In its audit of the resources collected from the Administrator of the Resources of the General System of Social Security in Health (Adres), the The Comptroller’s Office found corresponding transfers for the care of people injured or killed in traffic accidents where the vehicle involved did not have the Mandatory Traffic Accident Insurance (Soat) for said attention.
The control body found a total of 13 cases in which 102 million pesos would have been collected “generating a possible impairment of the resources of the General Health Security System for this amount”.
Additionally, it was detected that in the audit corresponding to the year 2018 and July 2021 some of the controls established for this type of procedures. This report names other irregularities related, for example, to the alleged provision of the ambulance patient transfer service.
In addition, it was found that charges were made for the service of emergency vehicles directed to care centers for patients who were in different and distant places. Services from the same ambulance also appeared with only five minutes difference between one transfer and another.
The Comptroller’s Office considered that it was unlikely that these vehicles could be lent so quickly, so it warned that at least “one of the documents differs from reality”.
Facts that were identified mostly in the Health Provider Institution (IPS) of Valle del Cauca and Córdoba.
Similarly, in the audit he drew attention to alleged double payments of ambulance transport expense claims for the same user and accident, with a different filing date for $102,745,121. “It is evident that the health service providers presented the same support more than once to presumably claim 2 or 3 times the same recognition for transportation service and that the Adres made double payments for these claims.”, said the entity.
An example recounted in the report was that of a citizen who died on December 12, 2014. State records show that 11 million pesos were paid to an IPS for his care after the person allegedly suffered a traffic accident on December 11. September 2019, five years after his death.
Another of them was evidenced in the care of a person who died on November 17, 2015, due to an alleged accident recorded on December 10, 2012 where 17 million pesos were paid, which, according to the claim, lost his life.
During the report, one of the most serious findings was the possible cartelization of services that are concentrated in certain IPS in the country. It was noted that, despite the fact that there was a care center near the place of the accident, the patient was taken to a more distant place that coincides with the IPS that most injured people use.
In the regions where there are more complaints, one or three IPS, were identified in Atlántico, Bolívar, Córdoba, Magdalena and Valle del Cauca.
According to the figures, there 786 records of complaints that the control body managed to georeference, “for which the accident gave rise to a claim (…) that was attended by the concentrating IPS (Inversiones Azulud SAS, Bahía SAS Diagnostic and Imaging Center, Bahía SAS Medical and Rehabilitation Center) and/or for which the patient was transported by ambulance”.
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