Chamber approves a project that makes health plans deal with treatments outside the list of ANS – Notícias

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

Elaine Menke / House of Representatives

Mothers of sufferers who had been injured by the resolution of the STJ adopted the vote in the plenary assembly

The Chamber of Deputies authorised this Wednesday (3) Bill 2033/22, which establishes protection assumptions for health exams or treatments that usually are not included in the list of procedures and occasions of the National Complementary Health Organization (ANS). The aim is to proceed with treatments that could also be excluded from health plan protection.

The proposal will go to the Senate for evaluation, the place it may be voted on subsequent Tuesday (9), in accordance with the president of the Chamber, Arthur Lira (PP-AL).

Among the regulatory factors, the proposal confirms that the list of procedures and occasions coated by health plans can be up to date by the ANS at every incorporation. The list can be a reference for contracted health plans from January 1, 1999.

When the therapy or process carried out by the attending doctor or dentist isn’t included in the list, protection should be allowed if:
– there may be proof of effectiveness, in accordance with health sciences, primarily based on scientific proof and a therapeutic plan;
– there are suggestions from the National Commission for the Incorporation of Technologies in the SUS;
– there may be a proposal from at the very least one health expertise evaluation group with a global popularity, whereas they’re additionally authorised for his or her nationals.

Decision of STJ
The Supreme Court of Justice (STJ) determined in June that the List of procedures and occasions in health is full, and that health operators usually are not obliged to deal with treatments that usually are not talked about in the list, however apart from some particular circumstances.

The list of ANS procedures lists 3,368 health occasions, together with consultations, exams, treatments and surgical procedures, in addition to drugs and orthoses / prostheses associated to those procedures. These medical companies should be supplied in accordance with the health plan.

PL 2033/22 was introduced by a working group of the Chamber of Deputies that was created to review the matter.

The rapporteur, deputy chief Hiran Gonçalves (PP-RR), criticized the resolution of the STJ, which brought about a nice uproar in accordance with him. “And he wished nothing much less. Millions of individuals who rely on health plans to remain wholesome and alive had been disadvantaged of the proper to endure acceptable treatments round them, identified by the health professionals accountable for it their therapy.”

Elaine Menke / House of Representatives

Hiran Gonçalves, rapporteur of the invoice

Hiran Gonçalves thanked the president of the Chamber, Art Lira, for the pace with which he analyzed the project. “The proposal goals to align the views of technical organizations and civil society, all the time guaranteeing the security and health of hundreds of thousands of beneficiaries of health care plans in the nation.

Already the deputy chief Tiago Mitraud (Novo-MG) defended the resolution of the STJ and criticized the proposal, as a result of it should hurt competitors and improve the costs of health plans. “It’s going to be a lot costlier and sophisticated to have health insurance coverage, and the little ones can be broke. The massive pharmaceutical firms can now encourage docs to prescribe experimental treatments with out the permission of Anvisa”, he warned.

Congresswoman Jandira Feghali (PCdoB-RJ) proposed the motion of moms who had been attempting to proceed the therapy of their youngsters, which might be damaged by the STJ’s interpretation of the function of the tax. “They got here right here all these weeks to battle for the approval of this project. The safety of life is above the revenue of health plans”, he defended.

Vice President Soraya Santos (PL-RJ) mentioned that the resolution of the STJ on the tax career will trigger deaths. “Life is the biggest reward we now have. The function should be nice, to find the greatest therapy”, he mentioned.

Deputy Chief Gilberto Nascimento (PSC-SP) mentioned that individuals had been in disaster with the chance of decreasing the protection of health plans. “The uncommon illness isn’t a situation that the particular person wished. They are sacrificing their funds to pay for health insurance coverage and they need to have rights,” he mentioned.

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Reporting – Francisco Brandão
Editing – Pierre Triboli

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