The Office of the Comptroller of Puerto Rico issued a qualified opinion of the fiscal operations of the Department of Health related to the Fund for Services against Remediable Catastrophic Illnesses. A qualified opinion is issued when the individual or aggregate noncompliances are significant, but not pervasive.
The Report reveals that the Board had not updated the Regulation for the Operation and Administration of the Fund for Services against Remediable Catastrophic Illnesses and its Evaluating Board of July 20, 2010. The evaluation performed reveals that the Regulation does not include the eligibility criteria for granting loans to applicants nor for the evaluation process by the Board.
The one-finding audit notes that the Regulation also does not include the procedures related to the requirements of non-resident persons, the disbursement of supplementary expenses and the formalization of agreements with hospitals. In addition, the Regulation should contain the forms used for the eligibility, evaluation and adjudication process of aid to the applicant.
This situation does not allow the members of the Board and the employees of the Fund to have the regulations that serve as a guide to perform their functions effectively and uniformly in accordance with Act 150-1996, on the Right to Health in Puerto Rico.
The Report recommends to the secretary of Health that he ensure that the Board submit the updated Regulation for his approval.
This Report covers the period from January 1, 2016 to September 30, 2020.
See Audit Report DA-21-13.
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