P.R. Laws tit. 24, § 7035

2019-02-20 00:00:00+00
§ 7035. Financing of the Administration and of the health insurance plan; other revenues

The health insurance plan established in this chapter, and the operating expenses of the Administration, shall be defrayed as follows:

(a) Health insurance plan. — For the 1993-94 fiscal year the sum of eighteen million dollars ($18,000,000) is hereby appropriated to the Administration from unencumbered funds in the Commonwealth Treasury. For subsequent years, a special self-renewable appropriation shall be consigned in the budget of expenses of the Administration, according to the needs of the health insurance plan. In addition, for the 1993-94 and subsequent fiscal years, the Administration shall be appropriated the savings generated by the Department by establishing of Act No. 103 of June [July] 12, 1985, as amended.

(b) Operating expenses. — For the 1993-94 fiscal year the sum of one million dollars ($1,000,000) is hereby appropriated to the Administration from unencumbered funds in the Commonwealth Treasury. For subsequent years, the operating expenses shall be consigned in the Joint Resolution of the General Budget of Expenses of the Government of Puerto Rico.

(c) Any additional unencumbered appropriations received by the government as of the 1993-94 fiscal year from the Federal Medicaid Program and other applicable federal funds.

(d) The budgetary appropriation of the municipal governments for direct health services in areas covered by health insurance plans shall be based on the percentages set forth in the following Table of Regular Funds Budgets of the municipalities, excluding the Special Surtax (CAE, Spanish acronym) and federal funds, using as base the regular funds budget of the previous fiscal year as of July 1, 1997.

$0 — $10,000,000 = 5%

$10,000,001 — $29,000,000 = 6%

$29,000,001 — $39,000,000 = 7%

$39,000,001 — $49,000,000 = 8%

$49,000,001 — $59,000,000 = 9%

$59,000,001 — $79,000,000 = 10%

$79,000,001 — $89,000,000 = 12%

$89,000,001 — $100,000,000 = 15%

$100,000,001 — henceforth = 17%

The Municipal Revenues Collection Center, henceforth CRIM, shall prorate between the monthly payments a sufficient amount to satisfy the contribution corresponding to each municipality according to the percentage established and shall remit the same on or before the tenth (10th) day of each month to the Insurance Health Administration.

While the schedule of the municipal contribution to the cost of the health reform for fiscal year 2005-2006 and for subsequent years is revised, the municipalities shall contribute an amount equal to the percentage established for fiscal year 2004-2005 or the present one, whichever is less, as provided in their budget. In the case of the Municipality of San Juan, it shall contribute the amount resulting from the application of the table to the budget for fiscal year 2004-2005, or the present one, whichever is less. For those municipalities that render direct or indirect preventive health services, CRIM shall withhold the payment to ASES until this institution agrees to return the corresponding contribution of those municipalities, as required by § 3326 l of this title. ASES shall totally or partially reimburse to the municipalities any expenses incurred for direct or indirect health services rendered by the municipalities without any restriction whatsoever.

(e) Income of the Administration from contributions by employers and individual employees for the payment of premiums.

(f) Income from funds encumbered by the Department to cover the leasing of medical-hospital facilities which are subleased.

History —Sept. 7, 1993, No. 72, Art. VI, § 11; Jan. 8, 1994, No. 1, § 2; July 1, 1997, No. 29, § 1; May 24, 2000, No. 88, § 2; renumbered as § 9 on Dec. 29, 2000, No. 463, § 9; July 19, 2002, No. 105, § 4; Jan. 23, 2006, No. 27, § 1.