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Resolucion 1405 de 2012 – Pago directo NO POS
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Establece una medida de pago dentro del procedimiento de recobro para garantizar el flujo oportuno de recursos a las Entidades promotoras de Salud e Instituciones Prestadoras de Servicios de Salud.
La medida autoriza al administrador del Fosyga para que antes de la auditoria de las cuentas radicadas para el recobro de servicios NO POS, y luego de descontar el promedio de glosas de los ultimos doce meses y una desviacion estandar, efectue el octavo dia habil siguiente al vencimiento del termino maximo para la radicacion de las solicitudes, el pago de los servicios.
Las condiciones para que las EPS puedan acudir a este mecanismo incluyen la renuncia el cobro de intereses de mora de los periodos en los que se aplique la medida, y a girar como minimo el 50% de estos recursos directamente a favor de las Instituciones Prestadoras de Servicios de Salud, para lo cual deberan remitir la autorizacion en el formato respectivo.
La Resolucion 1405 de 2012 deroga las resoluciones 1275, 4955 y 65 de 2011.
CONSULTORSALUD considera que la medida es buena para las EPS del regimen contributivo, pues son estas las entidades que recobran los servicios NO POS al Fosyga; sin embargo continua la falta de proteccion para las EPS del regimen subsidiado, sometidas a la falta de gestion y cumplimiento de las direcciones departamentales de salud que, contando con los recursos y la obligacion establecida desde la Ley 715 de 2001, se niegan a disponer de los mecanismos apropiados, y de los contratos y convenidos vigentes con los prestadores, para autorizar y pagar directamente estos servicios no incluidos en el POS a las IPS prestatarias, sin que medie la intervencion de las EPS.
Este incumplimiento (que debe ser resuelto inmediatamente con una medida similar), afecta al ciudadano, y genera iliquidez para las EPS y para la red de prestadores. Es deseable que se autorice a las direcciones departamentales de salud (distritales tambien), para que acojan este pago directo de recobros, manteniendo el colchon de las glosas historicas del ultimo año, mientras se efectua la auditoria.
Descargue: Resolucion 1405 de 2012 – Pago directo recobros NO POS desde el Fosyga
Este artículo tiene documentos adjuntos que podrá descargar para ampliar su información:
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