More than 6 million patients could be left without EPS, warned the Superintendency of Health

With the liquidation of Medimás in early March, in the last 3 years, the National Superintendency of Health has carried out this process for 13 EPS. With the latter case alone, about 1.5 million people who were affiliated are waiting for the transfer to entities that can guarantee their service.

According to the Supersalud monitoring reports, these are the companies that are in breach of Decree 2702 of 2014, which updates and unifies the financial and solvency conditions of the entities authorized to operate health insurance: S.O.S., Capital Salud, Capresoca, Convida, CCF Sucre, CCF Nariño, CCF Huila, CCF Guajira, Ambuq, Savia Salud, Comfaoriente, Coomeva, Essanar, Asmet, Ecoopsos, Coosalud and Medimas.

Figures presented by El Colombiano, show that 6,769,943 patients are affiliated with the EPS who have special surveillance by Supersalud. In fact, one of them is under inauguration. This means that such companies must submit an improvement plan to the regulatory body, also, they will have to constantly report their performance indicators in order to enter the risk of liquidation.

Despite being a “temporary” measure, processes lasting between six months and a year, some EPS have received extensions, leading them to operate at the limit of the law. The Colombian Association of State Social Enterprises and Public Hospitals, Acesi, had already warned of non-compliance with the financial indicators of several EPSs.

In fact, the deadline they had to comply with the requirements of Decree 2702 of 2014 was 31 December. There they had to prove a minimum capital, adequate equity, technical reserves and an investment regime for technical reserves, both in the subsidized and contributory regime; otherwise they would have to leave the market.

It should be noted that the EPS had 7 years to achieve “catch up”, where the government gave them gabelas and benefits to achieve compliance. According to experts, the portfolio that EPS accumulates is almost 10 billion pesos.

The Office of the Ombudsman denounced that a high percentage of complaints received by the entity are due to failures in the services provided by health providers in the country, so the call for better attention to users was reiterated.

said the ombudsman, Carlos Camargo.

The critical situation worries clinics and hospitals, which are greatly affected by the fact that, when the EPS is liquidated, they leave debts that “remain in the air”, for example, the departure of Comparte, Coomeva and Medimás, from the country's health system, left 50 hospitals in the department of Tolima, of the first, second and third level, a portfolio of 135 thousand 798 million pesos, which no one guarantees them will be recovered.

One of the big problems for users is that when their EPS is liquidated, they are transferred to other companies, under the promise that they will not be left without health coverage, but many of them are chronic patients, with ongoing vital treatments, or who are waiting for tests or procedures that have already been approved or are waiting for the procedure to be carried out. That is why they fear that they will be left without such procedures, which beyond a procedure can mean the life or death of patients.

KEEP READING: