Users were not previously informed of the total costs
Several private hospitals were fined by the Health Regulatory Authority (ERS) and forced to return to users tens of thousands of euros unduly charged because users were not previously informed of the total costs.According to the deliberations issued in the 4th quarter last year. The ERS concluded that Hospital da Luz, SA and CUF Descobertas Hospital, both in Lisbon, as well as the Boa Nova Private Hospital (Matosinhos) violated the right to prior information to users of the total amounts to be charged for health care, limiting in some cases the freedom of choice.
As for Hospital da Luz S.A, the ERS refers to dozens of cases that occurred in the Hospital da Luz - Lisboa and Hospital da Luz - Torres de Lisboa units.
It says that the provider's actions "did not prove to be suitable and effective" in order to safeguard the rights to information for all users who complained, to "full and unconditional discharge" in some cases and freedom of choice in others, and therefore opened proceedings.
Of 13 cases analyzed, the ERS orders the provider to review billing and return to users the amounts charged, which in the cases mentioned exceed 1,500 euros.
The regulator considers that both units of Hospital da Luz S.A. also violated their duty to keep their registration data up to date, namely information on agreements and conventions they hold.
It warns that health care providers should refrain from presenting incomplete estimates or budgets for treatment episodes and stresses that whenever it is not possible to estimate all the procedures, exams, consumables or drugs that may be used, "users should be clearly informed of the impossibility of an estimate and warned of the relevance of this in the total cost".
In the case of agreements with the SNS, ADSE or other public or private health subsystems or health insurance, the regulator says that providers should take "special care when transmitting information on the conditions of access of users to the health care they provide.
"It should be ensured that, prior to the provision of health care, users are fully informed of the existence of conventions or agreements and their applicability in the specific case, especially if the proposed acts are covered in the respective coverage," writes the regulator. As for the CUF Descobertas Hospital, the ERS mentions the case of a user who was presented with an estimate for a surgery worth 7,000 euros and subsequently received an invoice for payment of around 17,000 euros.
In this case, ERS says that the provider "put into question the rights and legitimate interests of users", primarily at the level of the obligations of "providing accurate, timely and transparent information" in a moment prior to the provision of health care.
In further investigation, the regulator says it has become aware of 12 more identical complaints (billing problems), having ordered the review of the invoices in question and the return of amounts unduly charged, which in the cases pointed out exceeds 21,000 euros.
The ERS has ordered CUF Descobertas Hospital to review and update the procedures in force and make the necessary corrections, and since some reported cases indicate violation of users' freedom of choice, the ERS has ordered the opening of the respective administrative offence proceedings.
Finally, as for the Boa Nova Private Hospital, it also says that there was evidence that the provider's actions "put into question the rights and legitimate interests of users" regarding the provision of "accurate, timely and transparent" information prior to the provision of health care, and orders the review and updating of procedures, making the necessary corrections and returning the amounts unduly charged.
Since at least one case was detected that indicates a violation of the user's freedom of choice, an administrative offence proceeding was also opened.
"Users should know, as accurately and as closely as possible, the total cost of the treatment and intervention proposed to them, so that they can confirm whether they are able to bear these costs themselves or through any subsystem or insurance contract they may have," the regulator stresses.
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