Government issued a decree that forces the transfer of millions of users to Nueva EPS, despite its crisis

The Ministry of Health issued a decree establishing new rules for the operation of EPS in different territories of Colombia....

Government issued a decree that forces the transfer of millions of users to Nueva EPS, despite its crisis

TL;DR

  • New Ministry of Health decree limits the number of EPS operating in Colombian territories based on population size and market share.
  • EPS with fewer than one million affiliates may continue operating unless their market share in a department falls below 3%.
  • Departments have specific minimum EPS participation percentages based on population size.
  • Millions of users will be transferred to larger EPS, with over 2.6 million expected to go to Nueva EPS.
  • The decree aims to organize health insurance, ensure economies of scale, and prevent systemic risks.
  • Critics, including Representative Andrés Forero, argue the decree disregards previous rulings and forces patients into a struggling EPS.
  • President Gustavo Petro defends the decree, citing cost savings and improved efficiency through territorialization.
  • Former minister Alejandro Gaviria criticizes the decision as inhumane and lacking justification.
  • Users transferred to a new EPS must wait 60 days before they can request a transfer, with exceptions for family reunification and indigenous communities.
  • Subsidized and public contributive EPS must contract at least 60% of their health spending with local State Social Enterprises (ESE).