CCSS Initiates Nullification Process for EBÁIS Contracts Managed by Cooperatives
The Costa Rican Social Security Fund moves to annul contracts amidst ongoing investigations into procurement irregularities.
The Costa Rican Social Security Fund (CCSS) has initiated the process to annul the contracts for the management of 138 EBÁIS (Basic Health Teams) across 10 health areas that are currently operated by cooperatives, following investigations related to the Barrenador case involving several former executives.
This decision impacts over 500,000 insured individuals in the Central Valley who rely on these health services.
According to the CCSS Board of Directors, an absolute nullity administrative procedure has been ordered for the bidding process No. 2023LY-000002-00011011442, which pertains to primary health care services in the ten areas under investigation.
The decision was formalized during the Board's session No. 9464 held on July 6, 2024.
As part of the annulment process, the Center for Administrative Procedure Instruction (CIPA) of the CCSS has been instructed to execute the necessary measures.
Furthermore, it has been agreed to establish temporary emergency contracts with the service providers who have been managing these EBÁIS in recent years, ensuring continuity of care while new bids are solicited and contracts awarded to interested parties.
The contracts being annulled were assigned to various cooperatives:
- Escazú, to the Cooperative CoGestionaria de Salud de Santa Ana (Coopesana).
- Santa Ana, to Coopesana.
- San Francisco and San Antonio, to Coopesana.
- Carpio - León XIII, to the Asociación de Servicios Médicos Costarricenses (Asemeco).
- San Sebastián - Paso Ancho, to Asemeco.
- Pavas, to the Cooperative Autogestionaria de Servicios Integrales de Salud (Coopesalud).
- Desamparados 2, to Coopesalud.
- Tibás, to the Cooperative Autogestionaria de Servidores para la Salud Integral (Coopesaín).
- San Pablo, to the Cooperative de Autogestión de Servicios Integrados de Salud de Barva (Cooopesiba).
- Barva, to Coopesiba.
Notably, the contract for San Francisco and San Antonio services had previously been annulled by the General Comptroller of the Republic.
The agreement to proceed with the nullification was unanimous, supported by eight board directors present at the meeting.
Prior to the decision, the Board evaluated three potential scenarios for managing the impact of the annulment:
1. The first and chosen scenario involved temporary emergency contracts with existing cooperatives to avoid service interruptions, under the urgent procurement model to retain familiar service providers.
2. The second scenario proposed that nearby health areas could absorb the population served by the EBÁIS under cooperative management utilizing extraordinary shifts, but this would be a temporary and contingency measure to prevent prolonged strain on nearby facilities, which could increase patient distribution significantly.
3. The third scenario considered institutionalizing the provision of services, transitioning to permanent management, which could take two to three years.
Martha Rodríguez González, a representative from the labor sector on the Board, highlighted concerns that such changes could lead to job losses among workers currently employed by the cooperatives.
Coopesalud, one of the cooperatives involved, stated that it plans to assert its defense during the administrative procedure as the nullification process unfolds.
This decision impacts over 500,000 insured individuals in the Central Valley who rely on these health services.
According to the CCSS Board of Directors, an absolute nullity administrative procedure has been ordered for the bidding process No. 2023LY-000002-00011011442, which pertains to primary health care services in the ten areas under investigation.
The decision was formalized during the Board's session No. 9464 held on July 6, 2024.
As part of the annulment process, the Center for Administrative Procedure Instruction (CIPA) of the CCSS has been instructed to execute the necessary measures.
Furthermore, it has been agreed to establish temporary emergency contracts with the service providers who have been managing these EBÁIS in recent years, ensuring continuity of care while new bids are solicited and contracts awarded to interested parties.
The contracts being annulled were assigned to various cooperatives:
- Escazú, to the Cooperative CoGestionaria de Salud de Santa Ana (Coopesana).
- Santa Ana, to Coopesana.
- San Francisco and San Antonio, to Coopesana.
- Carpio - León XIII, to the Asociación de Servicios Médicos Costarricenses (Asemeco).
- San Sebastián - Paso Ancho, to Asemeco.
- Pavas, to the Cooperative Autogestionaria de Servicios Integrales de Salud (Coopesalud).
- Desamparados 2, to Coopesalud.
- Tibás, to the Cooperative Autogestionaria de Servidores para la Salud Integral (Coopesaín).
- San Pablo, to the Cooperative de Autogestión de Servicios Integrados de Salud de Barva (Cooopesiba).
- Barva, to Coopesiba.
Notably, the contract for San Francisco and San Antonio services had previously been annulled by the General Comptroller of the Republic.
The agreement to proceed with the nullification was unanimous, supported by eight board directors present at the meeting.
Prior to the decision, the Board evaluated three potential scenarios for managing the impact of the annulment:
1. The first and chosen scenario involved temporary emergency contracts with existing cooperatives to avoid service interruptions, under the urgent procurement model to retain familiar service providers.
2. The second scenario proposed that nearby health areas could absorb the population served by the EBÁIS under cooperative management utilizing extraordinary shifts, but this would be a temporary and contingency measure to prevent prolonged strain on nearby facilities, which could increase patient distribution significantly.
3. The third scenario considered institutionalizing the provision of services, transitioning to permanent management, which could take two to three years.
Martha Rodríguez González, a representative from the labor sector on the Board, highlighted concerns that such changes could lead to job losses among workers currently employed by the cooperatives.
Coopesalud, one of the cooperatives involved, stated that it plans to assert its defense during the administrative procedure as the nullification process unfolds.
