios por Puerto Rico ( Entrepreneurs for Puerto Rico) and owner of a pharmacy in Cayey, recently stressed the importance of using these new Medicaid funds to cover the payment that dual participants have to make to finance Medicare Part B, which covers outpatient medical services.

A patient can pay up to $144.60 per month for Medicare Part B coverage.

If Medicaid funds cover Part B, patients can save up to $1,735 annually and that could represent an injection of over $200 million, according to data the Puerto Rican government presented in Congress.


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