Prejudicial Mediation Procedure in Health Matters (PROMESA) – Decree No. 379/2025
Health Department – Life Sciences Report | Prejudicial Mediation Procedure in Health Matters (PROMESA) – Decree No. 379/2025
On June 4, 2025, Decree of Necessity and Urgency No. 379/2025 (the “Decree”) was published in the Official Gazette, through which the Executive Power of the Nation introduces the “PREJUDICIAL MEDIATION PROCEDURE IN HEALTH MATTERS” (PROMESA). This initiative arises in response to the marked increase in judicial litigation in the healthcare sector, especially regarding claims by users against social security entities and prepaid medicine companies.
In this context, the Decree seeks to promote alternative dispute resolution mechanisms, optimizing access to healthcare and alleviating the judicial system, in line with the fundamental rights enshrined in the National Constitution and international treaties.
Main Features of Decree 379/2025
The Decree amends the Mediation and Conciliation Law No. 26,589, incorporating PROMESA as an optional and preliminary stage prior to the initiation of any judicial action in health matters, including amparo remedies and precautionary measures, provided that the respondent is an entity covered by Laws No. 23,660, 23,661, or 26,682. The most relevant aspects include:
• Optional Nature: The procedure is voluntary for the claimant. Once a judicial action is initiated, the right to mediation is waived.
• National Registry of Mediators: A specific chapter is created for mediators in health matters, with mandatory training and competency examination requirements, under the joint supervision of the Ministries of Justice and Health.
• Specialized Training: Basic and ongoing training programs are established for mediators, with technical, legal, and ethical content specific to the healthcare sector.
• State Participation: The Ministry of Health may intervene in mediation hearings when the case requires, through its legal representatives, to assist in the search for solutions.
• Invitation to Local Jurisdictions: The provinces and the Autonomous City of Buenos Aires are invited to adopt similar procedures within their respective jurisdictions.
Description of the Procedure: Annex I – PROMESA
Annex I of the Decree regulates in detail the operation of PROMESA, establishing the following guidelines:
• Governing Principles: Voluntariness, confidentiality, and promptness. The objective is to offer a less costly and more agile alternative for the resolution of health-related disputes.
• Scope of Application: Optional and preliminary procedure prior to any judicial action in health matters against social security entities and prepaid medicine companies, including amparo actions and precautionary measures.
• Legal Representation: The intervention of an attorney is mandatory for the parties. Free legal aid is provided for those who demonstrate insufficient resources.
• Appointment of the Mediator: The mediator is appointed by lottery before the National Directorate of Mediation and Participatory Methods of Conflict Resolution of the Undersecretariat of Access to Justice of the Ministry of Justice, at the request of the claimant through the Remote Procedures Platform (“TAD”). The claimant must pay a fee and notification costs.
• Hearings: The mediator must schedule the first hearing within five (5) business days of their appointment. Within the established mediation period, the mediator may convene as many hearings as deemed necessary, with a maximum interval of five (5) business days between them.
• Non-Appearance: Mechanisms are provided to reschedule hearings in the event of justified absence. Unjustified non-appearance by the respondent allows the claimant to conclude the procedure or request a new hearing.
• Early Conclusion: If the mediator detects a serious risk to the integrity of the claimant, the mediation must be terminated, and this must be recorded in the closing minutes.
• Mediator’s Fees: Fees are set according to the scale for matters without pecuniary value. If an agreement is reached, the fee is paid by the respondent; if no agreement is reached, it is covered by a special fund, with the possibility of reimbursement in the event of a cost order. A claimant who does not initiate judicial action after unsuccessful mediation must reimburse the fee to the fund.
• Requirements for Mediators: Prior registration in the National Registry of Mediators, approval of training programs, and passing a competency examination. Ongoing training is mandatory.
• Training Programs: The Ministry of Justice, together with the Ministry of Health, will approve the content of the training programs and the methodology of the competency examination for aspiring mediators in health matters. The required training programs are as follows:
o a) Basic training program in health mediation.
o b) Ongoing and mandatory training program.
• Applicable Regulations: Law No. 26,589 and its regulations apply, except for provisions incompatible with PROMESA.
This Decree will enter into force sixty (60) days from its publication in the Official Gazette.
Sincerely,