International Care Patient Assistance (ICPA) helps Hospital del Mar and Hospital de Sant Pau by charging patients for care once they have been discharged and return home to their countries.
According to documents seen by Spanish daily newspaper EL PAÍS, the ICPA oversaw the bills of 1,615 tourists at Hospital del Mar last year.
The ICPA received €852,000 (£753.386), according to fees received by the Advisory Board, but the group charged tourists €1.1805m (£1.04m).
The report added although some of the extra money went back to the hospital – an agreement on a set fee ensures the firm receives 55 percent of a patient’s bill – €9 out of every €10 paid by tourists above the official rate went to the IPCA.
But the contract with the Hospital de Sant Pau reportedly does not have the same agreement, which means it is impossible to know how much the IPCA fee is.
According to EL PAÍS, the hospital does not know what the company is charging foreign tourists – an average of 725 of whom pass through the hospital every year.
However, all documents containing elements such as business income and receipts, suggesting the margin charged by the ICPA could even be higher.
The report says a German tourist was admitted to the hospital after having a heart attack, and required a bypass and catheterization.
The bill came to more than €68,000 (£60,000) but the public rates approved by the Catalan regional government in 2013 show that the treatment costs less than a third at €19,908 (£17,600).
According to EL PAÍS, the hospital compensates for the cost of their service by increasing a patient’s bill but instead the ICPA acts as a third party and buys the right to provide assistance to hospitals at regulated prices and resell it to a patient at a much higher rate.
The hospitals have defended the ICPA and said they have insured the “vital payment for services rendered”, while the ICPA has said that “at all times” it has followed “the requests made by hospitals in managing the payments of tourists”.
Instead, the hospitals are blaming “pressure from insurance agencies” and follow-up care once tourists arrive home.