The Justice granted a precautionary measure presented by the Superintendency of Health Services of the Nation, and ordered that the prepaid health plans sued revert their prices to December 2023 with an update in accordance with the Indec Consumer Price Index.
He federal judge Juan Rafael Stinco decreed a precautionary measure that provides for this. In addition, what was paid in excess will be a credit in favor of users and companies were encouraged to determine a plan for these monetary refunds.
The head of the Federal Civil and Commercial Court No. 3, Juan Rafael Stinco, admitted the request of the Superintendency of Health Insurance and ordered a precautionary measure which orders prepaid medicine companies to retrograde their prices to December and make the increases with the Consumer Price Index prepared by INDEC.
Likewise, the decision ordered that what was paid in excess will be a credit in favor of the users and the companies must present a plan to return the money collected in excess.
In the Views and Considering clauses of his decision, the judge begins by mentioning:
“It should be noted that in the record the Superintendence of National Health Services and requests a precautionary measure against the Organization of Direct Business Services (OSDE), Swiss Medical SA, Medicus SA for Medical and Scientific Assistance, Omint SA for Services, Galeno Argentina SA. Medifé Civil Association, Italian Benevolent Society in Buenos Aires, Social Work of the Luis Pasteur Health Directorate, Hominis Prepaid Medicine SA, Essential Medicine SA, Mutual Association of the Hierarchical Staff of National Official Banks. Social Work of the Union of Civil Personnel of the Nation, Mutual Federada June 25 Reciprocal Protection Society, ACA Salud Cooperative for the Provision of Medical Assistance Services Ltda., Asociación Mutual Sancor, Prevention Health SA, Integrated System of Health Providers SA. MET Córdoba SA, Hospital Alemán Civil Association, Grupo DDM SA, British Hospital Association of Buenos Aires, Center for Medical Education and Clinical Research and Medical Circle of Lomas de Zamora; this in accordance with the demand and its extensions (presentations of 04/17/2024 and 04/22/2024) and requests that in accordance with art. 230 et seq. of the CPCCN, the defendant Prepaid Medicine Entities are ordered to refrain – as of the dictate – from making increases in the fees in all benefit plans without exception, and to retrograde the amount of the values to the fees in force as of 01.12. 2023, and eventual adjustments must be made in accordance with the index(es) that the Court considers corresponding. It also requests that the measure to be issued order the defendants to return and/or reimburse the sums that have been unduly received by them to date, in the manner in which the Undersigned deems appropriate.” ETC…
RESOLVED:
1) Grant the precautionary measure and order the defendants to refrain from increasing the contributions in all benefit plans without exception, and to retrograde the amount of the values to the contributions in force as of December 2023, which must be updated. in accordance with the Consumer Price Index prepared monthly by the National Institute of Statistics and Censuses (see considering IX).
2) Establish that in the event that the affiliates had paid the invoices with the increases left without effect by this decision, the resulting difference between said amount and the fixed update calculation constitutes a credit in favor of each. one of them
3) Set a period of five (5) days for each Agent of the defendant Health System to present an action plan to implement the monetary restitution ordered in the previous point, under the warning of taking the necessary measures to achieve compliance. .
4) Order the publication of this resolution by edicts in the Official Gazette for a period of two days with the specifications detailed in considering XI. 5)
Notify this decision to the email address that the defendants have established before the Superintendency of Health Services.
6) Establish that no judicial presentation is necessary in this case, so that individuals must channel their claims and/or reports of non-compliance in the manner informed by the Ministry of Industry and Commerce of the Nation, this channel being the most suitable means. for these purposes (considering XI)
7) Require the referral to these actions of the administrative files referred to in considering XII
8) Let the plaintiff know that she must comply with what is required in the last paragraph of considering XII.
Register, be notified with authorization of days and hours by the Secretary to the plaintiff and by email to the unsuitable defendants with the same character, the plaintiff being responsible for such diligence (conf. considering XI).
JUDICIAL POWER OF THE NATION
FEDERAL CIVIL AND COMMERCIAL COURT 3
JUAN RAFAEL STINCO
Date: 2024.05.03 13:19:16
https://es.scribd.com/document/729037518/Prepagas-el-fallo-de-la-Justicia
