The National Health Insurance (Senasa) announced it is suspending the contracts of 10 private primary care centers that serve patients under the subsidized health plan. The move, effective immediately, will shift these centers from a fixed-rate payment model to a pay-per-service system. The announcement comes as the government health insurance plan seeks to unravel much criticized contracting with private medical providers. The scheme negatively impacted the resources of the government public health system.
Previously, the government had said the finances of the entity were hurting because of the expansion of two million people in the subsidized plan. Yet, new reports indicate actions under the Santiago Hazim management, many times to favor private entities, have weakened the finances.
According to a statement from Senasa, this decision is a response to the agency’s ongoing financial struggles. Senasa’s new executive director, Edward Guzmán, stated the change aims to ensure resources are used “more equitably and transparently,” with payments tied directly to the services provided to patients.
The suspension is part of a broader strategy to optimize primary healthcare, Guzmán said. “We are concentrating state resources on a model that allows us to ensure greater sustainability, strengthen the public network, and offer better services to our subsidized plan members,” he explained.
The agency noted the measure will be implemented gradually. The affected centers will continue to provide services for 30 days following the notification, giving them time to discuss the new payment model with Senasa.
The announcement comes after the investigative news program, Nuria Piera Investiga has been releasing findings of complacent contracting with private firms in detriment to medical services offered by the state health plan management entity. Senasa handles over seven million insured customers, including more than two million people who do not pay into the plan.
To compensate for the drop in Senasa resources, the government recently allowed the transfer of resources from Iddopril, the health risk management entity.
The central government has been injecting extra funds into Senasa to ensure it maintains its services.
The new director of Senasa, Edward Guzman and the director of the Superintendence of Medical Insurance companies (Sisalril), Miguel Ceara Hatton submitted the initial investigations on irregularities in the past administration to the Attorney General Office. Guzman was appointed to the position in August 2025 and Ceara Hatton in August 2024. Former Senasa head, Altagracia Marcelino Guzman criticized he leadership at the Sisalril for not acting earlier.
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15 September 2025