Futile the Government’s actions to stop the exodus of doctors from Puerto Rico if healthcare plans do not open their preferential net stated Rafael Rodríguez, Secretary of the HealthCare Department, according to the article “Maniatado el gobierno en esfuerzo por mantener a los médicos en la Isla” by Leysa Caro González, published in the newspaper El Nuevo Día on February 15, 2017. Rodríguez indicated that if opportunity to become providers of insurance companies were not given to young and recently graduated doctors, they will end up leaving Puerto Rico. While Victor Ramos, President of the College of Surgeon Doctors agrees with Rodríguez, he also indicated that currently doctors have to wait around a year or year and a half in order to know if the insurance companies are going to employed them or not.

Ramos indicated that insurance companies have created what is known as preferential nets, which makes some doctors disappear since, even when the patient decides to be treated by these doctors, the deductible that they will pay is higher than what they would end paying if they are treated by a doctor that is part of the preferential net. He also stated that another factor for doctors to choose to leave Puerto Rico is the recent practice of insurance companies of unilaterally canceling contracts with the doctors and retaining and denying payments.

Currently, through the Resolution of Chamber 56, an investigation has been ordered over the following healthcare plans: Medicare Advantage, Triple-S Advantage, MCS Advantage, Centros de Servicio Medicare y Medicaid, Aveta y sus subsidiarias, MMM, PMS Medicare Choice y MSO of Puerto Rico. Rodríguez stated that the majority of the beneficiaries of Medicare in Puerto Rico belong to the “advantage” plans. He also stated that it is the Legislature and the Insurance Commissioner who have to make insurance companies to comply with the laws. Rodríguez expressed that, to his understanding, the Office of the Insurance Commissioner has not implemented its functions as it should.

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