Clinical Laboratories Assn. demands ASES chief’s ouster

The Clinical Laboratories Association Inc. said in a statement that “insurers sent [suppliers] the new contracts electronically for their signature through a platform that did not allow them to read the document before it was signed.”

By The Star Staff

The Clinical Laboratories Association Inc., in a written statement on Wednesday, denounced alleged mismanagement at the island Health Insurance Administration (ASES by its Spanish initials) and demanded the dismissal of the agency’s executive director, Edna Marín.

Instead of holding bidding, the association said, Marín allegedly conducted a “negotiation behind closed doors” with four insurers (MMM, Triple S, MCS and First Medical) so that all four would continue participating in the program.

“To this day suppliers don’t know what’s going to happen,” association members said in the statement. “These insurers sent them the new contracts electronically for their signature through a platform that did not allow them to read the document before it was signed. Despite having been informed of the situation, the director of ASES, Mrs. Edna Marín, remained firm that the new contract with insurers will begin on January 1, 2023 and providers have to sign their contracts before [today] or run out of patients. Everything appears to be designed to benefit the four insurers with the $4.7 billion that the program costs.”

“The process of contracting insurers for 2023 was carried out in a hurried manner, allowing insurers to impose on ASES their contractual conditions and their participation as health service providers, so as to ensure greater profits while affecting and perpetuating the collapse of the health system of all the people of Puerto Rico,” the statement added. “Despite commitments from the Governor and Secretary of Health to increase provider fees, negotiations with ASES resulted in a 57% reduction in lab fees, limiting access to hundreds of tests our patients need, given that the cost of these tests are substantially higher than what the insurer pays. While insurers increased premiums by 5%, they reduced rates by 57%.”

“The situation at ASES with the hiring of insurers, the lack of contracting of suppliers today projects a total fiasco for this administration,” the lab association continued. “The Laboratories Association has been demanding for years that ASES comply with its obligations to control insurers, without any result. We have been ignored for decades. They have also ignored the multiple complaints filed by us against insurers for violations of the Insurance Code and the Punctual Payment Law.”