Spanish
The head of the General Directorate of Information and Defense of Social Security Affiliates (DIDA), Elías Báez, announced that during the month of January the institution received 349 complaints and grievances and avoided more than RD$10 million in illegal charges and undue demands to patients and their families, as a result of the interventions carried out through the program "You Are Not Alone, DIDA 24 Hours With You".
He specified that this amount corresponds to actions carried out within the aforementioned program and is part of the accumulated actions developed from December to date, a period in which the DIDA has contributed to avoid between RD$63 million and RD$70 million in undue charges within the health system, through mediation processes, verification of accounts and continuous attention to complaints nationwide.
The head of DIDA explained that these interventions originate after receiving complaints related to the retention of patients for illegal charges, the requirement of provisional deposits to grant medical discharges, charges above the insurance coverage, and billing for services not yet audited, practices that contravene the Health Services Plan (PDSS) and the regulations governing the Dominican Social Security System.
Among the cases handled during the month of January, he cited that of an affiliate admitted in an emergency for a cerebrovascular event, whose discharge was conditioned on the payment of an amount exceeding RD$300,000, under the claim of waiting for administrative validations. After the intervention of the DIDA, the health center accepted the real availability of the family members, allowing the patient's discharge with a significantly lower payment, while the audit process of high-cost services and medications continues.
Likewise, he mentioned the case of another affiliate with a prolonged hospitalization in intensive care, whose death led to a millionaire financial demand for the release of the body. Thanks to institutional mediation, the provider was persuaded to abandon the retention, allowing the immediate release of the body and avoiding an initial disbursement of over RD$1.9 million, while the final medical bill is validated. "The common denominator in these cases is the vulnerability of the patient and their families to undue financial demands. From DIDA we intervene to ensure that only what really corresponds is paid as a difference or for uncovered services, duly audited, and never for undue charges or advance payments," emphasized Báez. In that regard, he clarified that, once the medical bills have been validated, DIDA guides affiliates on their responsibility to comply with the payment agreements established with the health centers, provided that said amounts effectively correspond to real differences and not to practices contrary to the law. The official reiterated that no health center can condition medical care, hospital discharge, or the delivery of a corpse to the prior payment of unaudited amounts, and urged citizens to report any irregularities through the official channels of DIDA, reminding that the DIDA 24 Horas Contigo program maintains permanent availability throughout the country. Finally, he assured that the institution will continue to strengthen its supervisory, mediation, and accompaniment work, with the commitment to protect the rights of affiliates and guarantee fair and timely access to health services, in accordance with the law.
