The Superior Audit of the Federation (ASF) detected a pending amount to be clarified of 48 million 059 thousand 287 pesos in the surrogate hospitalization services of the IMSS. In several contracts, the audit body identified inconsistencies in contracting, payment and deliverable procedures.
In 2020, the IMSS signed contracts with hospitals to care for both patients with COVID and other diseases and requirements. In 2021 he kept some contracts. The ASF analyzed ten of these.
It was on April 13, 2020, when health institutions, including the IMSS, signed a framework agreement with the National Association of Private Hospitals and the Mexican Consortium of Hospitals, in order to provide beneficiaries and beneficiaries with surrogate medical and hospital services, such as childbirth, pregnancy and puerperium care, cesarean sections, diseases of the appendix, hernias, gastric ulcers, endoscopies, etc.
On November 30, 2020, the members of the National Health System signed with the Association and the Consortium a second phase of the Framework Agreement, valid from December 1, 2020 to May 31, 2021.
On August 11 of that same year, the IMSS, individually, signed with the Association and the Consortium a third phase of the Framework Agreement in the face of the increase in cases of the SARS-Cov-2 disease (COVID-19), in which only the Decentralized Administrative Operation Bodies (OOAD) Morelos, Nuevo León and Puebla were considered, justified by a high demand for medical care in those entities.
Read: Public Account 2021: the Audit detects 11 thousand 149 million pesos to clarify; 64% corresponds to money for the states
What the ASF found was that the IMSS did not prove to have the controls, mechanisms and systems, nor did it verify compliance with the regulations to verify and follow up on the processes related to the contracting of the surrogacy service.
In addition, inconsistencies were found in contracting, payment and deliverable procedures. For example, of the contracts numbers S1M00142, S0M0019 and S1M0038, corresponding to Star Médica, Sanatorio Psiquiátrico del Carmen and Casa de Salud, there was no documentation proving the provision of services, in the payment files for 13 million 385 thousand pesos, 3 million 037 thousand pesos and 30 million 448 thousand pesos, respectively.
While contract number S1M0005 determined a difference of nine invoices for one million 619 thousand pesos, of the surrogate hospitalization service from October to December 2021, which was not provided by the IMSS.
Of the clinics and hospitals that reported surrogate hospitalization under the framework agreement, it was determined that the Decentralized Administrative Operation Body OOAD Chihuahua reported expenses of the Palmore Sanatorium for a total of one million 187 thousand pesos, without it having adhered to the Framework Agreement or any legal instrument that established a contractual relationship with the IMSS.
In addition, 15 requests for surrogacy of patients were identified in which an IMSS doctor who requested and authorized them was the same treating physician in the sanatorium that provided the service.
Read: The ASF detects possible damages to the treasury for 2 thousand 754.8 million pesos in the attention to the pandemic
On the other hand, the Institute did not provide the consolidated information of the patients who received the surrogacy service during 2021.
For all these facts, the ASF issued three promotions of Sanctioning Administrative Responsibility so that the Internal Control Body in the Mexican Social Security Institute or its equivalent carries out the pertinent investigations and, where appropriate, initiates the corresponding administrative procedure for the irregularities that public servants may have committed.
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