P.R. Laws tit. 24, § 3229

2019-02-20 00:00:00+00
§ 3229. Applications to the Fund; procedure and additional requirements

(a) Every person interested in receiving assistance from the Curable Catastrophic Illnesses Services Fund shall submit his/her application to the Evaluating Board, pursuant to the requirements provided in § 3223 of this title. The Board may require the following, if it deems it necessary:

(1) A copy of the last five (5) income tax returns;

(2) a credit report or notice from an institution which provides said service;

(3) evidence of debts, obligations and expenses, and

(4) any other document needed to determine the eligibility of the patient.

The financial information provided by every party interested in receiving the assistance of the fund shall be confidential and shall only be used to determine the eligibility of the patient. Under no circumstance shall the Board use said information to file any type off accusation or charge against the person interested in receiving the assistance of Fund.

(b) The Evaluating Board shall consider said application promptly. When it deems that the application complies with the medical and financial requirements of this chapter, it shall proceed to determine the following:

(1) That the hospital institution in or outside of Puerto Rico that is recommended by the patient’s physician is recognized by the Evaluating Board. If the recommended institution does not appear in the Board’s register, the Board may recognize the same or decide to authorize the diagnosis and treatment in any of those that it has previously recognized.

(2) According to the cost of the diagnosis and treatment, determine the appropriation to be granted to the patient for the treatment, including supplementary expenses.

(3) If the patient and the components of the family nucleus or those bound by law to support him/her, lack the financial resources or those of any other nature, including the means to obtain total or partial financing in private banking to defray all or part of the cost of the diagnosis and recommended treatment.

(4) The authorization chargeable to the Fund, whether through donation, loan, or a combination thereof, of all the amount of money that is needed to defray the expenses of the diagnosis and treatment and of the supplementary expenses.

[(c)] In those cases in which it determines that the total assistance of the Curable Catastrophic Illnesses Services Fund as a donation is pertinent, it shall authorize the payment of the diagnosis and treatment, including the supplementary expenses that it deems are in order and shall authorize their immediate disbursement, which shall be made pursuant to the regulations adopted by the Board.

[(d)] If from the evaluation of the case it arises that the patient or the members of the family nucleus can partially defray the cost of the diagnosis and treatment, the Evaluating Board shall authorize the disbursement of the remaining amount to defray the total cost of the diagnosis and treatment, including supplementary expenses that it deems pertinent and may authorize said disbursement as a donation, loan or a combination [of] both.

If the Evaluating Board determines that the patient is not eligible, it shall promptly notify it to the patient or his/her tutors.

Under no circumstance, with the exception of lack of assets in the Fund, shall the attention of any eligible case be delayed awaiting for the patient, his/her tutors or relatives to obtain a private donation.

History —Aug. 19, 1996, No. 150, § 11.