Paulo Rebelo emphasized that the readjustment is one of the smallest ever granted
Deputies from the Committee on Social Security and the Family received the head of the National Agency for Complementary Health (ANS), Paolo Rebelo, at a public hearing on Tuesday (14) in the Chamber of Deputies. The purpose of the meeting was to discuss readjustment of health plans, considered the largest ever, and a Supreme Court of Justice (STJ) decision that, in practice, exempts operators from coverage for treatments not on the ANS list.
Representative Rejane Dias (PT-PI), author of the discussion request, questioned the 15.5% rate the agency had authorized to readjust individual health plans. Parliament considers the increase exaggerated. “It makes us really worried, in the scenario of the pandemic that is not over yet, in the scenario of rising food prices, cost of living, and fuel, which have directly affected the most vulnerable,” he said.
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Paolo Rebelo, emphasized that the entire process of calculating plan modifications is carried out in accordance with the legislation and in a transparent manner. He noted that the agency gave a negative adjustment of -8.19% in 2021 precisely because of the pandemic. Thus, the adjustment in 2022 will be about 6% compared to 2020. He states that, from this perspective, the increase is one of the smallest increase ever granted.
It means there is an annual readjustment of 2.98%, not 15.5%. This is why it is considered one of the smallest modifications to have been applied historically by the National Supplemental Health Agency. That’s why you have to look not just at a picture, but at a movie of what happened, considering the years 2021 and 2022,” think about it.
Representative Jandira Feghali (PCdoB-RJ) disagrees and says that despite this, readjustment is very high in the face of the entire crisis situation the country is facing. He noted that “even if the increases are historically lower, the effect is significant, because the current social situation of people is a difficult one, from high unemployment, instability, low income.”
disease roll
STJ’s decision to consider the list of diseases in the ANS as comprehensive rather than exemplary was another point discussed at the meeting. By virtue of STJ’s decision, the plans are exempt from covering expenses not provided for in the agency’s list.
Representative Carmen Zanotto (Citizenship-SC) has demanded that the ANS set some rules so ongoing treatments are not paralyzed, because many families are already affected. “We are now in a moment of concern and legitimate emotion for Brazilian society as a whole, based on the position of Syrians for Truth and Justice. What is the suffering of parents and family members? Will my operation stop?” he asked.
The head of the ANS stated that he had already issued a note with a recommendation that the treatment could not be stopped. It also ensures that health plans cannot fail to cover these treatments. “The plans that serve their beneficiaries cannot be interrupted. He explained that it is clear that a person who has been cut off by a court ruling can only be reversed by another judicial decision, but the fact that STJ’s decision said that the role is comprehensive will not prevent the continuation of these treatments “.
Paloma Marinho, who has an 8-year-old son with autism, says that, the day after STJ’s decision, she received a letter from the health plan suspending some procedures. “The ANS List Tax Judgment was one day and the next morning I got an email from the health plan suspending my son’s treatments so it was automatic. Then I would have to hire a health professional, which isn’t cheap. No lawyer will sue from like that.”
The head of the ANS said he is sensitive to all cases and ensures that he will improve the observation that recommends continuing treatment. He said the ANS is open to all complaints by calling 0800.701.9656.
Since the passage of the STJ resolution, on June 8, about 30 bills to regulate this issue have been submitted through the National Congress. Additionally, eight draft legislative decrees have been introduced in recent days proposing to suspend an NSA decision that authorized modifications to individual health plans.
