P.R. Laws tit. 24, § 61j
Every person or institution who enters into an agreement with the Secretary of Health to offer and render medico-hospital assistance services to persons or families eligible to receive them, chargeable to public funds of the Commonwealth and its municipalities, shall comply with the following requirements:
(a) Shall establish an internal system of fiscal auditorship which permits the Secretary of Health or his representative to verify the active cost of the medico-hospital assistance services to be offered to persons or families eligible to receive such, chargeable to public funds of the Commonwealth and its municipalities.
(b) Shall establish an internal system of medical auditorship, acceptable to the Secretary of Health, and which permits him or his representative to verify, at least once every year, the quantity, variety, duration, utilization and quality of the medico-hospital assistance services rendered to persons or families eligible to receive them chargeable to public funds of the Commonwealth and its municipalities.
(c) He shall annually submit to the Secretary of Health the reports as may be requested in regard to his services and he pledges himself not to request additional payments from his patients for services rendered chargeable to public funds.
(d) He pledges himself to reclaim from insurance plans of medico-hospital assistance services, the reasonable charge of the services covered by the policy of the person insured with these plans when said insured person is also eligible to receive the services chargeable to public funds of the Commonwealth and its municipalities. In these cases, the Secretary of Health shall be solely responsible for paying that portion of the reasonable charge of the services not covered by the policy of the insured.
History —June 21, 1969, No. 56, p. 100, § 11, eff. July 1, 1969.