Wednesday, June 22, 2011

AHPR: MCS owes $50M for Mi Salud

AHPR: MCS owes $50M for Mi Salud

By : AURA N. ALFARO

The Puerto Rico Hospitals Association (AHPR by its Spanish acronym) said Monday that insurer MCS owes several local healthcare institutions more than $50 million in accumulated debt for services provided to patients under the local government’s Mi Salud program.
AHPR President Jaime Plá called for the government to intervene to resolve the situation.
“The hospitals could reach a point where they would only see Mi Salud patients with medical emergencies, and each institution will be forced to take measures and make their own decisions on what course of action to take regarding what MCS owes them,” Plá said in statement.
Plá noted MCS owes several hospitals more than $50 million for services rendered during the past month, stating the institutions need the money to cover operational costs, including payroll, and basic necessities for hospitalized patients.
The AHPR issued the statement after Puerto Rico Health Insurance Administration (ASES by its Spanish acronym) Executive Director Frank Díaz said Monday that he and two other cabinet members — Treasury Secretary Jesús Méndez, and Office of Management & Budget Executive Director Juan Pavía – had met with representatives of MCS Health Management Organization (HMO), the division that handles its Mi Salud contract, and reached an agreement.
According to the release, MCS HMO will receive “a substantial disbursement from ASES that, according to the insurer, would allow it to establish a normal payment schedule with providers.”
MCS and Humana Health Plans of Puerto Rico provide physical-health coverage, while APS Healthcare provides mental-health services, under the government-funded health reform program for more than 1 million beneficiaries, which was revamped under the Fortuño administration as Mi Salud.
MCS administers the metro north, north, west, northeast and San Juan regions, while Humana administers the east, southeast and southwest regions.

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