A federal judge from the province of Buenos Aires suspended the increases in the quotas of the companies of prepaid medicine authorized by the decree of necessity and urgency (DNU) 70/23 of the government of Javier Mileiin response to a member’s claim.
This is Judge Elpidio Portocarrero of Tezanos Pinto, acting as surrogate during the fair in the federal civil, commercial and administrative litigation court of San Martín, who the day before issued another precautionary measure suspending the authorization by DNU so that the clubs could become sports corporations.
The ruling resolved to “grant the requested precautionary measure, ordering the National State to suspend the application of articles 267 and 269 of the DNU”, and orders the provider SIMECO – Servicios Consejo Salud – “to readjust the fees corresponding to the plan assistance” of a member, “leaving without effect the increases made in application of the decree”.
Given the monthly increase in the installments, there is no justification or detail of such increase from the accompanying invoices, which allows the plaintiff to have more information about it and to know the reason that led to the final value communicated,” the judge said.
But he also warned that “the judicial protection requested implies putting the actions of the National State in crisis, by repealing consumer and user protection standards of the prepaid medicine system.”
“Consequently, I understand that judicial protection must specifically cover the suspension of the effects of that state act,” that is, the increases in quotas authorized by the DNU.
The ruling only applies to that particular member, who reported a 62 percent increase in his February bill.
This is a 78-year-old man, retired, who earned 223,811.84 pesos in December of last year and 157,541.23 in January.
The bill he received in January (two, actually, since the second included an additional increase) rose to 267,787 pesos.
The SIMECO member “requires permanent health benefits and medical follow-up for having suffered a stroke in 2017 and heart problems, in addition to age-related ailments,” explains the ruling.
For the judge, “the circumstances surrounding the retired status of someone who requires effective judicial protection, added to the absence of impact on a public interest, that the measure will not produce irreversible legal effects, plus the concurrence of the other requirements, suggest without ambiguity the suspension of the budding state act”.
Portocarrero de Tezanos Pinto questioned that “the functions of the Enforcement Authority, which monitored compliance with the PMO’s benefits, contracts and plans, have been repealed.”
“Fundamentally in the article that was to supervise and guarantee the reasonableness of the contributions of the benefit plans; regarding the increase in the contributions, the Enforcement Authority had to authorize the increase ‘when it is based on variations in the cost structure and reasonable calculation risk actuarial,'” he summarized.
Source: Ambito
