In view of the increase in the number of complaints due to increase in fees of prepaid medicine enabled by DNU 70/2023 Of xavier miley, some courts recommend about five precautionary measures per day to prevent them. What happens is that those cases are all resolved individually, they have specific characteristics (for example, requests from retirees or relatives of disabled patients) and they sue specific companies. Is it possible that there could be a decision with general effect that would suspend major increases for all members of all health providers? Last week a door was opened for Registry of Collective Proceedings of the Supreme Court Indicated that an amparo – directed against the State and which requests the unconstitutionality of the articles of the decree freeing the prices of private pharmaceutical services – is being processed with the only case that has so far been registered there, A file against the Italian charity society which is in charge of the judge of San Martín, Martina Fornes.
In protection against Italian hospitalizations, Fornes granted – on 15 January – a precautionary measure requested by 78-year-old Marta Cristina Brauchli, who alleged that it was impossible for her to cope with the increase of 40 percent in January and almost 30 percent in February. Had to pay the fee, which represented almost half of his retirement wealth, 323,089 pesos. As is known, Everything increases except pension and salary, The ruling “invokes the principles that should govern the protection of people’s health and life” as rights recognized in the International Covenant on Economic, Social and Cultural Law, Costa Rica’s Agreement of San José and civil and international covenants. . Political rights”, with all the constitutional status. Their decision was to directly suspend the increase for this particular woman. They did the same in other cases with similar characteristics. People who have to undergo treatment, who are in a precarious situation and In many cases dependent on income which the state has decided to limit.
There are cases against other prepaid companies in the Foreign Court. It is not clear why the only case involving the Italian Society was so far registered in the Court’s registry of the cases at stake. mass event rights, because there are other similar orders. Assuming the judge rules on the merits, the collective impact – as things stand today – will be for the Italian partners. The news is that this may change. Among the files that were queued up to be registered as a collective action was that of the lawyer Eduardo Santiago Wilson, who pointed out against the State. DNU directly questions the constitutional validity of Articles 267 and 269 (which removes state control from prepaid companies and allows free prices) and last week the Registry of Collective Procedures informed him that his claim should be processed in the same court that obtained the registration of the collective protection. That is, the Office noted, for “Substantive equality in the effect of collective rights”,
Wilson’s presentation was presented to the Federal Civil and Commercial Court 3 of Juan Stinco, who accepted it at the end of the year and requested registration as a collective process at the Court. The court refused to allow the fair. The High Court registry had not responded to the magistrate until a few days ago, when he complained after the fair ended. Court is managing time and delays With the discussion that it is better to sort out the politics (in this case the DNU could be rejected by the Congress). After a wasted month and a half, Stinko had to send Fornes (along with other similar people) to safety. Now the potato is very hot and the key is in the judge’s hands. He must first decide whether or not to take the case and ultimately whether or not to get involved. If this happens, a precautionary measure with a common criteria may or may not be issued. We will have to see what analysis he makes. Then there would come the underlying question regarding the constitutional validity of the articles contained in the DNU. Wilson argued about the scope of his claim, “The right to health is, by nature, a right to collective effect, a collective benefit shared by the universe of users of services provided by prepaid medicine companies.”
Among the precautionary measures, which prevented a surge in individual claims, Judge raised questions on ending control, He explained that DNU 70/23 modified the regulatory framework of prepaid pharmaceutical companies and social actions (Law 26,682), repealing paragraph 5 subsections g and m of Article 267 and replacing the wording of Article 17 through Article 269. . enforcement authority that supervised Compliance with PMO (Compulsory Medical Scheme) benefitscontracts and plans”, and it had to monitor and guarantee the rationality of the quotas of benefit plans; with regard to increases in quotas, the enforcement authority had to authorize the increase ‘when it is based on variations in the cost structure of risks and appropriate actuarial Calculate’ (…) As a result, The increase occurred as a logical result of prepaid drug companies’ lack of oversight and/or lack of need to request authorization from them. for which the claim is made here.” Furthermore, it points out in the securities it analyzed that the companies do not provide any justification for the increase in quotas.
Fornes decided to suspend the increases and noted that only that part of Article 17 could be applied that remains intact, which says that “at the time of the contract, according to age groups with maximum variation, for benefit schemes “Differential prices can be established.” “Three times between the price of the first and last age group”.
In the courts of San Martin, Two other judges took precautionary measures that halted the increase in prepaid payments, and the courts of Tres de Febrero and Mendoza did the same., In some cases the criteria differed from those of Fornes. He proposed reversing the increase for individual cases but Use the rep index as a reference for any adjustments (Taxable remuneration of stationary workers). There are some protections where the prepaid plan aims to charge retirees almost exactly what they get in retirement.
In Buenos Aires Province, the Ministry of Production headed by Augusto Costa ordered The cancellation of the January and February raises is a “preventive measure” for the OSDE company, which it considered humiliating., for a member with “more than 15 years of seniority”, “older adults”, “and with pre-existing diseases”. He demanded that they guarantee the service and pointed out that the criteria should be the same: the increase for January would be less than 6 percent. The portfolio under consideration has the power to adopt such measures. This process is carried out through the Provincial Directorate for the Protection of the Rights of Consumers and Users, which receives complaints. If the firm fails to comply, a fine of up to 780 million pesos may be imposed. In advance, an attempt is made to hold a conciliation hearing. If this fails, the matter reaches there judicialization, The example of a complaint for the rights of users and consumers, at least in the province ruled by Axel Kicillof, is an alternative route.
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