2024-06-07 14:18:17
The Nationwide Superintendent of Well being, Luis Carlos Leal Angarita, offered this Thursday a report on the principle conditions encountered by the intervening brokers in three EPS lately subjected to compelled administrative intervention measure.
Leal Angarita defined that the studies of the intervening brokers help the choices made by the Nationwide Well being Superintendency and reveal a part of the truth of the EPSs intervened. Subsequent.
EPS Well being
The auditor recognized bills within the operation of medical facilities for 104,226 million pesos on the finish of 2023. Leal Angarita careworn that these investments ought to be made by the IPS, not by the EPS, particularly when the medical facilities belong to the identical enterprise group, evidencing inappropriate vertical integration. As well as, a number of contracts had been signed with out clear advantages for Sanitas.
Evaluation of the well being scenario and characterization of the inhabitants
The report revealed a scarcity of element within the distribution of the affiliated inhabitants, the supply of companies, the put in capability of the suppliers and the gaps in provide. The absence of study on social and financial circumstances, description of high-cost pathologies, intervention packages and prioritization standards was additionally noticed.
Contract for the availability and shelling out of medicines
Sanitas signed a contract with an exclusivity clause that stops the availability and shelling out of medicines by different suppliers, apart from short-term permission from the contractor. This example limits the operational capability of the EPS to handle the distribution of medicines.
New EPS
12,645,762 bill information had been discovered within the audit, valued at greater than 4.4 billion pesos, not included within the monetary statements officers, which whole 5.7 billion pesos. This discovering multiplies the EPS debt considerably.
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Lack of studies from suppliers
The EPS made funds to suppliers with out verifying the efficient provision of companies, particularly in well being promotion and prevention. Within the first quarter of 2024, community adequacy was 87.7%, with gaps of 12.3%.
Enhance in medical spending
Medical spending elevated by 58% between 2022 and 2023 attributable to changes in technical reserves, leading to an accident fee of 118.93%.
Inconsistent registration of advances
Inconsistencies had been reported within the registration of advances granted since 2008, which haven’t but been legalized.
EPS SOS – Western Well being Service
A big danger was noticed because of the focus of the first degree in a linked supplier (Comfandi), complicating the effectivity analysis.
Low execution of Potential World Cost (PGP) contracts
A low execution of 82.35% of the PGP contracts signed with COMFANDI between August 2023 and March 2024 was reported, which is equal to $19,629 million. As well as, difficulties had been encountered in recovering greater than 14 billion for companies supplied by different IPS attributable to contractual inconsistencies.
Superintendent Statements
«All of those findings require a a lot deeper evaluation., which we’re going to consider along with the work plan offered by every intervener. Because the Superintendency we’ve got the accountability of verifying that this plan is fulfilled. “We’re going to do all the things to ensure that well being sources are used appropriately to guard individuals’s lives,” mentioned Leal Angarita.
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