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Las Condes Clinic Sues Ex-Manager Over Excess FONASA Patients

In 2020, private clinics were instructed by authorities to keep a number of beds available for patients using the public health service, FONASA. The ex-general manager of the private clinic admitted more patients than stated. This cost the clinic nearly CLP$8.6 billion (US$11.7 million).

The board at the Las Condes Private Clinic (CLC) is suing ex-general manager Fredy Jacial over a multimillion-dollar loss due to the admission of too many patients who subscribe to the public health service FONASA during the first months of the pandemic in 2020.

According to La Segunda, Jaciel did not tell the board about the number of FONASA Covid patients, and the amount paid by the public institution per patient “was below 50 percent of what CLC charges.” This ended up costing CLC about CLP$8.6 billion (US$11.7 million).

As reported by La Segunda, CLC’s complaint alleges that “there were days when there were over 117 FONASA patients referred from the public health system. That’s what happened, for example, on June 11, 2020. Which is why exceeding 64, in this case, by 53 (more than was stated), are FONASA patients that CLC should not have admitted.”

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What is FONASA?

FONASA, the acronym for Chile’s National Health Fund, is a public entity dedicated to collecting, managing, and distributing state funds for the Chilean health system. This way, if people are not affiliated with the private insurance system (ISAPRE), they can access the health system through FONASA, which offers lower prices than ISAPRE plans.

FONASA operates with public hospitals, and ISAPRES are affiliated with private clinics, which offer better conditions for the patients, for a higher price. Therefore, the FONASA system is often collapsed, with people having to wait for months for a doctor appointment, treatment, or even surgery at public hospitals.

Over the past year with the pandemic, public hospitals have been saturated with COVID patients, which is why the Health Ministry’s Intensive Care Beds Centralized Management Unit required private clinics to have a number of ICU beds available for COVID patients affiliated with FONASA. This number kept getting higher, reaching 64 during the peak of infections.

However, with Jaciel admitting more than even that number, the clinic is accusing him of “disloyal management” for not informing the board about the increase of COVID patients.

This is not the first time the CLC has presented lawsuits over financial damages against a former manager. Last year, in October, the Clinic filed a case against another ex-general manager, Jaime Hegel, for CLP$2.8 billion (US$3.8 million) over a credit issue.

 

CLC also announced a lawsuit against the Treasury in January 2021, over financial damages as a “product of the government measures taken during the Covid-19 pandemic.”

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