Spanish
Santo Domingo.- President Luis Abinader ordered this Friday that the National Health Insurance Council (Senasa) modify the internal regulations of that institution, and a technical commission of five members be created, who will be appointed by the Executive Branch, with the aim of impacting the efficiency and effectiveness of its functions.
This, within the framework of a series of measures aimed at strengthening the supervision, control, and risk management of the aforementioned entity.You may be interested in: http://Santiago Hazim requests house arrest without impediment to leave due to health condition
By order of President Abinader, Dr. Arismendi Díaz Santana will be appointed to that commission, who will coordinate it, as well as Pedro Ramírez Slaibe, Federico Lalane José, magistrate Alexis Read (once his functions in the Supreme Court of Justice are concluded) and Nora Elizabeth Sánchez Padilla, former coordinator of Citizen Participation, informed the Presidency in a note. To that end, the head of state instructed the Minister of Public Health, Víctor Atallah, in his capacity as president of the Senasa Council, to convene that body, which also includes the legal advisor to the Executive Branch, the Superintendent of Health and Occupational Risks, and the executive director of SENASA, to modify the internal organic regulations of the insurer and propose them to the National Council of the National Health Insurance. The Public Ministry accused 10 people, including the former general director of Semana, Santiago Hazim, of diverting more than 15,000 million pesos through a corruption scheme that spanned 5 years. The accusation describes a criminal network that combined document forgery, corruption, administrative fraud, and money laundering. The prosecution alleges that the objective was to divert public funds, manipulate internal processes, and financially benefit a group of officials and associates. The Executive Branch said it was aware that neither Law 87-01, which creates the Dominican Social Security System, in its article 159, nor the Organic Regulation of the National Health Insurance, detail the regulatory tools aimed at guaranteeing the best functioning of the body and a constant dynamic of accountability. Among the changes promoted by President Abinader that will be discussed by the National Council of the National Health Insurance, to assist and advise the National Council, being responsible for monitoring, evaluating and issuing periodic reports on the operational and financial situation of the National Health Insurance. This commission will complement the activities of the Council, ensuring that a permanent team oversees the main administrative and financial aspects, given that the Council is legally composed of officials and representatives with many other attributions and responsibilities. Among the functions attributed to this technical commission would be to know and give "no objection" to the contract subscription initiatives that exceed, per month, the amount of five million Dominican pesos, annually indexable in accordance with the inflation index established by the Central Bank of the Dominican Republic, whether they are of an administrative nature or for the provision of health services, that may have a financial impact on the National Health Insurance. Likewise, it would be up to him to gather information, analyze, monitor and report by written periodic report to the members of the Council on the following: The financial transactions and operations of the National Health Insurance; the contracting of services intended to be carried out or carried out by the Executive Directorate; the authorizations granted during the period in the different financing schemes (contributory and subsidized) of the National Health Insurance, and the claims received in second instance for the different financing schemes. Likewise, the hiring modalities and payment mechanisms for the provision of health services by the National Health Insurance; the fulfillment of the financial commitments of the National Health Insurance corresponding to medical authorizations and reimbursements to affiliates; the bank availability of the National Health Insurance, which includes information on bank balances, investments in process and/or cancellations of investments that are required, and the fulfillment of the registration of administrative purchase contracts in the system of the Comptroller General of the Republic. The President's instruction also points to an organic design in which the National Health Insurance Council meets regularly with the frequency and speed appropriate to its functions, and highlights aspects such as the publicity of the minutes, resolutions and certifications issued by the Council and the inclusion in the regulations of the rule that stipulates that procurement and contracting operations must comply with the principles established by the current public procurement and contracting law. Abinader also instructed the Minister of Public Health, in his capacity as president of the National Health Insurance Council, to convene the members of the aforementioned Council within a period not exceeding 90 days, in accordance with the provisions of article 159 of Law 87-01, as well as in accordance with articles 9 et seq. of the Organic Regulation of the National Health Insurance, and to present to it a proposal for a comprehensive reform of said regulation in which, among other operational aspects, the attributions, internal organization, liability regime, operation, rules, form of convocation and decision-making of said council are defined with greater quality and strengthened.
