Wednesday, November 29, 2023

SISALRIL fined the clinic for improperly billing Social Security partners

Santo Domingo.- dr. Jesús Feris Iglesias Superintendent of Health and Occupational Risks, reported that proceeded to authorize a medical center in the National District after finding enough findings that describe the prohibited practice of improper charges of two members by request deposits or advance payments as a requirement for access to medical care which violates the Social Security law and its complementary regulations.

Feris Iglesias added that the punishment was implemented in compliance with the functions provided by Law No. 87-01 and Res. No. 563 of the National Social Security Council (CNSS), the Superintendency of Health and Occupational Risks (SISALRIL)through DJ-GIS Resolution No. 0022-2023. The same goes for a fines up to 101 minimum wages.

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The superintendent reported that this sanction against a recognized medical center was first presented by SISALRIL throughout its operation period, thus showing its management’s strong commitment to creating incentives for proper Family Health Insurance application, with a guarantee for the benefits included in social security and faithful compliance with Law 87-01, thus marking a standard that serves as an example for all health centers in the country.

“From our regulatory role in the Social Security System, at SISALRIL we will remain vigilant against any violation of the law, whether due to improper billing or any other violation committed to the detriment of the members of the Health Service Providers , which not only “They violate the current rule, but they create exclusion mechanisms that are not consistent with the nature of the service they provide.”

He recalled that during the 2022-2023 season, the largest number of sanctions was presented in the history of the institution. 1,198 affiliate cases were positively affected. This represents a historic milestone for the Dominican Social Security System that must continue to be strengthened, so the citizen empowerment and timely reporting.

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