2023-05-20 05:13:57
AIn addition to the functions of the Adres, one of the points that has generated the most controversy is that of the EPS, since article 49 of the bill was approved establishing that those EPS that currently operate in the country will continue to do so. doing so for a period of two years, as long as they meet the conditions of permanence. Then, they will become Health and Life Managers.
This transformation, according to the bill, does not imply its liquidation, but rather a dissolution process.
“The assets, liabilities, patrimony, will pass en bloc to the Health and Life Management Entity with subrogation of all the duties, rights and obligations, in the terms in which the National Government regulates it. The transit of the affiliates in charge of the EPS that are transformed, to the rules of social health insurance, will be determined by the National Government”.
If it is law, it will be the National Health Superintendence that will authorize, through an administrative act, the operation of the EPS that, through their transformation, are interested in managing medium and high complexity services for the population that are assigned to them. authorize and contract and the fulfillment of the other functions.
Other articles referring to the EPS that have already been approved in the Chamber are 53 and 54, which deal with the inspection, surveillance and control of said entities, and their administrative expenses.
Article 51 was also approved, which establishes that EPSs that are authorized to operate and meet the requirements to become managers, must state in writing to the Ministry of Health and Social Protection their intention or not to accept said transformation. .
According to article 50 of the reform, the Health and Life Managers will be entities of a private, public or mixed nature, which will contribute to comprehensive risk management in the assigned health territory.
New functions
They are assigned 19 specific administrative functions:
Coordinate with Departmental and District directorates the support required by the Ministry of Health and Social Protection in the organization of Comprehensive and Integrated Networks of Health Services for the Health Territories; contribute to its strategic planning and implement effective mechanisms for Care Coordination within the Comprehensive and Integrated Networks of Health Services.
They will also have to execute, under the direction of the Territorial Entities and the Adres, the activities of monitoring and evaluating the performance of the network in the complementary component; implement situational rooms that allow the analysis of information; deliver periodic reports on the operation of the complementary component of the networks.
They will participate in the Advisory Council for Planning and Evaluation of Comprehensive and Integrated Networks of Health Services; they will contribute to the efficient, rational and optimal use of financial resources; they will manage training plans to strengthen the operation of the complementary component; They will present assistance to the members of the network.
Its functions include managing, in coordination with the CAPs, access to the complementary component of the Riiss through the referral and counter-referral system and with the support of the Unified Public Health Information System; and guarantee timely and expedited access to health services and pharmaceutical services.
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