Deputies question ANS readjustment of health plans and suspension of treatment following STJ decision

2022/06/14 – 21:11

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Paulo Rebello has confirmed that the readjustment is one of the smallest ever provided

Deputies from the Social Security and Family Committee received Paulo Rebello, president of the National Agency for Complementary Health (ANS), in a public hearing in the Chamber of Deputies on Tuesday (14). The aim of the meeting was to readjust the health plans, which are considered the largest ever, and the decision of the High Court of Justice (STJ), which in practice exempts operators from covering treatments not on the ANS list.

Deputy Rejane Dias (PT-PI), the author of the debate request, questioned the 15.5% rate allowed by the agency to readjust individual health plans. The rise was seen as excessive by parliamentarians. “We are really concerned, in a scenario of a pandemic that is not yet over, about a scenario of rising food prices, the cost of living, fuel, which has directly affected the most vulnerable to the most vulnerable,” he lamented.

Paulo Rebello has ensured that the entire process for calculating plan readjustments is carried out in accordance with the law and in a transparent manner. He recalled that the agency had given a negative adjustment of 8.19% in 2021 due to the pandemic. Thus, the readjustment in 2022 would be around 6% compared to 2020. In this sense, the increase is one of the lowest ever.

“It simply came to our notice then. It is therefore one of the smallest readjustments ever applied by the National Supplemental Health Agency. That is why we need to look not only at a photograph, but also at a film about what happened in 2021 and 2022, ”he said.

Deputy Jandira Feghali (PCdoB-RJ) disagrees and says, however, that the readjustment is very large in the face of the country’s current crisis situation. “Although historically the increases have been smaller, the impact is great, because the current social situation of people is a difficult situation, high unemployment, precariousness, low income,” he said.

Billy Boss / House of Representatives

Rejane Dias is concerned about the rising cost of living

disease census
Another point that was discussed at the meeting was the decision of the STJ to consider the list of diseases in the ANS as accurate and exemplary. With STJ’s ruling, the plans are exempt from covering unforeseen expenses on the agency’s list.

Deputy Carmen Zanotto (Citizenship-SC) has demanded that the ANS make rules so that ongoing treatments are not stopped, as many families are already suffering. “We are now in a moment of legitimate concern and emotion for the whole of Brazilian society, based on the position of the STJ. What is the severity of father, mother, and family? Will my proceedings be suspended? ‘ , he asked.

The ANS president has announced that he has already issued a statement stating that treatment cannot be suspended. He also made sure that health plans could not fail to cover these treatments. “Plans that are serving their beneficiaries cannot be interrupted. Of course, what was suspended by a court ruling can only be revoked by another court ruling, but the fact that the STJ’s decision says the role is absolute will not prevent further treatment,” he said.

Paloma Marinho, who has an 8-year-old son with autism, says she received a message from the STJ’s decision to suspend some procedures the day after the STJ’s decision. “The ANS list tax ruling was one day and the next morning I received an email from the health plan to suspend my son’s therapies, so it was automatic. Then I’ll have to hire a lawyer who specializes in health care, and that’s not cheap. No lawyer will sue you, ”he said.

The ANS president has said he is sensitive to all cases and has assured that he will improve the release recommending follow-up treatments. He said the ANS is open to all complaints by calling 0800.701.9656.

Since the STJ’s decision on June 8, about 30 bills have already been tabled through the National Congress to regulate the issue. In addition, eight bills have been introduced in recent days, proposing to suspend the ANS decision that allowed adjustments to individual health plans.

Report – Silvério Rios
Editing – Georgia Moraes

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