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ADSE has already submitted new private rate cards

Robert Mason by Robert Mason
August 23, 2019
ADSE has already submitted new private rate cards
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Six months after the big groups threatened to break with ADSE, the Public Institute board brought the new price lists to the General Supervisory Board, President João Proença told Business. The document is still provisional.

Six months after the large private health groups threatened to break agreements with ADSE, the health subsystem management sent its advisory board the new price lists that will apply to the agreed regime.

The document is still provisional, and therefore subject to change, according to explained to the President of the General and Supervisory Board (CGS), João Proença.

“The tables were sent to the General and Supervisory Board, indicating that they will be distributed to some providers to collect contributions that allow ADSE to draft the final version,” said João Proença Thursday.

The official did not disclose the content of the tables, stating that they have yet to be analyzed. “The General Council will speak, regardless of waiting for the final version.”

The new price lists, which set out how much the health subsystem has to pay for each medical act to the private providers who have an agreement with ADSE – and who are therefore in the so-called agreed regime – have been in negotiations at least since October 2017, that is, almost two years ago.

The most sensitive subjects concern the setting of maximum prices for prostheses, surgery, and hospital medications.

Without fixed prices, ADSE began to apply the so-called regularizations, requesting the correction of billing for previous years, based on the analysis of minimum or average prices presented by other providers.

It was the demand for the payment of 38 million euros earlier this year that led, last February, the groups Luz Saúde and José de Mello Saúde to threaten to break the agreements with ADSE.

The threat alarmed the beneficiaries and worried the Government and the President of the Republic, but eventually failed to materialize.

At that time, the board of directors promised “within a very short time” to present a new price list that would prevent the application of regularization. The deadlines were successively postponed and, according to the chairman of the General and Supervisory Board, the now arrived document still admit amendments.

  • The ADSE General and Supervisory Board have representatives from trade unions, retired associations, and the Government.
Robert Mason
Robert Mason
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