De manera conjunta el Ministerio de Educación y el Ministerio de Salud publicaron un proyecto de decreto con el que se daría aval para que las empresas de medicina prepagada participen en la prestación de servicios de salud para los afiliados a regímenes excluidos de la Ley 100 bajo un régimen diferente al de medicina prepagada.
Recordemos, que según el Decreto 780 de 2016 las EPS podrán organizar la prestación de servicios de salud de los trabajadores de las entidades que quedaron expresamente exceptuadas del Sistema General de Seguridad Social en Salud, cuando éstas celebren contratos para tal efecto.
Del mismo modo, esta ley menciona que las sociedades de medicina prepagada tienen como objeto social la gestión para la prestación de servicios de salud o la prestación directa de estos servicios bajo la forma de prepapago, o en las modalidades especificadas (deben especificar en su objeto las modalidades de atención que ofrezcan). Estas modalidades servirán de fundamento para clasificar a la empresa como de medicina prepagada.
En este sentido, y valiéndose de un concepto emitido por el Ministerio de Salud el pasado 4 de noviembre, se establece que el Gobierno podrá modificar el Decreto 780 de 2016 para permitir de manera expresa que las empresas de medicina prepagada participen en la prestación de servicios.
Adicionalmente, se especifica que el Fondo de Prestaciones Sociales del Magisterio es autónomo para definir con que entidades o personas contratará la organización de la prestación de servicios de salud del plan de beneficios del magisterio. Sin embargo, debe haber una autorización del Ministerio de Salud y la Supersalud.
Medicina prepagada en los regímenes de excepción
Por lo tanto, de oficializar este borrador de Decreto, las empresas de medicina prepagada quedarían habilitadas para prestar servicios de salud al magisterio y otros afiliados a los regímenes de excepción tal y como se establece a continuación:
“Todas las Entidades Promotoras de Salud -EPS- y las Empresas de Medicina Prepagada podrán organizar directamente, a través de prestadores de servicios de salud, la prestación de los servicios de los trabajadores de aquellas entidades que quedaron expresamente exceptuadas del Sistema General de Seguridad Social en Salud cuando con las entidades allí mencionadas se celebren contratos para tal efecto”.
Artículo exclusivo: En medio de polémicas, Senado estadounidense votará sobre el aborto
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