An audit states that the Amapá government has increased the total value of parliamentary amendments available to the state after declaring it has made enough radiographs to examine 98% of its population.
According to a report, the state management recorded 720,471 Chest X-ray procedures only at Santana Hospital (neighboring municipality of Macapá) in 2020-a 59,345% jump compared to 1,212 exams performed the previous year. The 2022 Census says there are 733,759 inhabitants throughout the state.
The ministry states that the government of Amapá failed to justify the explosion of radiographs and charges the return of R $ 6.8 million. The value would be the sum of inflated procedures in the data of the (Unified Health System).
The audit report does not say whether the information was intentionally inserted in the system to raise the amendment money or if there was any failure when recording hospital production.
The document states that the ministry team analyzed the answers presented by the hospital and the State Secretariat, besides investigating additional information, and did not identify “supporting elements capable of justifying the exorbitant increase in procedures”.
The ceiling of money that parliamentarians may indicate to the health of states and municipalities is defined precisely by the volume of exams, consultations and hospitalizations of the previous year.
The ministry says it has already sent to the government of Amapá a guide for the payment of $ 6.8 million.
The State Secretariat denies irregularities and says that there was “material error” during the registration of hospital production in the SUS data network.
In a statement, the folder states that it mistakenly inserted the code of the chest radiography procedure (02.04.03.015-3) next to the field intended for the registration of the number of procedures made in November 2020.
The typing would have generated “the automatic reading of 720,204 exams performed – value that, in fact, corresponds to the digits of the code rather than a real amount,” says the secretary. Real production was 72 exams that month, according to the same note.
The Ministry’s report does not mention the hypothesis of error at the time of inclusion of data on outpatient production as a justification given by Amapá. The State Secretariat says that this argument was prepared after the report and “currently is internally in administrative proceedings.”
The state was governed by Waldez Goes (PDT) during the explosion of registered exams. Current Minister of Integration and Regional Development of the Lula Government (PT), he was sought by the report and did not speak.
In 2021, Amapá received R $ 54.1 million in extra amount of amendments to fund actions in hospitals and outpatient clinics, most of which (R $ 42.8 million) was intended in the form of amendments of the rapporteur general, whose distribution was controlled by the Congress summit.
Following, the main authors of the state amendments were the current president of the Senate, Davi Alcolumbre (União Brasil), with R $ 8.28 million passed on, and Senator Lucas Barreto (PSD), with R $ 2.8 million.
The audit calls for the return of the money by stating that “the non -compliance mentioned provided the receipt of funds by the State improperly, from parliamentary amendments by insertion of information not compatible with the actual production”.
The government of Amapá says that the total amount passed on to the state by amendments was still below the allowed ceiling, which would reach R $ 66.6 million in 2021.
“It is, therefore, an operational digitation failure, not yet detected by the federal system during processing, nor identified by the unit responsible at the time of sending. At no time was it intended to manipulate information to obtain improper resources,” says the State Health Department.
The folder also says that the federal government passed $ 12 million less than it should be in relation to the SUS in 2020.
The calculation of transfers to Amapá was made by Denasus (National Audit Department) from March 2024. This was one of the processes opened by the Ministry of Health to verify that states and municipalities to increase its amendment ceiling. This type of irregularity was, in 2022.
In June last year, the audit team paid a visit to the hospital and considered that it is not possible to perform the number of exams with the existing structure. There were only three doctors qualified for the procedure and a radiography room, with a fixed equipment in operation.
There were still two mobile X-ray equipment, but only one worked at that time, according to the report. The team found exposed electrical wiring on the wall and floor and “flaws in isolation in the x-ray room shield”.
The head of the hospital data said to the audit that she didn’t even have a password of her own access to the system and that she used someone else’s account. The audit also states that the State Secretariat did not answer the questionnaire about the feeding of computerized SUS systems.
“This fact contributes to failures to enter production information in SIA-SUS, which can result in improper receipt of resources,” says the report of Denasus.
Santana State Hospital also shared data on 405 chest radiographs made in 2020, but all records were without stamp of the guardian. The audit team considered records without validity.
The audit also evaluated data from the State Health System, which pointed out “excessive number of outpatient production”, with 4,733 more procedures than declared to the network that arrives at the Ministry of Health.
