The president of the Dominican Medical Guild (CMD) accused health plans (ARS) of placing themselves above the law and deciding which doctors can offer services. If the physician is not assigned a code in the ARS’s system, then that doctor will have difficulties participating in the Dominican medical system. Dr. Wilson Roa, president of the CMD, said that this affects the physicians who have been authorized by the Executive Branch to serve as doctors in the country.
The way the system works, if the physicians have not been assigned the ARS code, they cannot prescribe pharmaceuticals to be billed to the system, and their services are not authorized as payable by the health plans. Roa said this is a big obstacle for the medical practice in the country and especially affects low income patients. He said this is a situation that needs to be resolved.
Speaking during the interview with the Corripio Media Group were Wilson Roa Familia, Santos Ramírez, Carlos Roa, Fulgencio Severino and Alma Bobadilla.
“We doctors, after six or eight years of studies, what empowers us to do our medical work is the exequatur that the Executive Branch gives us. Now the ARS companies effectively decide whether you can practice or not and if you are not assigned a code, the prescriptions you write will not be valid in any pharmacy, because it will be rejected by the system,” said Carlos Roa.
Wilson and Carlos Roa criticized that the ARSs are paying physicians RD$262 per each patient consultation. Making matters worse, the transactions are on a credit basis, with the law giving the ARS 45 days to pay the health care bills. But he said that many ARS companies often take longer than that to pay, and God forbid if the physician makes a clerical error in the billing process which will undoubtedly lead to more delays in reimbursement for services rendered.
The physicians criticized what they called the lucrative nature that prevails in the Social Security Law 87-01, that they say was adjusted to benefit the financial capitals that now dominate the health system.
“The law was designed to cater to the ARS businesses enriching a few financial emporiums. In short, private ARS companies are big businesses and their role seems to boil down to manipulating clinics and doctors to maximize profits,” said Roa.
Ramírez advocated doctors should have a voice in the National Social Security Council to address problems within the health care system that are affecting patients and physicians alike. But as it stands, the financial companies that are the owners of the health plan companies are reaping huge profits.
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Hoy
16 May 2018
