The Consell Demands 1,022 Million Euros from the Government for Healthcare Services to Non-Residents of the Community

The Consell has authorized the Department of Health to demand 1,022.9 million euros from the Spanish Government, owed due to the lack of compensation from the Healthcare Guarantee Fund (FOGA) and the Healthcare Cohesion Fund, for healthcare services provided in the Valencian Community to patients from other regions and foreign individuals since 2012.

This was approved in the Consell's plenary session on Tuesday, where the Valencian government's spokesperson, Ruth Merino, also urged the central government to "pay what it owes" to the Valencian Community regarding dependency care.

Regarding FOGA, Merino explained that the Consell makes this claim "every year." According to the Consell, the state government owes the Valencian Community, through the Healthcare Guarantee Fund, 23.1 million euros for Primary Care services to visitors from other regions between July 2012 and December 2013, as well as an additional 798.9 million euros for services to displaced individuals in Specialized Care from July 2012 to the present.

Additionally, the central government also owes, through the Healthcare Cohesion Fund, more than 99.6 million euros for settlements from the years between 2013 and 2023; as well as another 101.3 million euros for the settlement of billing generated in the Valencian Community for healthcare services provided to foreign individuals.

Thus, the Consell demands the payment of funds lost due to the inoperability of the implementation of the Healthcare Guarantee Fund as provided in Royal Decree-Law 16/2012, of April 20, on Urgent Measures to ensure the Sustainability of the National Health System.

According to the Consell, under the aforementioned decree, and within the framework of the Healthcare Guarantee Fund, economic compensation for healthcare services to displaced individuals between autonomous communities should have been implemented, but "currently this mechanism has had very limited reach and is causing significant economic harm to the Generalitat."

Thus, the retroactive compensation for services provided from July 2012 (the effective date of Royal Decree-Law 16/2012) to December 2013 in Primary Care to visitors from other regions remains pending.

In the information systems of the Department of Health, more than 199,000 Specialized Care services provided annually to displaced individuals from other autonomous communities are being individually identified and recorded, representing an expense of 77.6 million euros per year that "has not been compensated."

Furthermore, since the entry into force of Law 17/2012, of December 27, on the General State Budgets, the Healthcare Cohesion Fund acquired an extra-budgetary nature, so that autonomous communities that, like the Valencian Community, present positive balances in the joint settlement of the Healthcare Guarantee Fund and the Healthcare Cohesion Fund must be compensated by the Ministry of Finance.

Additionally, all healthcare services provided to foreign citizens with a European Health Insurance Card or from countries with reciprocal healthcare agreements are billable, but "the calculation methodology for the settlement of this billing used by the National Institute of Social Security (INSS) and the Ministry of Health does not respect the legitimately acquired collection rights of the communities and generates significant losses for tourist regions like the Community, with perverse effects and unjust enrichments of some at the expense of others," criticized the Valencian Government.