This is how the decree that moves them to Nueva EPS puts 2.6 million Colombians at risk
Transferring 2.6 million affiliates to the EPS that has not presented financial statements since 2023, which has increased its debts fourfold in less than two years (from ...
TL;DR
- A new decree limits the number of health insurers (EPS) operating in Colombian territories based on population.
- Approximately 2.6 million people will be transferred from other EPS to Nueva EPS.
- Nueva EPS is described as being in "chaos" with increased debts and a history of unaddressed tutelas.
- The decree mandates that EPS with less than one million users will maintain their status, but those with less than 3% market share in a department will cease operations.
- Specific participation percentages are required for EPS to operate in departments of varying population sizes.
- The transfer process includes an "special affiliation assignment" mechanism and a 60-day waiting period for users to change providers.
- Exemptions for transfers include family reunification and indigenous communities.
- Critics, including former Health Minister Alejandro Gaviria and user association presidents, condemn the decree as detrimental to patient care and free choice.
- Concerns are raised about the operational capacity of Nueva EPS to handle the influx of millions of new affiliates, potentially disrupting treatments and services.
- Legal challenges are expected, with a representative planning to request a contempt of court incident for a previously suspended decree.