Decree No. 719 of 2024 amends key aspects of the General System of Social Security in Health, and focuses on guaranteeing the continuity of affiliates in the event of voluntary withdrawal or liquidation of Health Promoting Entities (EPS). Through it, measures are established to ensure the provision of health services through mandatory assignments and transfers to receiving EPS certified by the National Health Superintendency, and to promote stability in the Social Security System in Health and guarantee the fundamental principles of this system in Colombia.
Likewise, it establishes measures for the assignment of affiliates, continuity in health treatments, and labor protection during transfer processes, addressing the mobility of affiliates between the contributory and subsidized regimes and detailing the corresponding rights and economic benefits.
In summary, the Decree seeks to ensure the continuity and quality of health care for affiliates of the General System of Social Security in Health, establishing guidelines for their mobility between regimes and guaranteeing their rights within the framework of Social Security in Colombia.
Guarantee of Access to Health for Affiliates in Transfer Process
- Temporary Suspension of Transfers and Updates: In specific situations such as forced administrative intervention to liquidate an EPS, voluntary withdrawal authorized by the National Health Superintendency, among others, transfers of affiliates in the Single Affiliate Database (BDUA) and in the Transactional Affiliation System (SAT) are suspended, as well as updates from territorial entities in the BDUA until the corresponding assignment is made.
- Continuity in Current Treatments: It is guaranteed that affiliates can continue with their health treatments at the state, level of complexity, or specialist care in which they were being treated, without setbacks in care. The receiving entity must ensure that there are no delays in the initiation or continuity of ongoing treatments.
- Labor Protection: Labor protection is established for assigned affiliates, considering the length of stay they had in the previous entity, in accordance with current regulations. The Administrator of the Resources of the General System of Social Security in Health (ADRES) may indicate the necessary information to guarantee this protection.
- Contingency Plan: Receiving EPS must establish a three-month contingency plan to guarantee the care and continuity of health services, including priority measures such as advance payments, contracting proposals, among others, until new contracts or adjustments are formalized.
In summary, Decree 0719 of 2024 seeks to ensure that affiliates in the process of transfer receive continuous and quality health care, protecting their rights and guaranteeing the continuity of their treatments, as well as their labor stability during this process of mobility between EPS.