MENTAL HEALTH ORGANIC LAW

On January 5^th, 2024, the Mental Health Organic Law, approved by the National Assembly was published in the Official Gazette. Mental health is recognized as a human right by the Law; hence it must be handled under a comprehensive community care model, that establishes measures to guarantee its protection and promotion.

The purpose of this regulation is providing a legal framework for mental health that fosters, controls, and ensures people’s exercise of mental health rights. To this end, among its purposes, the Law recognizes mental health as part of a comprehensive health care, seeking to establish mental health policy and prevention as its central axis, promoting comprehensive health, and guaranteeing access to mental health services through the National Health System.

Prepaid Medicine and Medical Assistance Insurance Companies

As this regulation is mandatory for public and private entities, there is a specific impact on companies that finance comprehensive prepaid health care services and insurance companies that offer medical assistance insurance coverage, since the services offered must henceforth cover outpatient care; voluntary and involuntary hospitalization; prescription of medicines, including narcotic and psychotropic substances; and palliative care. 

There are specific requirements for services within the coverage, such as:

• Prescription of medications: Only professionals with third-level degrees in medicine; and physicians specializing in mental health are authorized to prescribe medication.
  
  
• Voluntary hospitalization: When outpatient treatment is not sufficient, hospitalization may be required, in which case, if the patient is conscious, their informed consent is required. For minors, parental consent applies. In persons who are legally incapable of proving their consent, this should be given by their legal representative, guardian, or curator; their spouse or cohabitant; their children of legal age; their parents; or their siblings of legal age.
  
  
• Involuntary hospitalization for emergencies and urgencies: Must follow the same rules as voluntary admission for authorization, except for the patient’s informed consent.
  
  
• Involuntary non-emergency rooming-in: Any involuntary non-emergency rooming-in procedure may be performed only with a court order. The interested person must initiate a voluntary procedure request, by the provisions of the General Organic Code of Procedure.
  
  

Health facilities providing public and private mental health services must obtain or renew their operating permit from the National Health Authority within one year from the date of publication of the Law in the Official Gazette, that is, until January 5^th,2025. 

Modification of Prices in Plans and Contracts

As a result of the modification of the coverage services in the prepaid medicine and medical assistance insurance plans and contracts, the National Health Authority will allow the adjustment of prices of fees or premiums, as provided by the Superintendence of Companies, Securities, and Insurance.

Specific regulations

Within 180 days from the publication of the Law in the Official Gazette, the President must issue the Regulation for its application of the Law. Additionally, the National Health Authority must publish in its institutional web page the list of health establishments authorized to provide mental health services within 120 days from the publication of the Law in the Official Gazette. On the other hand, the Superintendence of Companies, Securities, and Insurance must issue a regulation on price adjustments in contracts and health coverage plans within an undetermined period.

If you have any questions, the Tobar ZVS Insurance team will be pleased to provide you with specialized advice. For more information, please contact us at rdesola@tzvs.ec.

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This publication contains information of general interest and does not constitute legal opinion on specific issues. Any analysis will require legal advice from the Firm.