Triple-S agrees to extend Medicaid contract to Sept. 30

Written by  //  July 6, 2017  //  Financial District, Insurance  //  No comments

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Triple-S is headquartered in Guaynabo. (Credit: © Mauricio Pascual)

Triple-S Management Corporation announced Wednesday its subsidiary, Triple-S Salud Inc., has agreed to extend its contract with the Puerto Rico Health Insurance Administration for the provision of health services in the Metro North and West regions of the government’s health insurance program, to Sept. 30, 2017.

This extension of the coverage that was to expire June 30 is intended to ensure the continuity of services while the parties conclude negotiations for the renewal of the contract through the remainder of the Commonwealth’s 2017-2018 fiscal year, which ends June 30, 2018.

Under the contract extension, ASES (as the Puerto Rico Health Insurance Administration is known by its initials in Spanish) will increase its payment to Triple-S Salud from a rate of $165.93 to $183.38 per member per month (PMPM) for the Metro North region and from $138.37 to $148.99 PMPM for the West region.

The new rates reflect cost and utilization trends for the 2016-2017 fiscal year, Triple-S said.

These new rates are subject to CMS approval, which is expected to occur during the 90-day extension period. Upon reaching an agreement on outstanding terms of the contract renewal, the new rates will also apply for the remainder of the 2017-2018 fiscal year.

The Puerto Rico health insurance program serves more than 1.4 million members in eight regions across Puerto Rico, with approximately 390,000 members in the two regions insured by Triple-S Salud.

“We’re pleased to have reached a financial agreement with the government of Puerto Rico to continue providing high-quality, cost-effective care to this extremely important patient population over the next three months,” said Roberto García-Rodríguez, CEO of Triple-S Management.

“We’re confident we will be able to reach an agreement with ASES on outstanding terms of the renewal negotiation, which will enable us to continue providing services for the remainder of the government’s 2017-2018 fiscal year,” he added.

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