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Private health companies are preparing to comply with the ruling: when will they present the refund scheme and which companies it covers - Infobae
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Las prepagas se preparan para acatar el fallo: cuándo presentarán el esquema de devolución y a qué empresas abarca
Las claves del fallo de la Justicia en favor de la medida cautelar que presentó la Superintendencia de Seguros de la Salud del gobierno de Javier Milei
www.infobae.com
May 03, 2024
The keys to the ruling of Justice in favor of the precautionary measure presented by the Superintendency of Health Insurance of the government of Javier Milei; how companies reacted
Measure against prepaid
In the Superintendency of Health Insurance this afternoon there was an exultant atmosphere due to the court ruling that ordered prepaid medicine companies to limit their increases to inflation and, above all, return what they overcharged since last December.
According to the court request that the Ministry of Health had promoted, through the Superintendence of Health Services. This implies, according to the ruling granted to the Government that:
- Leaves increases without effect from 12/1/2023 onwards
- Returns the quota values to 1/12/2023, which must be updated according to the CPI
- Set a period of five days for prepaid medicine companies to present a plan stating how they are going to return what they overcharged people.
- The universe is the 23 companies that were in the precautionary of the Superintendency, which represent 95% of the users of the prepaid medicine entity.
Three of the main companies in the sector assured that they are analyzing the ruling, but that they will abide by it. “What Justice says will be done. We have 5 days to present the return proposal. These are decisions that companies, in general, are going to abide by. I don't imagine anyone failing to comply," they added from one of them.
During this Friday, there were contacts from the Ministry of Commerce led by Pablo Lavigne with some companies to adjust the increase scheme detailed yesterday by the Government and that the companies had already been applying. “There were some doubts, but in the end everything was fine. And in the middle this failure fell. Let's see how we continue. The appeal instance is an option, of course,” they said from another of the market firms.
Gabriel Gonzalo Oriolo, health superintendent
These are the following companies:
- ACA Health
- British Hospital Association of Buenos Aires
- Mutual Association of the Hierarchical Staff of National Official Banks.
- Sancor Mutual Association.
- Center for Medical Education and Clinical Research.
- Lomas de Zamora Medical Circle.
- Galen Argentina
- Grupo DDM
- German Hospital
- Essential Medicine
- Medicine Prepays Man
- Medife
- Medicus Prepaid Medicine
- OF
- Federated Mutual June 25 Reciprocal Protection Society.
- Social Work of the Luis Pasteur Health Directorate.
- Social Work of the Union of Civil Personnel of the Nation.
- Omint Prevention Health SA
- Integrated System of Health Providers SA
- Italian Benevolent Society in Buenos Aires.
- Swiss Medical S.A.
The precautionary clarifies that "no judicial presentation is necessary in this case, so that individuals must channel their claims and/or reports of non-compliance in the manner informed by the Ministry of Industry and Commerce of the Nation, this channel being the most suitable for such purposes.” In addition, it orders “the referral to the case of the administrative files reported in the record and finally informs the plaintiff that it must inform all the agents of the Health system that are marketing health coverage, whether prepaid medicine companies or social works with authorization to offer superior plans or whatever they are called.”
In this matter, the Government acted on two levels: on the one hand, the National Commission for the Defense of Competition ordered health companies to limit their increases to the consumer price index (CPI) through an administrative resolution; On the other hand, the Superintendency of Health appeared before the Court with this request for reimbursement, which of course leaves room for an appeal from one of the companies involved.
The Government, which had released health prices, reversed its steps and began this battle, which will allow it to reduce the consumer price index (CPI) between half and one point in May, according to private calculations.
