health

Enacted law requiring the plan to cover treatment outside the ANS list

President Jair Bolsonaro sanctioned this Wednesday, 21, the invoice that ends the restriction of procedures coated by well being plans, the so-called tax function of the ANS, chargeable for regulating non-public sector operators. Law 14.454/22 has been printed in the DOU and is now in power.

According to the ANS, the complete list is a list of well being procedures, authorised by a call of the company and periodically up to date, which incorporates examinations and coverings with obligatory protection by well being plans, in accordance to the plan’s help segmentation.

The textual content was unanimously authorised at the finish of August by the Federal Senate, coming from the Chamber of Deputies. The difficulty reached the National Congress after a STJ choice in June exempted well being plans from paying for therapies, examinations and medicines not coated by the ANS. Previously, instances outside the list had been determined in courtroom.

According to the federal authorities, the law’s sanction seeks to stop the interruption of medical treatment, particularly for these affected by uncommon ailments.

According to the textual content, for the well being plan to be required to cover a sure treatment, it have to be of confirmed effectiveness; to be really helpful by Conitec – National Commission for the Implementation of Technologies in SUS or by a specialised group of worldwide renown.

Another change launched by the law is the provision that now states that personal law entities that function well being plans are additionally topic to the provisions of the Consumer Protection Code.

Passed a law requiring the plan to cover treatment off the ANS list.(Image: Freepik)

Brazil in the wrong way

THE FenaSaúde regretted the sanction of PL 2033/22.

“The change places Brazil towards the world’s finest practices for evaluating the inclusion of medicine and well being procedures, makes it tough to correctly plan costs and compromises the predictability of care prices, which might lead to excessive month-to-month charges and the mass expulsion of beneficiaries of supplementary well being care. “

The topic additionally warned that such a measure might additional have an effect on the monetary situation of the sector. Finally, he stated he was contemplating going to courtroom.

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LAW No. 14 454 OF SEPTEMBER 21, 2022

Amends Law No. 9656 of June 3, 1998, which offers for personal well being care plans, to set up standards that enable the protection of well being examinations or therapies that aren’t included in the list of procedures and occasions in complementary well being care.

THE PRESIDENT OF THE REPUBLIC

I give discover that the National Congress enacts and I sanction the following law:

Art. 1 This law amends Law No. 9,656 of June 3, 1998, which offers with non-public well being plans, to set up standards that enable the protection of well being examinations or therapies that aren’t included in the list of procedures and occasions in supplementary well being care .

Art. 2nd Law No. 9,656 of June 3, 1998 enters into power with the following modifications:

“Art. 1º Legal entities ruled by non-public law that handle well being plans are topic to the provisions of this law, with out prejudice to compliance with the particular laws that governs their exercise, and at the similar time to the provisions of Law No. 8,078 of 11 September 1990 d. (Consumer Protection Code), adopting, for the functions of making use of the guidelines established right here, the following definitions:

…………………………………………. . ……….. ………………………….. …… …………………. …………………. “ (NR)

“Article 10. ………………………………………. ………………………………………… … ………………. ……….

…………………………………………. . ……….. ………………………….. …… …………………. …………………. …… …….

§ 4 The scope of the scope of complementary well being care, together with transplants and really advanced procedures, can be established in a rule edited by the ANS, which can publish a list of procedures and occasions in complementary well being care, up to date with every inclusion.

…………………………………………. . ……….. ………………………….. …… …………………. …………………. …… …….

§ 12. The list of procedures and occasions in supplementary well being care, up to date by the ANS with every new inclusion, is a primary reference for personal well being care plans contracted from January 1, 1999 and for contracts tailored to this law, and units pointers for healthcare.

§ 13. In the case of a treatment or process prescribed by a doctor or dental assistant that isn’t included in the list referred to in § 12 of this text, protection have to be licensed by the well being plan operator, supplied that:

I – there’s proof of effectiveness, in the mild of well being sciences, primarily based on scientific proof and a therapeutic plan; or

II – have suggestions from the National Commission for the Integration of Technologies in the Unified Health System (Conitec) or have a suggestion from a minimum of 1 (one) well being know-how evaluation physique that’s internationally recognized, supplied that also they are authorised for his or her residents. ” (NR)

Art. 3 The law enters into power on the day of its publication.

Brazil, 21 September 2022; 201st of Independence and 134th of the Republic.

JIR MESSIAH BOLSONARO

Marcelo Antonio Cartajo Queiroga Lopez

Tatiana Barbosa de Alvarenga

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