“The MUFACE system is fully guarantee.” The main mutuality of officials through which the healthcare of 1.5 million public employees is managed on Wednesday in statements to ABC that its operation allows any affected by the possible denial of an oncological treatment to which it considers that it is entitled This decision can resort and that in those cases MUFACE will review the performance of insurers to assess whether it is disagreement to the provisions of the health concert that regulates its operation.
The nearly one million officials and relatives entrusted to the healthcare branch of MUFACE, who until this year have been providing Adeslas, Asisa and DKV and who from within a few months will provide Adeslas and Asisa alone, are among the collective of potentials affected by the practices of the Atrys Health-Bienzobas denounced by ABC. Exerted pressures to private health doctors to reduce the prescription of the most expensive treatments.
Sources close to mutuality transfer that the first informal explanations provided by MuFACE to the scandal uncovered by ABC ensure that this It does not have “objective data” that prove the existence of practices of this nature in the field of the health concert, but that in the event that there could have been any case, the mutualists who have seen some treatment to claim this situation may have encouraged.
MUFACE SOURCES Remember that mutuality has a claims channel through what is called the Mixed Commission, which «allows you to review the acting of insurers If you consider itself disagreement to the provisions of the concert «. In that procedure, they explain these same sources, the mutualist can claim if a certain treatment is not authorized and the matter is resolved either by direct management of the Provincial Service of MUFACE with the insurer in question or in a mixed commission, which meets with monthly character. In case of no agreement in these instance, the matter rises to a National Commission, which is responsible for interpreting the application of the concert perimeter to each particular case.
If this administrative route did not work, patients would still have the possibility of raising a contentious-administrative appeal and ultimately go to the contentious-administrative jurisdiction of the courts to defend their rights.
CSIF insists that MuFace has to investigate
In any case, from MUFACE it is ensured that In the last year no matter has been raised Relative specifically to chemotherapeutic treatments to the Mixed Commission. ABC has asked about the existence of claims of that nature in the course of the last three years both in Muphaz and in Mugeju or Isfas, the other mutualities that manage the health care of the personnel of the justice and army services, respectively, without obtaining a response on the matter.
MuFACE’s response occurs after the CSIF union has expressly requested explanations to the direction of mutuality for the revelations made by ABC. From the union it is insisted that MUFACE must investigate the existence of possible cases of denial of treatments, since in most cases these practices are undetectable by the patients, and the mutualists are encouraged “to denounce for the seriousness of the information that have come to light and the response of the Spanish Society of Oncology.”
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