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Denuncian presunta estafa de 36 IPS que facturaron servicios sin tener infraestructura física - Salud | CiudadRegion Noticias
ADRES La Administradora de los Recursos del Sistema General de Seguridad Social en Salud (ADRES) ha denunciado ante la Fiscalía General de la Nación a 36 Instituciones Prestadoras de Salud (IPS) por presunta estafa y falsedad , al facturar servicios médicos sin contar con la infraestructura física necesaria para prestarlos.
ADRES solicita investigación a la Fiscalía El director de la ADRES, Félix León Martínez , confirmó que la entidad ha solicitado formalmente a la Fiscalía iniciar una investigación contra 36 IPS que, a pesar de contar con un registro de habilitación , no disponían de la infraestructura requerida para la prestación de servicios de salud.
La irregularidad se detectó tras auditorías iniciadas en 2023 , cuando se identificó que estas IPS facturaban servicios sin tener instalaciones operativas . Ante estos hallazgos, el 12 de septiembre de 2024 , la ADRES ordenó la suspensión de pagos a 52 IPS , las cuales habían radicado cuentas por más de 70 mil millones de pesos .
Hallazgos de la ADRES y medidas adoptadas Las auditorías realizadas por la ADRES permitieron establecer que estas 36 IPS pretendían apropiarse ilegalmente de 79.511 millones de pesos . Para prevenir esta posible defraudación al sistema de salud, la entidad implementó nuevos controles tecnológicos y auditorías en terreno , permitiendo detectar anomalías y desviaciones en las reclamaciones presentadas.
De las 52 IPS inicialmente notificadas , los resultados fueron los siguientes:
26 IPS no presentaron recurso de reposición , por lo que la suspensión de pagos quedó en firme.10 IPS presentaron recurso, pero fue resuelto de manera desfavorable .3 IPS están en proceso de notificación .9 IPS lograron demostrar su capacidad operativa y les fue restablecido el pago .4 IPS aún están en estudio .Las irregularidades detectadas se concentran principalmente en la región Caribe , con 28 municipios afectados en Atlántico, cinco en Córdoba y uno en Magdalena .
Fraude con reclamaciones de accidentes de tránsito Uno de los factores clave que encendió las alarmas en la ADRES fue el aumento inusual de reclamaciones por servicios médico-quirúrgicos , supuestamente prestados a víctimas de accidentes de tránsito relacionados con vehículos sin SOAT o inexistentes .
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Según explicó Félix León Martínez , estos casos fueron identificados mediante auditorías en terreno realizadas por tres firmas contratadas en 2024 y un equipo interno de auditoría concurrente . Además, el Grupo de Innovación y Analítica de la ADRES se encargó de la contrastación de datos para validar las reclamaciones.
Garantías para la transparencia en los recursos de salud Las denuncias presentadas por la ADRES ante la Fiscalía buscan que se investigue a los responsables de esta presunta estafa al sistema de salud . Las autoridades trabajan para evitar que recursos públicos sean desviados y garantizar que el dinero destinado a la salud llegue a las verdaderas IPS que cumplen con la normativa .
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