Medical coverage for about one million Puerto Ricans on Medicaid is in danger because of the $60 million debt that insurer Medical Card System has piled up with physicians.

MCS is one of the three providers for Mi Salud (My Health), as Medicaid is known in Puerto Rico.

The president of the Independent Practice Association, or IPA, Dr. Joaquin Vargas, said Wednesday that the situation is critical, especially for medical groups in metropolitan San Juan.

Vargas said that the problem had caused uneasiness among Mi Salud patients because of the possibility that the doctors having contracts with MCS might stop providing their services.

The press reported that the laboratories and doctors in Greater San Juan already have stopped accepting Mi Salud patients due to the fear that MCS won't pay.

Vargas's complaint comes nearly a week after Health Secretary Lorenzo Gonzalez announced the cancellation of the government's contract with MCS for non-fulfillment of the agreed-upon conditions.

The IPA asked that - to avoid future problems and as a basic part of the chain that provides medical care to Puerto Ricans - it be allowed to participate in the negotiations to choose a replacement for MCS.

The doctors' demand is shared by laboratories and pharmacies who provide service to the beneficiaries of Mi Salud.

MCS alleges that the government owes it more than $240 million, but according to San Juan Gov. Luis Fortuño's administration it is ready to disburse about $90 million to the insurer.

MCS president Jose Duran in June said that months ago he notified the authorities of the difficulty of maintaining healthcare services through Mi Salud.

He blamed the problems on growing use of services, which combined with the low premiums allocated to the program and the delays in government payments to MCS put the viability of Mi Salud in danger.

Mi Salud is due to receive $9 billion in federal Medicaid funding between 2011 and 2019.