Nueva EPS's Suspicious Balance Sheet: Health of 1,1 Million People in Uncertainty

The disclosure of Nueva EPS's financial situations for the years 2023 and 2024 continues to create great uncertainty, especially in the Valle del Cauca region. In this region, the access to healthcare services for more than one million people is directly linked to this institution, and the ongoing financial crisis is increasingly raising public concerns. Although the financial reports contain significant losses and economic obligations, the dimension of the debt relationship with the service providers in the region has not been fully clarified. Authorities have repeatedly emphasized that the current data remains insufficient to determine the institution's true debt level. Therefore, what kind of healthcare services the local population will receive in the future is currently a big question mark.

Department Health Minister María Cristina Lesmes has stated that the announced financial statements have not yet passed financial audit approval. Due to this deficiency, it has become impossible to determine the exact total debt amount owed by Nueva EPS to hospitals, clinics, and other healthcare institutions. Lesmes pointed out that the official non-certification of these statements seriously hinders transparency. The competent authorities carefully refrain from announcing any definitive figures until the certification process is completed. This situation leads to both the victimization of healthcare service providers and the erosion of public trust.

Nueva EPS is the largest health insurance institution in the region, with approximately 1,1 million registered members in the Valle del Cauca department. This massive number of members also makes the institution the largest potential debtor in the regional healthcare system. The financial report in question was prepared in line with a decision made by the Cundinamarca Administrative Court, and Nueva EPS was obliged to fulfill all its obligations. The court stipulated that the institution must submit its financial statements to the National Health Superintendency, Court of Accounts, and Ministry of Health. Despite this, the failure to present a transparent table suggests that legal processes are also insufficient.

The Regional Health Ministry announced that there are serious difficulties arising from the structure of the payment systems in determining the real value of the pending debts. According to Lesmes, while a portion of the payments is made through a direct payment mechanism, another portion is carried out in the form of treasury transfers that the local government cannot track. It has been noted that the direct payments are not at the eighty percent level as claimed by the institution, but remain at a significantly lower rate. Since the transfers made through the treasury do not appear transparently in Nueva EPS's records, the audit mechanisms become dysfunctional. This structural issue both deepens the lack of inter-institutional trust and prevents the financial statements from being realistic.

Historical discrepancies between the past reports of the EPSs and the healthcare service providers' own records also further complicate the process. The main reason for these differences is that refunds and objections in invoices have not yet been fully integrated into the financial statements. Lesmes mentioned that there is even talk of the existence of an 11 billion peso debt dating back to 2008 and still not included in the system. The existence of such old and unresolved items continuously makes it impossible for the institution to create a definitive financial balance sheet. Currently, the Ministry of Health and healthcare institutions are conducting a joint review to determine the current and accurate debt amount.