Chamber approves project that forces health plans to cover treatments outside the ANS list – Notícias

03/08/2022 – 18:51
• Updated on 08/03/2022 – 19:26

Elaine Menke/House of Representatives

Mothers of sufferers affected by the STJ’s resolution voted in plenary

The Chamber of Deputies authorized this Wednesday (3) invoice 2033/22, which establishes a protection speculation for health examinations or treatments that usually are not included in the list of procedures and occasions of the National Supplementary Health Agency (ANS). The goal is to proceed remedy that could also be excluded from health plans’ protection.

The proposal goes to the Senate for evaluation, the place it might be voted on subsequent Tuesday (9), in accordance to the chamber’s president Arthur Lira (PP-AL).

Among the regulatory points, the proposal stipulates that the list of procedures and occasions lined by health plans might be up to date by the ANS in every establishment. This list will function a reference for contracted health plans starting January 1, 1999.

When a remedy or process prescribed by an attending doctor or dentist just isn’t included in the list, protection should be approved if:
– In the mild of health science, there may be proof of effectiveness primarily based on scientific proof and therapeutic plan;
– There are suggestions by the National Commission for Incorporation of Technology into SUS;
– Have not less than one advice from a health know-how evaluation physique that is internationally famend, supplied they’re additionally acknowledged by their nationals.

STJ resolution
The Superior Court of Justice (STJ) determined in June that the list of procedures and occasions in health is exhaustive, and health operators usually are not obliged to cover the remedy supplied in the list, besides in some distinctive conditions.

The ANS Procedures Catalog lists 3,368 health occasions, together with consultations, examinations, therapies and surgical procedures, as well as to medicines and orthoses/prostheses related to these procedures. These medical companies should be supplied as per the health plan.

PL 2033/22 was launched by a working group of the Chamber of Deputies created to analyze this subject.

The rapporteur, Deputy Hiran Gonçalves (PP-RR), criticized the STJ’s resolution, which he stated triggered big common unrest. “And it was not for much less. Millions of people that depend upon health plans to keep wholesome and alive had been disadvantaged of the proper to endure acceptable therapies for his or her problems prescribed by the health professionals chargeable for their remedy.”

Elaine Menke/House of Representatives

Hiran Gonsalves, invoice informer

Hiran Gonçalves thanked Chamber President Arthur Lira for rushing up the evaluation of the project. “The proposal goals to align the views of technical establishments and civil society, all the time guaranteeing the security and health of hundreds of thousands of beneficiaries of health care schemes in the nation.”

Already Deputy Tiago Mitraud (Novo-MG) defended the resolution of the STJ and criticized the proposal, contemplating that it might hurt competitors and improve the costs of health plans. “Getting health insurance coverage might be dearer and complex, and small individuals will go broke. Big pharmaceutical firms can now induce docs to prescribe experimental treatments with out visa approval”, he warned.

Congresswoman Jandira Feghali (PCdoB-RJ) praised the mobilization of moms who need to proceed remedy for his or her kids, which might be disrupted by the STJ’s interpretation of the function of taxes. “They got here right here all these weeks to battle for the approval of this project. Saving lives is above the income of health schemes”, he defended.

Deputy Soraya Santos (PL-RJ) stated the STJ’s resolution on tax rolls will trigger demise. “The best present we’ve is life. In the seek for the finest remedy, the function should be exemplary”, he argued.

Deputy Gilberto Nascimento (PSC-SP) stated individuals had been determined at the prospect of lowering the protection of health plans. “A uncommon illness just isn’t a situation that an individual desires. They are sacrificing their cash to pay for health insurance coverage and they need to have rights,” he stated.

Learn extra about the invoice course of

Reporting – Francisco Brando
Editing – Pierre Triboli

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