Contraloría confirmó hallazgo fiscal por más de $80 mil millones contra exinterventor de Saludcoop,
*El presunto detrimento patrimonial se dio durante la intervención forzosa de la EPS en la vigencia 2015, bajo la administración de Guillermo Grosso Sandoval como Agente Interventor
Una indagación preliminar adelantada por la Contraloría General de la República confirmó un hallazgo fiscal por más de $80.631 millones de pesos contra el exinterventor de la EPS Saludcood, Guillermo Grosso Sandoval, tal como se había evidenciado en una auditoría concluida a finales de 2016 (sobre la vigencia 2015) a la entonces intervenida empresa, hoy en liquidación.
Tales recursos debían haberse destinado a la prestación de servicios de salud a favor de los afiliados de la EPS y, en su lugar, fueron invertidos en gastos de administración.
Se trata de hechos nuevos, distintos a los que en su momento dieron origen al millonario Proceso de Responsabilidad Fiscal de la Contraloría contra Saludcoop EPS.
En este caso, se determinó que la EPS Saludcoop sobrepasó en más de $80.631 millones el tope de los recursos destinados a Gastos de Administración.
Por la naturaleza de las irregularidades encontradas en la auditoría, se decidió llevar a cabo una Indagación Preliminar, que concluyó confirmando el mencionado hallazgo.
Gastos desbordados llevaron a liquidación forzosa
La Contraloría auditó en 2016 a la EPS Saludcoop hoy en liquidación. El informe, liberado en noviembre de ese mismo año, versó sobre la vigencia 2015 (período en el que la entidad se encontraba intervenida).
Durante el mencionado ejercicio auditor, el equipo de la CGR evidenció irregularidades relacionadas con los Gastos de Administración reportados por la EPS en cuantía de $371.469,6 millones.
Esta suma superaba abiertamente el límite previsto en la normatividad, que para la vigencia auditada y respondiendo a los recursos recibidos por Saludcoop por concepto de UPC, se había establecido en $266.961 millones como máximo posible para gastos de administración de la EPS con esos dineros.
La Indagación Preliminar confirmó el detrimento patrimonial, toda vez que se establecieron los criterios técnicos contables necesarios para determinar el porcentaje del 10% destinado a Gastos de Administración de las EPS, establecido en la Ley 1438 de 2011.
En efecto, el informe técnico de la CGR que soportó la indagación preliminar concluyó que la cuantía de los recursos recibidos por la EPS Saludcoop en Intervención por concepto de Unidad de Pago por Capitación – UPC, durante la vigencia 2015, ascendió a dos billones seiscientos treinta mil novecientos cincuenta y siete millones novecientos dos mil cuarenta y un pesos con treinta y cuatro centavos ($2.630.957.902.041.34), tomando como base el Estado de Resultados del periodo 1 enero a 30 de noviembre de 2015.
La hasta entonces intervenida EPS Saludcoop entró en liquidación forzosa el 1 de diciembre de 2015, por lo que la auditoría de la Contraloría cubrió la vigencia 2015 hasta esa fecha (del 1 enero al 30 de noviembre).
El informe técnico ratificó que, durante el periodo auditado, Saludcoop E.P.S. En Intervención efectuó Gastos Administrativos que “representan el 15,4% de los ingresos de la Unidad de Pago por Capitación – UPC, superando el límite establecido en el artículo 23 de la Ley 1438 de 2011 (…)”.
La conclusión general del informe técnico de la Contraloría, fue que:
“De acuerdo con el análisis de la información suministrada y el acervo probatorio obtenido se evidencia que los gastos de administración causados por la Entidad Promotora de Salud SALUDCOOP EPS OC En Intervención, para el periodo 1 de Enero a 31 de Noviembre de 2015 ascienden a cuatrocientos cuatro mil ochocientos ochenta y nueve millones setecientos cincuenta y un mil seiscientos ochenta y nueve pesos con noventa y dos centavos ($404.889.751.689,92), representando el 15,4% de los ingresos por concepto de la Unidad de Pago por Capitación – UPC, superando el límite establecido en el artículo 23 de la Ley 1438 de 2011, para la inversión de los recursos provenientes del Régimen Contributivo del Sistema General de Seguridad Social en Salud, en un monto de ochenta mil seiscientos treinta y un millones trescientos treinta y cinco mil novecientos treinta y seis pesos con setenta y nueve centavos ($80.631.335.936.79)”.
Detrimento a los recursos de la salud
Los hechos evidenciados constituyen un detrimento a los recursos del Sistema General de Seguridad Social en Salud, posición que no sólo la Contraloría ha venido reiterando, sino que ha sido ratificada tanto por la Corte Constitucional, como por la Jurisdicción de lo Contencioso Administrativo.
Ya la Corte en Sentencia C-549 de 2004 había afirmado que “las cotizaciones al sistema de seguridad social en salud se erigen como contribuciones parafiscales (…), pues constituyen un gravamen que se cobra a un grupo de personas afiliadas al Sistema De Seguridad Social en Salud, cuya destinación específica es financiar ese mismo Sistema, con fundamento en los principios de solidaridad, eficiencia y universalidad”.
Por lo anterior, los recursos del sistema no son propios de las EPS, sino que se trata de recursos públicos que deben destinarse a la prestación del servicio público de salud, por lo que no se pueden destinar a fines diferentes.
La Contraloría pudo entonces evidenciar que Saludcoop EPS OC En Intervención no presentaba margen de utilidad derivada de los giros de la Unidad de Pago por Capitación – UPC, porque precisamente su realidad económica la había llevado a una intervención administrativa forzosa.
Adicionalmente, la claridad con la que se superaron los topes de los Gastos Administrativos fue confirmada también por la misma Superintendencia Nacional de Salud, durante el trámite de la Indagación Preliminar.
Presuntos responsables
Para individualizar la presunta responsabilidad en el detrimento patrimonial evidenciado, la Contraloría evaluó el conjunto de actividades, económicas y jurídicas, adelantadas por las personas a cargo de las administración de los recursos públicos de la UPC, identificando al señor Guillermo Enrique Grosso Sandoval como presunto responsable, toda vez que para la fecha de ocurrencia de los hechos actuaba en calidad de Agente Especial Interventor, con funciones de Representante Legal de Saludcoop EPS OC En Intervención.
En desarrollo de la mencionada Indagación Preliminar, la Contraloría pudo verificar la ocurrencia de una afectación al patrimonio estatal, y pudo concluir a partir del material probatorio decretado y practicado, que existían méritos suficientes para trasladar la actuación a la Contraloría Delegada para Investigaciones, Juicios Fiscales y Jurisdicción Coactiva.
Hallazgo trasladado a la Procuraduría y a la Fiscalía
Por la gravedad de los hechos evidenciados por la Contraloría, se ordenó el traslado del expediente no sólo a la dependencia competente, sino que la decisión fue comunicada por el Contralor General tanto al Procurador General de la Nación, Fernando Carrillo Flórez, como al Fiscal General de la Nación, Néstor Humberto Martínez.
Para tales efectos, el propio Contralor en su condición de denunciante calificado, puso los hechos en conocimiento de Procuraduría y Fiscalía para que, en el marco de sus competencias y funciones, se adelanten las investigaciones penales y disciplinarias a las que haya lugar.
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