In the last year, 18% of the total registered claims were due to the denial of medicines and/or medical devices.
The National Health Superintendence sanctioned Audifarma and Sumiprocess pharmaceutical managersfor not fulfilling their duties with affiliates to the health system, such as the timely and complete delivery of medicines.
The entity made the decision of Impose penalties of 230 monthly minimum wages in force to Audifarma and 250 salaries to sumiprocess, After indicating that these managers did not comply with the guidelines related to the dispensation of medicines and/or medical devices, in addition to the denial to report relevant information to determine the impact of their breach.
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“There is a legal vacuum due to the lack of regulation of pharmaceutical managers and logistics operators of health technologies; However, this does not prevent us from acting, since, As guarded subjects, they assist duties clearly established in the statutory law that regulates the fundamental right to health and some general rules of the health sector that are applicable to it, ”said the Superintendent of Health, Giovanny Rubiano.
The official stressed that Currently in Colombia there are 137 pharmaceutical managers identified, that act within the health system from a contract concluded with an EPS, which has the responsibility of paying that pharmaceutical manager (provider of health technologies) for fulfilling a specific role within the SGSS: dispensing ambulatoryly and in a way timely medicines and/or medical devices.
“It is not admissible that the same pharmaceutical manager signs contracts with different EPS without having the logistics capacity and installed, to attend to all its affiliates, normalizing the creation of slopes for the delivery of health technologies, and the worst, without monitoring of these slopes for delivery, ”he said.
According to data registered by the National Superintendence of Health, In the last year 18% of the total registered claims dealt with the denial of medicines and/or medical devicesdue to lack of opportunity in the dispensation or incomplete delivery of these.
In total, A total of 290,836 claims were presented, of which 276,014 are authorized technologies charged to the Capitation Payment Unit (UPC) and 14,372 are for non -covered technologies.
“Therefore, On this occasion we impose fines on these two pharmaceutical managers that have breached the timely dispensation of medicines and/or medical devices to the patients of the SGSS and the report of the required information, ”added the Supersalud.
Audifarma
Giovanny Rubiano said that In the case of Audifarma, “the Superintendency found that there were deficiencies in the reports of information and breach repeated in the dispensing of outpatient medications In the department of Caldas, affecting the users of the health system belonging to the EPS with which the contracts had been signed. For these reasons, the Supersalud, through an administrative measure, imposed a penalty consisting of a fine that amounts to two hundred thirty (230) minimum legal monthly wages in force – SMMLV ”.
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Sumiprocess
The National Superintendence of Health explained that In the case of the Sumiprocess Pharmaceutical Manager, the breach in the regions was greater.
“In relation to sumiprocess, pharmaceutical manager who signed a contract with an indigenous EPS to operate in the department of La Guajira (at the time), It was found as a result of an audit process, evidence of irregularities in the delivery of medical devices, not delivery of the required information and not subscription of the improvement plan That, by legal provision, they must submit to correct evidence. Through an administrative measure, a fine consisting of a fine that amounts to two hundred and fifty (250) current legal monthly minimum wages – SMMLV, ”said the official said.
He explained that in the case of La Guajira, At the time of the inspection action the manager did not have a minimum inventory of medicines and/or medical devices available in its pharmaceutical establishmentindicating that from the requirement by users, the manager barely ordered another city, where they were sent by land, thus breaking the opportunity in the dispensation and security measures for the transport of these technologies in health.
“The growing claims for lack of timely delivery or denial of a medicine already authorized by the EPS, They have forced the Supersalud to use the legally available measures to exercise control actions About these guarded, ”he said.
Another of the findings detected by the Delegation of Administrative Investigations of the Superintendence of Health, is the breach in the established regulations and regulations.
“That the pharmaceutical manager does not have the entire regulation, as with other SGSS actors, Nor implies that responsibility falls only to the insurer. Many forget that they voluntarily acquired obligations within the SGSS Linked to the population affiliated with the EPS with which they signed the contracts for the dispensation of health technologies, this being the determining fact of responsibility with the health system, ”added Giovanny Rubiano.
Source: Integrated information system.
