Supersalud orders EPS to remove authorizations for patients with serious illnesses: which ones?

The Superintendent of Health, Giovanny Rubiano, proposed eliminating the prior authorization procedures for long-term treatments in order to improve access to medical care for patients with serious and chronic diseases in Colombia.

Through a thread on X, the official said: “If a user suffers from a chronic disease that requires long-term treatment, the user should not have to go through authorization procedures and other access barriers to health technologies and treatments required for their care. The EPS should not only have them identified, but also facilitate access and availability to these technologies and their treatment.”

#SupersaludMásHumana : "If you suffer from a chronic disease that requires long-term treatment, the user should not have to go through authorization procedures and other access barriers to health technologies and treatments required for their care. The EPSs do not… pic.twitter.com/oX0jh7gqGu

— Supersalud (@Supersalud) February 25, 2025

Diseases that are classified as serious or chronic are: cancer, diabetes, hypertension, heart disease, arthritis, chronic obstructive pulmonary disease, COPD; multiple sclerosis, HIV/AIDS, epilepsy and hypothyroidism.

The list of conditions mentioned above, in addition to preventing normal daily activities and requiring very extensive treatments, requires constant medical attention. This, coupled with long waiting times or difficulties in accessing appropriate medications and treatments, has led many users to file complaints.

According to recent information from the National Health Superintendency, 68 percent of complaints related to incomplete delivery or non-delivery of health technologies correspond to five main EPSs: Nueva EPS, Salud Total, EPS Sanitas, EPS Sura and Coosalud.

This situation is worsening in other EPSs in the country. AsmetSalud is one of them. Of the 26 patients with rare diseases, 65 percent are still waiting for the necessary medicines to be delivered to them.

Regarding the New EPS , Bernardo Camacho, its intervening agent, stated that they have executed a plan to find solutions that benefit those who suffer from these chronic diseases: “we made an evaluation of the different pharmaceutical managers and we have made important changes that allow them to catch up with the industry and thus be able to guarantee the dispensing of medications.”

Due to the situations mentioned with the EPS, Rubiano asked to speed up and propose solutions for the delivery of medicines to patients with special health conditions. This is in order to reduce the structural problems that have been reflected in the Colombian health system in recent years.

Giovanny Rubiano García demanded that the EPS, under intervention and not intervened, advance in solutions for the delivery of medicines to patients with special health conditions. In the total of claims for health technologies not delivered, untimely or incomplete, 5 EPS… pic.twitter.com/yj0UifIaxN

— Supersalud (@Supersalud) February 25, 2025

Although beyond delays and lack of deliveries there are many problems with the health system that affect the majority of Colombians, the measure suggested by Supersalud could be a decisive step to resolve one of the problems that affects the quality of life of an important sector.