Healthcare Sector Debt Collection: How to Recover Receivables in the Face of the Non-Seizability of Funds

Currently, Colombia’s healthcare sector is facing one of its deepest financial challenges. For service providers, laboratories, and healthcare institutions (IPS), debt collection has become a legal “minefield” due to a fundamental principle: the non-seizability of healthcare funds.

In today’s financial landscape, IPS and healthcare providers in Colombia face an unprecedented challenge. The liquidity crisis—worsened by recent massive seizures exceeding COP 2.1 trillion against entities such as Nueva EPS—has prompted a strong message from the Government: “healthcare funds are non-seizable.”

Many creditors ask themselves: If I can’t seize assets, how can I collect? In this article, we analyze the regulatory framework and the strategic actions creditors must take.

1. The Legal Shield: What Does Non-Seizability Mean?

According to Article 48 of the Colombian Constitution and Law 100 of 1993, social security resources cannot be used for purposes other than healthcare. This means that assigned revenues, contributions, and ADRES funds have special protection.

Golden Rule: Resources of the General System of Social Security in Health (SGSSS) are non-seizable. However, this rule is not absolute—and that is where opportunities for effective debt collection arise.

The principle of non-seizability is not new, but its enforcement has become stricter. Its legal basis lies in Article 48 of the Constitution and was reinforced by Article 25 of Law 1751 of 2015. More recently, the National Health Superintendence reiterated through Circular 032 of 2025 that funds intended for patient care cannot be diverted to pay commercial debts through generic seizures.

Does this mean your company cannot collect? No. It means that attempting to seize “Master Collection Accounts” is currently a blocked path. Success now depends on identifying funds that are subject to seizure and using direct payment flow mechanisms.

2. The Exceptions: When Seizure Is Possible

The Constitutional Court has clarified that non-seizability cannot be a “blank check” for EPS or sector entities to avoid paying their debts. Seizure may be requested when:

• The obligation concerns labor liabilities of the debtor entity.
• The debt arises from the effective provision of healthcare services (Ruling C-566 of 2003). If the creditor is an IPS that already provided the service, the healthcare resource has “already fulfilled its purpose” and may be subject to precautionary measures to pay the actual service provider.
• Through Ruling C-1154 of 2008, the Constitutional Court made it clear that healthcare funds may be seized when there is a clear, express, and enforceable obligation recognized by a judicial ruling.

3. How Should Creditors Act Today?

Given the cash-flow crisis, reactive management (waiting to be paid) is no longer an option. Recommended actions include:

Ongoing Reconciliation and Settlement
The biggest obstacle in collecting from EPS is the “claim objection” (glosa). An effective creditor must have legal and accounting teams reconciling receivables monthly. Without an accepted and reconciled invoice, judicial action will be futile.

Perfect Enforceable Titles
Ensure your invoices meet all legal requirements and are supported by evidence of service or medication delivery. A poorly issued invoice is an uncollectible debt in court.

Executive Proceedings with Strategic Precautionary Measures
If pre-legal collection fails, creditors should initiate executive proceedings requesting seizure, while legally substantiating the exception to non-seizability. It is crucial to prove that the claimed payment covers the costs of healthcare services already rendered.

Despite the legal shield, the law and Constitutional Court jurisprudence leave windows open for creditor action. Collection strategies may target:

• Administrative Expenses: EPS have a margin allocated to their own operations (10% in the contributory regime and 8% in the subsidized regime). These funds are not protected by healthcare non-seizability since they are not directly used for patient care.
• Financial Returns: Income from proprietary investments or certificates of deposit (CDTs) belongs to the EPS’s assets and can be pursued judicially.
• Fixed Assets: Properties or vehicles of the EPS that are not essential to providing medical services.
• Labor Credits: If payment is needed to cover healthcare staff salaries, creditors may invoke protection of the minimum subsistence level—one of the few exceptions the Court allows to overcome non-seizability.

Managing healthcare receivables today requires more than collection calls; it requires deep knowledge of jurisprudence. Non-seizability protects the funds, but it does not absolve the debtor. Creditors who know how to navigate the legal exceptions are the ones who will maintain liquidity.

Do you have frozen receivables in the healthcare sector?
At Trébol Jurídico, we are experts in recoveries and the management of this type of portfolio. We are here to help you recover these debts—contact us.