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PC 1146

Para enmendar los incisos (b) y (k) de la Sección 3 del Artículo VI de la Ley Núm. 72 de 7 de septiembre de 1993, según enmendada, conocida como la “Ley de la Administración de Seguros de Salud de Puerto Rico”, a los fines de establecer que los Policías Estatales y Municipales acogidos a la cubierta de salud del Plan de Salud del Gobierno de Puerto Rico no tendrán que solicitar referido médico para acudir directamente a un médico especialista de su preferencia; y para otros fines relacionados.

2025-2028 Session

Puerto Rico bill exempts state and municipal police from needing referrals to see specialists directly under government health plan, creating faster specialist access for this group only.

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Bill Summary · PC 1146

Legislative bill overview

Bill PC 1146 amends Puerto Rico's Health Insurance Administration Law to exempt state and municipal police officers from requiring physician referrals before visiting specialist doctors of their choice. The bill specifically modifies sections (b) and (k) of Article VI, Section 3 of Law 72-1993 to grant this direct-access privilege exclusively to police covered under the Puerto Rico Government Health Plan.

Why is this important

Police officers currently enrolled in the government health plan would gain expedited access to specialists without the gatekeeping requirement of primary care physician referrals, potentially reducing wait times for specialized medical care. This creates a distinct benefit tier within the public health system, raising questions about resource allocation and equity in healthcare access for government employees versus the general population.

Potential points of contention

  • Healthcare equity concerns: Granting police officers direct specialist access without referrals while other government employees and the general public must obtain referrals raises fairness questions about two-tiered healthcare systems
  • Cost implications: Removing the referral gatekeeping mechanism may increase specialist utilization and healthcare costs for the government plan, with unclear budgetary impact analysis
  • Precedent setting: Establishing occupational carve-outs in the health system could prompt similar demands from other government employee groups (teachers, firefighters, etc.), fragmenting the unified health plan structure

Compiled from official sources — confirm details with the bill’s official record.

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