The District Personery of Barranquilla initiated special surveillance of all the EPS after learning of the decision of guardianship of the Third Municipal Civil Court that favors children and older adults with cognitive and physical disabilities, whose care had been denied by the liquidated Coomeve EPS.
According to the aforementioned ruling, the Health Promoting Entities, EPS now involved in care are: MutualSer, Sanitas, Cajacopi, New EPS, Compensate, Sura, Total Health and Coosalud that they must, within 48 hours following the notification of this ruling, “restore and guarantee the continuity and provision of health services without interruption required by the plaintiffs, especially nursing, according to the health conditions of the guardians in the same way that it had been previously provided by Coomeva EPS SA”, underlines the court order.
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As will be remembered, the tutela action was filed by the Personero de Barranquilla Miguel Angel Alzate Salcedo; the Regional Ombudsman, Miguel Linero De Cambil Álvarez and the Atlantic Provincial and Regional Attorney, Margarita De la Hoz Jureacting as informal agents of those affected.
The provision of health services without interruption required by the plaintiffs, especially nursing, according to the health conditions of the guardians
In its ruling, the Judge warns of the need and urgency to attend to the requirement raised by the plaintiffs, before the liquidation of Coomeva EPS SA, that in the peremptory term of 48 hours following the notification, the provision of services is guaranteed. required prescribed by the treating physicians in theas EPS in mention.
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The plaintiffs are children, adolescents and elderly people with disabilities, affiliated with Coomeva EPS, with diagnoses of cerebral palsy, autism, behavioral disorder, Down syndrome, Lenos Gastaws, orphan refractory epilepsy disease, disability due to tumor cerebral and total exhaustion, among others.
It was established in what was stated in the guardianship that since December 28, 2021, Coomeva EPS arbitrarily suspended the 24-hour nursing service for children, adolescents and elderly people with disabilities.
Miguel Alzate Salcedo, representative of Barranquilla.
The medical nursing service was suspended because Coomeva EPS stopped paying the value of the same to the provider Hogar Salud IPS.
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Following this decision, Coomeva EPS not only failed to comply with pending payments to Home Health IPS to continue with the nursing service, but, on the contrary, imposed another provider: Amadis IPS.
There are 3,000 guardianships against Coomeva
Given all these irregularities, the National Health Superintendency ordered on January 25, 2022 the liquidation of EPS Coomeva, after evidencing the impossibility of correcting the financial situation in which it finds itself and as protection for the life and health of its 1.2 million affiliates in 24 departments of the country .
According to information from the Superintendency, the EPS has liabilities close to 1.7 trillion pesos, a level of indebtedness of 1.6 times the value of the asset, a gap of 204,230 million pesos in adequate equity and accumulated losses of more than one billion pesos. pesos.
In the last three years, EPS affiliates filed 30,000 guardianships and 193,100 complaints and claims for poor provision of health services.
BARRANQUILLA
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