One of the most alarming cases concerns the care of non-existent war veterans for millions of dollars.
There are cases of professionals who claim to have treated patients in an office and, just one hour after the end of that service, register the care of other members in an establishment located 240 kilometers away.
Irregularities are also evident in sensitive areas such as cardiology and gastroenterology. Internal reports detected volumes of practices that are not consistent with operational capacity or a reasonable working day
In the midst of the internal audits being carried out by the Government of Javier Milei in PAMI, a series of irregularities in the provision of medical services have come to light, exposing millions of dollars of deviations and situations that are difficult to justify, generated during the administration Kirchnerist
.Recent controls identified inconsistencies both in billing and in the execution of practices, which set off alarm bells within the country's largest social organization.
One of the most relevant cases detected corresponds to the so-called “War Veterans module”. According to the surveys, in the last 90 days, 4,409 medical orders were validated for this group, but they were issued to members who do not have that benefit.
This diversion generated losses totaling $102,803,877 “for benefits that don't match.”As a result of this situation, the agency initiated an investigation involving “more than 400 general practitioners, equivalent to 5.6% of the payroll”, as reported by officials. The volume of cases under analysis reflects the magnitude of the irregularities detected in this specific area of the system
.
But this is not an isolated event. The audits also detected inconsistencies in health care records that are materially
In one of the most striking examples, a gastroenterology provider, who has only two operating rooms, stated that he had performed 283 practices on 95 patients in just five hours. According to the auditors, this level of activity clearly exceeds any possible operating limit
.
These findings are part of a series of controls that seek to identify deviations in billing and in the effective provision of services. The agency pointed out that one of the key tools to improve oversight is the implementation of the “unified and updated Nomenclator of Primary Care Physicians”
.In this sense, they explained: “Unifying the nomenclator will also allow us to better control the actions of the doctor and the provision actually performed.” The measure aims to organize practices, reduce regulatory dispersion and facilitate the monitoring of each benefit within the system.
The audits are still ongoing and the cases detected reinforce concern about the use of resources within the PAMI, in a context where the irregularities of Kirchnerism imply a significant economic impact that harms millions of people.
