The current president of the country, Jair Bolsonaro, ended up sanctioning this Wednesday, the 21st, a bill that makes it mandatory for health plans to pay treatments that were not part of the basic reference list of the National Supplementary Health Agency (ANS). See what changes in practice.
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The proposal that was sanctioned puts an end to what is called the exhaustive role of the ANS.
In this way, the idea that the list is exemplary ends up being re-established, that is, the list with the list of the agency's procedures will only serve as a reference for the plans. It no longer means that the items contained therein are the only ones that can be covered and offered to citizens.
Health plans will be required to cover procedures
That is why beneficiaries will now also be able to request coverage for treatments that are not explicit in the list. For this, it is important to know that there will need to be some scientific evidence about the procedures or that the treatment in question is, in a certain way, recognized by some institution of renown.
At the end of August, the National Congress ended up concluding what was being processed there and also put an end to the exhaustive list of the ANS. This legislative initiative came as a response to a decision taken by the Superior Court of Justice (STJ), which ended up determined that health plans were not required to cover treatments that were outside the determined list used in the agency.
It is also worth noting that the supplementary health sector was waiting for Jair Bolsonaro's opinion, as they were already evaluating that this matter was about of a political decision and that an eventual veto would end up causing a certain negative highlight, which would be dangerous as we are so close to the beginning of the elections.
Not everyone agrees
In recent weeks, we have received reports that Minister Marcelo Queiroga was already telling some people that he would not recommend a veto to the chief executive. It's important to say that Queiroga has been criticizing the project before. He said that the approval would have a very big impact on the sector.
“Individual plans are practically not offered by membership anymore. So, when it comes to opting for more procedures, more medications on the list, there are certainly costs linked that will be passed on to the beneficiaries. And some of them will not be able to afford these costs. This is the reality”, said the minister.
“For me, it was much easier to get here and defend an exemplary and broad list, but it is up to the Minister of Health to alert the senators, who will analyze this proposal, about what are the most appropriate ways to provide health, not only as a right of all and a duty of the State but also in the context of private health plans”, he concluded his position.
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