P.R. Laws tit. 24, § 7033

2019-02-20 00:00:00+00
§ 7033. Models for rendering services

The Administration shall establish through regulations the different models for the rendering of services which may be used in offering the health plans created by this chapter.

The models for the rendering of services that are used shall have the following features in common:

(a) Primary care shall be strengthened by groups of professional physicians concerned with health and by other primary purveyors authorized to practice in Puerto Rico, as defined in applicable local and federal legislation and regulations.

(b) The emergency room care shall be of high priority, in the ambulance transportation system as well as in the emergency medical care.

(c) The Administration shall only contract with insurers that do not have any direct or indirect financial interest in, or relationship with subsidiary-owners or affiliates of a health facility that renders services to the beneficiaries of the health insurance created by this chapter, except with such health service organizations duly defined and authorized by the Insurance Commissioner.

(d) The models to be implemented shall have strict use control measures.

(e) All the models shall be reinforced by a health and prevention education system, with special emphasis on lifestyle, AIDS, drug abuse, and mother and child health. The Department shall be responsible for the promotion of health.

(f) The insurers and/or health service organizations shall include in their model of services to be rendered, the use of all Commonwealth facilities contracted with the private sector in the region.

History —Sept. 7, 1993, No. 72, Art. VI, § 9; Jan. 8, 1994, No. 1, § 2; renumbered as § 7 by Act Dec. 29, 2000, No. 463, § 7; July 19, 2002, No. 105, § 4; Dec. 29, 2003, No. 334, § 1; Aug. 8, 2010, No. 123, § 7.