Doctors’ Association backs down from mandatory medical fees

The Costa Rican Doctors’ and Surgeons’ Association revoked a decree setting minimum prices for all medical procedures performed by private practitioners. The proposed floor fees would have increased costs for some procedures by up to 300 percent.

The association’s president Alexis Castillo said in a news release that the Health Ministry had notified the association that the decree was invalid and that set prices could only be approved via executive decree.

Under Costa Rican laws, only a government agency can approve and publish an executive decree in the official newspaper La Gaceta.

The Doctors’ Association published the new price list on May 2 but suspended its enforcement following an outcry from patients, consumer rights’ groups, the Ombudsman’s Office, politicians and public health agencies.

Castillo said despite the repeal of the tariff list, the association will move forward with a study of fees charged by private practitioners for more than 9,000 medical procedures.

Results of that study will be part of a new request to update prices that the association will submit to the Health Ministry, Castillo said.

No love for mandatory minimum medical fees

President of the National Insurance Institute (INS) Elián Villegas welcomed the demise of the mandatory price list, saying it “would have negatively affected a large sector of the population.”

He also asked the Doctors’ Association to refrain from insisting on establishing minimum prices via decree.

“That was a decision taken by a small group and that would have negative effects on most of the Costa Rican population, especially on those with lower income,” he said.

Following publication of the decree, INS officials had publicly said that the high increase in prices for medical procedures would also directly impact insurance costs.

Health Vice Minister María Esther Anchía said Monday that the Doctors’ Association decision to pull the price list was the right thing to do. She also warned the group to properly substantiate any new tariff hike proposal it might be considering.

Anchía explained that a 2010 ruling from the Government Attorney’s Office stating that the Doctor’s Association has the prerogative to calculate tariffs. But all tariff settings must be approved by executive decree.

Anchía said a new tariff petition from the Doctors’ Association would have to be in line with the country’s economic situation and that the Ministry has the power to conduct its own study to analyze the cost-benefit ratio.