A form of health system fraud that has taken advantage of the vulnerability of more than 50 pregnant women in recent months to collect large sums of money for maternity leave is being reactivated in the country.
(Read: They will extend paternity leave: this is how it would work after approval)
This is evident after an analysis of the EPS associated with Gestarsalud, especially those most vulnerable, can have access to decent, equal and quality health from the assurance model.
Specifically, in the systematic surveillance of health resources carried out by Gestarsalud and its EPS, behaviors of some companies in different regions of the country that affiliate pregnant women through an employment relationship were identified in order, with alleged illicit forms, to appropriate the payment of maternity leave.
The fraud starts when they contact pregnant women; the company that will act as employer affiliates them as workers, paying them on a minimum wage basis for the first months; in some cases they are only affiliated by health, without contributing to the other social security systems; then, in subsequent months, they increase the contribution base to salaries that in some cases can reach a variation of 200, 400 percent or more; in that way, At the time of delivery, the salary base is much higher and on it the EPS must recognize the payment of maternity leave.
The fraud occurs in the appropriation of the resources of the maternity leave which is established according to the price at the time of delivery, as defined by current provisions.
It has been identified that as soon as the period of maternity leave begins, the contribution base is lowered again and in some cases they are disengaged, even before they complete this period.
According to the information collected by the associates in Gestarsalud, more than 50 pregnant women have been victims in recent months of this fraud, which despite having been documented since 2017 continues to occur without any substantive interventions by all the entities involved in the process.
As it is a recurring fraud, it is estimated that the loss of resources could be in the millions.
Due to these facts, the EPSs associated with Gestarsalud have already filed criminal actions with the Public Prosecutor’s Office and have delivered evidence to the different entities, requesting their intervention to stop these fraudulent actions.
