Do a Report Format of the assignment INTRODUCCIÓN, SCOPE OF THE REPORT, resume of ASES, OCS and department of health CONCLUSION Y recommendation
Kind regards. The Office of the Commissioner of Insurance (“0CS”) welcomes the opportunity to present your comments regarding Senate Bill Number 546 (the “Bill”), which would amend Act No. 45-2016 to clarify the classification of HIV within infectious disease categories and the period in which the results of HIV screening tests must be notified to the Department of Health.
Law No. 45-2016 was enacted to enable the early identification of those with undiagnosed HIV, in accordance with the recommendations established in the Declarations for HIV Detection Tests of the United States Preventive Services Task Force ( United States Preventive Services Task Force Screening for HIV Recommendation Statements) and by the Centers for Disease Control and Prevention (“CDC”). To achieve this objective, HIV screening tests were established as a mandatory coverage requirement of all public and private medical plans. Likewise, requirements were established for health providers to report test results to the Department of Health.
In this matter, the Department of Health is the governmental entity that oversees the notification requirements imposed on doctors and laboratories of the results of diagnostic tests for infectious diseases, according to the categories established by the Department of Health itself through order or regulation.
As explained in the explanatory memorandum of the Project, the amendment to Act No. 45-2016 by virtue of Act No. 142-2019 inadvertently created an incongruity between the category assigned to HIV and the term provided for the notification of the results of screening tests for said disease. The Project seeks to standardize the provisions in law with the regulatory framework adopted by the Department of Health.
The Bill does not contemplate amendments to the Puerto Rico Insurance Code nor to the Puerto Rico Health Insurance Code [1]. [2] Nor does it create a provision in law that applies to the insurance business or impacts the rights of the insured. Therefore, and in view of the fact that the Project affects the operations of the Department of Health, the OCS differs from the latter’s opinion on the suitability of the adequate classification of HIV within the categories of infectious diseases and on the appropriate term for the notification of the results of the tests, for their corresponding health use. From another perspective, we favor the Project to the extent that it clarifies and resolves inconsistencies in the law.
We appreciate the opportunity to express ourselves on this legislative measure. We are fully available to assist you in this or any other matter that you may entrust to us.
The Puerto Rico Health Insurance Administration (ASES) thanks the Health Commission of the House of Representatives of Puerto Rico (hereinafter, the “Commission”), for the opportunity they give it to offer its input regarding the impact which will entail the approval of P. del S. 546. In response, the Administration presents and submits its comments regarding the reference project.
Senate Bill 546 aims to “amend Article 6 of Law 45-2016, as amended, in order to incorporate a technical amendment in its transitory provisions for the purpose of clarifying the classification of HIV and confirming the notification period. to the Department of Health; and for other related purposes. ”
Improving access to treatments necessary for the quality of life of each beneficiary of the Government Health Plan (PSG or Plan Vital) is a matter of great importance for ASES. We understand the purpose of this piece of legislation in keeping an adequate registry to guarantee access to health services for the HIV population in Puerto Rico. We understand the merit of the legislative measure, for which we make ourselves available to the Department of Health of the Government of Puerto Rico in accordance with the provisions of Section I of the bill.
In accordance with the request of the Puerto Rico Senate Health Commission, we submit to your consideration and study the position and recommendations of the Department of Health on Senate Bill No. 546 (P. del S. 546). The reference measure proposes “to amend Article 6 Law 45-2016, as amended, in order to incorporate a technical amendment in its transitory provisions for the purpose of clarifying the classification of HIV and confirming the notification period to the Department of Health; and for other related purposes. ”
We have reviewed this measure and after consulting it with the officials of the Division of Prevention of STD / HIV and Viral Hepatitis, which is attached to the Central Office of AIDS and Communicable Diseases Affairs (OCASET) of the Department of Health , we express the following:
The Department of Health supports. We agree with the legislative intention to resolve the confusion created by Law 142-2019, which in turn amended Law 45-2016, as amended by classifying HIV as a Category 3 notification condition and at the same time establishing the notification period with a limit of 5 days or less, which is the notification period of conditions under Category I, as provided in Administrative Order No. 358 of the Department of Health. This confusion affects the failure to comply with the mandate to establish effective regulations as required by Law 45-2016 itself, as amended,
Senate Bill 546 is aimed at resolving this confusion, amending Article 6 of Law 45-2016, as amended, making it clear that notification of the HIV diagnosis will be made within the first (5) days in accordance with the notification of conditions within
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Category I. In this way, we would be in a better position to apply the intention of Law 45-2016, supra, in compliance with the reports of the final or preliminary results of the HIV tests.
For all the aforementioned, the Health Department endorses Senate Bill 546 without reservation.
LAW
To amend Article 6 Law 45-2016, as amended, in order to incorporate a technical amendment in its transitory provisions for the purpose of clarifying the classification of HIV and confirming the notification period to the Department of Health; and for other related purposes.
STATEMENT OF MOTIVES
Law 45-2016 was enacted as part of public policy to achieve early identification of HIV in undiagnosed people. It establishes the requirement that the screening test for HIV be offered in the routine tests of all medical evaluations. Likewise, it provides that all final results that determine a positive diagnosis be reported to the HIV / AIDS Surveillance Program of the Department of Health. To this end, it suggested the electronic route as an alternative for the reporting of said results.
Law 45-2016 was later amended by Law 142-2019 with the purpose of enforcing the use of electronic means as the only way to report new HIV diagnoses on the Island. The Statement of Motives of Law 142-2019 establishes Furthermore, said amendment intends that these new HIV diagnoses be reported in the first twenty-four (24) hours, as are other infectious diseases under “Category IIIâ€. To this he adds that the electronic report in the first twenty-four (24) hours of the HIV diagnosis (including a preliminary positive diagnosis), is crucial to meet the goal of the new Comprehensive HIV Surveillance, Prevention and Care Plan proposed by the Department of Health. , and with which it is expected to comply by the year 2021.
The aforementioned “Category III†refers to those that were assigned through Administrative Order No. 358 of October 5, 2016 of the Department of Health. According to said Administrative Order, diseases, pathogens and / or conditions classified under “Category III” must be notified to the Department of Health immediately. However, it classifies HIV in “Category I”, which requires notification in a period not exceeding five (5) days. Similarly, Article 1 of Law 142-2019 (which amends Article 5 of Law 45-2016), indicates that the report will be submitted within the next five (5) calendar days. In addition, in the transitory provisions (Article 2 of Law 142-2019) it refers again to the period of five (5) days. However, it does state that HIV will be classified as “Category III†(Immediate Notification).
A review of the legislative process of Law 142-2019 confirms that the bill was originally presented with a notice period of twenty-four (24) hours. However, it was subsequently amended to set it at five (5) days. This allows us to conclude that the final legislative intention was to establish it in five (5) days, but that, inadvertently, other provisions were left unchanged in reference to the shorter period, including that of the Classification of HIV in Category III.
The inconsistency between the notification period of five (5) days and the classification of HIV as Category III referred to in Law 142-2019 has caused confusion when setting procedures and establishing adequate regulations. For such purposes, and in order for the procedures to be uniform and consistent with the current legislation, it is necessary to clarify that the prevailing notification period will be five (5) days. This is consistent with Administrative Order No. 358 of the Department of Health, which classifies HIV in “Category Iâ€, with a notification period of no more than five (5) days.
For the aforementioned reasons, the specific intention of this Legislative Assembly is to clarify it by means of an amendment, thus eliminating any confusion and ensuring consistency in the procedures.
Section 1. Article 6 of Act 45-2016, as amended, is hereby amended to read as follows:
“Article 6.-
The Department of Health, in consultation with the Office of the Insurance Commissioner and the Puerto Rico Health Insurance Administration, will establish the regulations and forms that are required for proper compliance with this Act, within a term no longer than ninety (90) days, counted from its validity. The Department of Health shall adopt the necessary regulations in order to provide for the electronic submission of reports of final or preliminary results within the next five (5) calendar days, in accordance with the classification of HIV under Category I in such a way that it can be ensure compliance with the provisions of this Law. “
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