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Federal gov’t approves new healthcare model for P.R.

Puerto Rico Gov. Ricardo Rosselló announced that the Center for Medicare and Medicaid (CMS) approved Puerto Rico’s newly established publicly funded health insurance model, known as “Vital,” which currently provides essential medical coverage to over a million citizens on the island.

“We’re grateful to the federal government for approving Puerto Rico’s health insurance model. Our patients now have the right to decide which insurer and which health providers respond best to their needs,” said Rosselló.

Puerto Rico’s “Vital” plan provides medical coverage to those that cannot afford traditional medical plans while allowing patients to choose their preferred insurance company and healthcare providers.

The new model allows patients to choose among five insurers and their health providers such as doctors, laboratories, therapists and hospitals, among others. In addition, each insurer must have a network of services throughout Puerto Rico to allow greater mobility and freedom of choice for patients.

Rosselló added that “patients have until Jan. 31 of this year to request any change of insurer and thus be able to use another provider network. At present, more than 450,000 patients have opted to change their insurer.”

The Chairman of the Board of Puerto Rico’s Health Insurance Administration (known as ASES for its initials in Spanish) and Secretary of the Department of Health, Rafael Rodríguez, said “this approval demonstrates the professional and correct work we have done for the benefit of our patients that today have more than 5,000 providers in ‘Vital’.”

Meanwhile, the Executive Director of ASES, Angela Avila, said “we’re extremely pleased with the decision by CMS regarding the “Vital” plan. It allows us immediate access to the federal funds allocated by Congress retroactively to Nov. 1, 2018. ”

Ávila added that “this decision should end any uncertainty that some sectors tried to raise. ‘Vital’ is here to stay and will give our patients more rights.”

The approval by CMS is given pending a process that includes demonstrating compliance with existing regulations.

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