Find out who they are
- Redacción elvocero.com / 19/04/2021https://www.elvocero.com/gobierno/designa-a-grupo-que-buscar-la-igualdad-en-medicare-y-medicaid/article_be0e2d54-a10a-11eb-bd84-97e825bded33.html
Pedro Pierluisi announced today the names of the health care industry professionals that make up the multi-sectoral working group that will prepare proposals and strategies to work with the federal government to achieve equal treatment in the Medicaid and Medicare programs.
Pierluisi appointed as members of the group the president of the Puerto Rico College of Surgeons, Dr. Víctor M. Ramos Otero, and the president of the Puerto Rico Hospital Association, Jaime Plá Cortés.
Also, the president of the Puerto Rico Medicaid and Medicare Products Association and president of Triple-S, Roberto García Rodríguez; the executive director of Mennonite Health System, Ricardo Hernández Rivera; the regional director of government relations for Puerto Rico-Arizona-Nevada-New Mexico and U.S. Virgin Islands for Walgreens Pharmacy, Coral Cummings-Pino; the president of the IPAS Association, Jorge Hess; and the president of FIDE, Luis Pizarro Otero. https://e249eecadb9f5cd116bd3bf1ae9438a0.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html
The multisectoral group is chaired by the Secretary of the Department of Health, Carlos Mellado, and co-chaired by the Executive Director of the Puerto Rico Federal Affairs Administration (Prfaa), Carmen Feliciano. It also includes the resident commissioner in Washington, Jenniffer González Colón; the executive director of the Health Insurance Administration (ASES), Jorge Galva; and the executive director of the Financial Advisory Authority and Fiscal Agency (Aafaf), Omar Marrero.
"I appreciate the availability of each of the members of this excellent multisectoral working group. Our joint goal is to contribute to and improve the health of every resident of Puerto Rico, achieving equal treatment in the Medicare and Medicaid programs, and better access to health care for everyone on the island," said the governor.
The group will seek that the implementation of Medicaid and Medicare on the island be the same as in the United States.
Currently, Puerto Rico's Medicaid program differs from programs in the United States in several important respects. The public health system (including Medicaid) does not provide long-term care services. In addition, Medicaid operates through a fully vertically integrated health system, i.e., program decisions are made at the top level of government and go down to the roots of the program, although there is some delegation of power to lower levels.
Also, among the differences in the way states and Puerto Rico are treated in the Medicaid program are the federal government's contribution, the cap on the funds allocated, the amount of benefits applied to the island and the percentage based on the poverty level.
Approximately half of Puerto Rico's 3.5 million inhabitants depend on the public health system for their medical care.
Medicare vs Medicaid: the differences
Medicare is the U.S. government-administered health coverage program that provides medical care to people over age 65 regardless of their medical history or income. It went into effect in 1965 as part of an amendment to the Social Security Act to address what was then a lack of health coverage for many seniors.
According to official data at the time, before the program was created, less than half of the elderly population had health insurance.
In the beginning, Medicare consisted of two parts. Plan A (hospital insurance) and Plan B (services not covered by Plan A, such as doctor's appointments). In 1997, Plan C (Medicare Advantage) was added to give beneficiaries the possibility of receiving care under private health plans. Almost a decade later, in 2006, Plan D or prescription drug plan was included.
Medicaid is the health care program for low-income individuals and families. It was created in 1965 under the same amendment to the Social Security Act that established the Medicare program. Under Medicaid, the federal government disburses funds for a portion of the program and the states must cover the difference. In the case of Puerto Rico, the federal government pays 30% of the cost and the island government pays the rest under the Vital Plan.
Like the Medicare program, Medicaid beneficiaries who are U.S. residents must close their plan before moving to Puerto Rico and reapply in Puerto Rico to receive benefits under the Vital Plan. The same is true in reverse, if Puerto Ricans move from the island to the mainland.