Following the excessive proportion and coefficients in IOMA for providing prosthetic detection within the framework of the investigation Implant files, Buenos Aires social work directory was signed on Thursday Creating a new product registry, which will be implemented in February, This erestricts intermediaries to reduce costs and includes public consultation. It starts with the introduction of a prosthetic, and then goes on with the rest of the benefits.
This decision was taken from the President of IOMA, Pablo Di Lececa, who tried to abandon the decision by the Argentine team. International Consortium of Investigative Journalists (ICIJ) they make up Infobae, Nation and Profile According to him, "since March, the work on this issue has continued, and it has passed several administrative and supervisory jurisdictions."
In December last year, the official of the Cambiemos, acknowledged as the third IOMA holder, In addition to the IOMA prosthetic nomenclature, there were additional charges. There were high prices above the market value some consultants reported by Argentine ICIJ team, within the framework of the IOMA has provided a bribe to the healthcare providers for the placement of a prosthetic or orthopedic prosthetic company. These illegal payments were also reflected in the soundtracks of physicians and doctors.
After explaining "they are not IOMA doctors"Because social work does not hire them directly, but agrees with health care providers with groups and communities, Di Liscia IOMA"not only to approve the experience, but also to "be active in criminal complaints"«
According to the information provided by the Agency, From March 2016 to courts, mostly 27 statements against IOMA providers . These suspects represent specific situations, but most of them are experience in social work. According to the official, they also started 250 administrative processes against employees, contractors, doctors and suppliers; IOMA 44 providers have been suspended; and they have released 14 people.
There is also a practice of illicit payments from doctors to patients online pit canal he joined in January this year. Someone from IOMA reported receiving them 300 claims thus.
According to provincial government sources, governor Maria Evgenia Vidal "has publicly asked for everything that can be ruled out, taking into consideration that Zioi, who has been suspected of IOMA since the year of globalization,. They asserted that Di Leecia knows the changes in this aspect, and the governor said that he would conduct regular monitoring with HMOMA as well as with other agencies and ministries.
Di Leecia assured Infobaemoreover, that negotiations are still open association of doctors introduction of new nomenclature of professional practice and updating fees Doctors serving IOMA suffer. According to experts, this is outdated – it starts in 1958 and they are asking for more things to pay for every medical practice.
Discussion is invaluable
Repatriation nationalist Grasilla Okcane has been accused by IOMA's health providers of paying bribes paid by social work providers in choosing their products in August last year to the Buenos Aires Provincial Institution Building (IFCA).
«This maneuver for reimbursement can not be made without the doctors' care, but always high market prices, without the participation of the IOMA authorities responsible for establishing a price tag established by the nominee. Without such a situation, fraud is not viable– said the deputy.
Comments from vendors Infobae they said they would "enter" the bribe that the provider paid to the doctor at a price set at the nominalizer. He also dropped out of the published audio Infobae this week,
In a complaint filed by the Bureau of Justice, Offi- cia presented comparative examples of the value of some prostheses in the Ocaña IOMA nomenclature and its market cost. At this price, IOMA has paid for 2016, 2017 and 2018, more than 500% of prosthesis.
In addition, the President of the IOMA Association of Employers (IOMAA), which unites about 400 people on social work, agrees with the agreement on the prosthetic nomenclature signed by providers in 2016 with "100% and 700% higher market than with the desire to support entrepreneurs working with millionaires, they will return to IOMA officials. "
However, Refused to pay IOMA. «Claim values do not correspond to reality"Di Leecia says." When it came to the new leadership, it was the first thing to close the crane. The administration, which took place on December 2, February 2, 15, before the departure of IOMA, raised the price increase from 35% to 50% for prostate cancer until October 2014. We leave it ineffective, evaluate the price, and rearrange the nomenclature with a 20% discountMercosur, 25% for imported prosthesis, and national "because it was later launched" and did not provide any prosthetic prosthesis prostheses, as providers did not want to sell them in 2016.
Di Leesia the prosthetic prostheses were dropped by doctors, it is not justified and there is no request from another firm for a different prosthesisYes, he agrees to pay a bribe to sell their products to IOMA.
This experience has been reported by the affected service provider and is documented in the agreed documentation and audio Infobae. "In many cases, a doctor has chosen an orthopedic surgeon as he goes to surgery and supplies a set of equipment, and every orthopedic surgeon has their own dentures, so logistic agreement between a physician and a provider is made before surgery," he said. .
However, he says, "This is IOMA's health auditors who should analyze this discrepancy" and "we still need to improve many mechanisms"The more we grow in the audit, the better. We need a computerized change and methodological change"There are 300 to 350 health auditors in IOMA and about two million branch offices in Buenos Aires.
Di Leecia said this in the new registry of suppliers Distributors and sellers – It is necessary to strengthen the providers of prosthesis, orthopedics and supplies in order to eliminate intermediaries and get direct purchases from the manufacturers. "This is aimed at reducing 20% of the cost of IOMA and improving the quality of its suppliers, as well as preventing the sale of poor quality equipment," said IOMA, the first buyer of the provincial level and the second largest country after PAMI.
The market has responded to the potential risk that is too concentrated,it makes sure that there are no unique suppliers that do not guarantee the monopoly and guarantee most of the offersThere are no suppliers of "IOMA" prosthetic and suppliers that can postpone delivery. That would not be the case with the producers.
IOMA budget for this year 44 million pesos. Of them 5.6% are prosthesis, about 2500 million people, about 50,000 prostheses. Approximately 6% were made out of the nominal, ie, through pricing.
Today, the largest social workforce in Buenos Aires has around 500 providers of prosthesis, umbilical cords and accessories, and according to the conversations conducted by the Argentine Chamber of Chambers, Implants and Medical Equipment (CADIEM), IOMA acquires 80% of its 20 prosthetic manufacturers or distribution chains available. The remaining 20%, as they are actually covered by 20 or 30 other suppliers. "
According to these reports, they value it at IOMA Suppliers in the new register range from 50 to 100, among national and foreign manufacturers they sell their products in the country.
The new product registry will be implemented in February. It also determines the transparency of the procurement process and the requirements of the warranty obligation (suspension of compliance in case of non-compliance with IOMA) and scoring (product contracts), suspension or revocation of registration, "D.Lessis said.
Registration "he said. This will be public advice on the web. "This is part of the process we are doing information digitization. When we arrived, everything turned into paper, "says a social worker. As part of the situation they find, "IOMA considers 160 information and 23 related affiliated registrations unrelated to attachments."
Manufacturers are suspicious
However, direct agreements with manufacturers do not guarantee the removal of polls, as many international companies in the United States, which sell their products in Argentina, have blamed doctors and officials for selling their products to the local healthcare system.
"We will sign the agreements match, which means that these contracts can be checked and we strive to comply with the rules of the manufacturers, "said Di Lececa, when the ICIJ Argentine team raised the issue.
Global research Implant files For example, two of the foreign manufacturers who participated in meetings with IOMA to attend the new registration will be among the ten most adversely affected by the US FDA registered medical devices by 2017. Johnson and Johnson, for example, last year received 99.179 negative results and took the third place in the rating. Abbott ranks fourth, with 69,007 dissatisfied.
Other debt recognized by the IOMA owner update Nomenclature of professional practice In individual sanatoriums participating in IOMA's patients or private offices. Despite medical progress, it may look awesome, but nowadays 1958
"For 10 years, we have submitted IOMA a range of practices and fees agreed with scientific societies of each specialty." All presidents of the HMOMA, which we have recognized, they said they should change the nomenclature, but They then say that they need to explore the costs and that no progress can be made. There is no political will to resolve this issue, "warns Eduardo Martiarena, leader of the Treaty of Independent Medical Institutions of Buenos Aires (CEMIBO), which incorporates seven provinces of major provinces.
The outdated form of this practice affects payments and is already delayed. «There are many non-existent and even contradictory experiments as well as many modern projects are not considered. We have to change ourselves to a libel invoice, which forces us to misrepresent the truth in order to place unexpected actions codes"Said the orthopedic surgeon.
Requirements of medical associations combination of fees. "You need to upgrade the nomenclature, which may be appropriate. If the prosthesis costs more, we help slow down the system and optimize costs. In any case, the system can not continue we can not work that way– says Martyaren.
The IOMA agrees with two different federations that combine different doctors, the Buenos Aires Provincial Medical Federation (FEMEBA) and the FEMECON Conurbano Medical Federation. Also, agreements were signed with seven other medical communities in the most important cities of the region.
One of them is Platense Medical Association. "We would like the practical system and the prosthetic to spend on IOMA's spending: doctors who are human resources. We are addressing the IOMA Renewal of 30% payments– says his secretary, Cardiologist Patricia Follerti.
According to the current values of the radiator, the traumatologist on traumatic surgery of the walls, clavicles, patella or stenum condemns IOMA of 1700 pesos and 2 900 pesos, depending on length of service and specialty. For anyone who includes a hip, a femoral, a type, or a fibula, charges between 4,800 and 8,300 pesos.
According to Fletcher, IOMA has halted negotiations. "There is no invitation to a specific date of the body that tells about the issue, and we discussed this topic for about three months, in October, we made a proposal from various scientific societies that they accepted, but did not accept it. «
From the social work of Buenos Aires, they do not deny that "negotiations have been halted". "We believe it's necessary to adjust payments today, but demand a 30% increase, which means a 30% increase in all IOMA benefits," they warn.
Di Leecia, with Gustavo Jimenez, member of the Mars Del Plata Doctors Association
In this regard, the "Platex Medical Association" invites doctors and associations of scientific societies of various specialties to the meeting on Tuesday the "what measures it should take". They do not consider the termination of benefits as professionals.
Ocaña's complaint about bribing IOMA's medical providers was taken into account by Silver, Marcelo Romero No. 6 prosecutor's office. Other evidence to prove that the prosecutor on November 5 sent an official letter to IOMA asking for a list of acquired prosthetic medications for the last five years, the doctors asking for them, the dismissals, the reasons for the auditors and the reasons for their decision. as a list of providers.
Taking into account that the Agency has not responded, it has confirmed the prosecution's resignation last Thursday, and he puts it Infobae, yesterday the IOMA Legal Framework was adopted. In the course of social work, the Justice refused to receive the requested information or documents.
This week, a witness who was accompanied by a lawyer of the IFI was also invited to the Prosecutor's Office for requests for bribes from IOMA prosthetic providers.
Romero also asked to see why La Plata prosecutor's office, Betina De Lacky, is facing a previous complaint of OFI in June, with no significant success in these months. The complaint was based on the information available to the person who asked for the identity card, the condition of about 20 doctors involved in these maneuvers. Preliminary investigation of the PSE involves the statements of at least six patients who have suffered from maneuverability, with which the doctors suspended or suspended their operations or in some cases had to pay for prosthetics from the patient's pocket.
Suspects of Okan and PPS are not the only ones in the issue of justice. Since 2011, Seilant has made about thirty complaints from the Anti-Corruption Specialists and the Unified Trade Union (SUPTTIOMA) in their previous efforts. The last ten will begin in 2016. It is also crucial to current guidelines that condemn the persecution of the APIOMA and its allies. «I would like to Ask the governor to abandon the current authorities to conduct anti-corruption and judicial investigations. We offer APIOMA experts and documentation about illegalities, "he said Infobae.
"APIOMA collects about 400 specialists, of which 70 are auditors and we do not protect any corrupted auditor," he said. This week, he has made a new trial because he assures that IOMA will pay salaries to auditors, and the Justice has ordered the return to justice. SUPTTIOMA, a non-profit union, has a registered but not a trade union status recognized by the Ministry of Labor.
Idelmar Seillant, president of APIOMA and SUPTTIOMA trade union
According to the latest analysis by APIOMA, from January 2016 until October 2018, claims are filed on Monday. 4,800 million Peso was paid in IOMA due to additional payment Guild against companies and companies associated with UPCN trade unions, which is strong in the social work of the region and supports SUPTTIOMA.
The Argentinean team of international consortium of scientific journalism took part in it Implant files it is integrated with Mariel Fitz Patrick (Infobae); Maya Jastreblanski, Ivan Ruiz and Ricardo Brom (La Nación); Emily Delfino (Profile) and Sandra Cruizianelli (for profile).