The Ministry of Health issued a resolution that modifies the criteria under which health promoting entities (EPS), or those who fulfill their functions, may operate in the national territory. The measure establishes new standards for its authorization, authorization and permanence, within the framework of the implementation of the preventive, predictive and resolutive health model.
As provided, EPS must reorganize their operation based on a scheme of functional subregions for the integral territorial management of public health. The National Superintendence of Health will be in charge of updating the administrative acts of operation, incorporating the new territorial scope defined by the Ministry.
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“The territorialization process will be developed from a tipology of categorized subregions according to their degree of urbanization, dispersion and ethnic approach”, Says the document. In these areas, the number of authorized EPS will be limited, with the exception of those with a lower proportion of affiliates, which could be excluded from the corresponding territorial scope.
In metropolitan type subregions, for example, All current EPS will be allowed, except for those whose participation in the total number of affiliates is less than 3%. In other cases, such as rural or high dispersion areas, the number of enabled entities will be more restricted, with a maximum of three EPS by subregion.
The resolution also details the procedure for the reallocation of affiliates once the updated authorization of the EPS has been issued. This task will be in charge of the Ministry of Health and the administrator of the Resources of the General System of Social Security in Health (ADRES), Based on the Single Affiliate Database records (BDUA).
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Guillermo Jaramillo, Minister of Health and Social Protection
Cesar Melgarejo – Portfolio
The standard determines that receiving EPS may not reject assigned users. “The assignment of affiliates will be carried out without distinction of the origin regime, and its effectiveness will be from the first calendar day of the month following the delivery of the information”Indicates the resolution.
During the first 60 days after this allocation, Affiliates will have the possibility of moving to another authorized EPS within the same functional subregion. In particular situations, such as when members of the same family remain in different entities, the transfer may be carried out immediately.
As for indigenous EPS (EPSI), these will continue to operate in the territories where they are already enabled and may receive registered indigenous population, with priority for those entities with local presence. Besides, Compensation boxes that manage health programs with less than 500,000 affiliates will not be able to receive new users in regions where they do not have prior authorization.
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EPS with less than 3% of affiliates in a metropolitan subregion will not be able to continue operating in that area.
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EPS who wish to withdraw from a functional subregion must request it from the Superintendency within the year following the issuance of the new authorization. The application must be based on technical reasons and contain a plan of pending obligations with providers and suppliers. “The withdrawal will be subject to the decision of the Superintendency, which will have a maximum period of six months to resolve each case,” says the normative act.
From the entry into force of the resolution, The EPS will have a year to adapt their operational capacity to the new qualification criteria defined in the technical annex. These include components such as risk management, user attention, citizen participation, information systems and articulation with the integral and integrated territorial health networks (RIITS).
“Compliance with the standards will be verified by the National Superintendence of Health, which will prioritize visits and audits according to the level of risk and performance of each entity”, Is explained in the articles.
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The Ministry and Adres will reassign affiliates based on new authorizations, and the receiving EPS will not be able to reject assigned users.
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Besides, The updated operation authorization will be valid for three years, renewable after verification of compliance with the established conditions. The resolution also includes financial and patrimonial monitoring measures of the EPS, in accordance with the provisions of Decree 780 of 2016 and its complementary standards.
Finally, the Superintendency must keep updated a public repository with the information about the authorizations of the EPS, its territorial operation and entities that are under administrative measures. This provision seeks to strengthen the transparency of the system and guarantee the traceability of regulatory decisions. It is worth noting that the regulations repealed Resolution 497 of 2021.
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Diana K. Rodríguez T.
Portfolio journalist
