An investigation by Colombian authorities have found that out of approximately 14,600 requests for reimbursement submitted health insurance companies (EPS) over four years, some 11,000 had irregularities, El Tiempo reported Thursday.
The recently exposed multi-billion dollar embezzlement scandal in the health sector led the Technical Investigation Team (CTI) of the Prosecutor General’s Office to review the payment requests for medical services and medication of five EPS.
“Only 25%, that is it to say 3,672, of the reimbursements had no problems,” said the Prosector General’s Office. The payment requests were made between 2006 and 2011.
Investigators from the CTI individually examined the payments requests made by Salud Colpatria, Coomeva, Ecopsos, Famisanar, and Solsalud.
It was found that these payment requests were reimbursed without proper consideration, receipts, or any official letters from Fosyga, the government agency that administrates health subsidies.
In some cases, payments were made supported by claims with names that did not coincide with that of the patient. Other claims were for people who were not even affiliated to that particular EPS and in certain instances the medication authorized did not reach the patient.
“The payments were made at the whim of the officials,” the CTI review concluded.