After meeting with Lyra, Health Plans says it has signed an agreement to suspend and cancel unilateral breach of contracts Policy

After meeting with Lyra, Health Plans says it has signed an agreement to suspend and cancel unilateral breach of contracts  Policy

Representatives of health plan operators announced an agreement on Tuesday (28) to unilaterally suspend and cancel cancellations of contracts for patients on ongoing treatment.

The decision was made after a meeting with the Speaker of the House of Representatives, Arthur Lira (PP-AL), and Rep. Duarte Jr. (PSB-MA) – rapporteur of a proposal in the House of Representatives to reform the legislation regulating investment plans.

According to Duarte Jr., the operators committed to suspending unilateral terminations and not making new cancellations while discussing the proposal to recast the legal framework of the plans.

When those concerned were asked, they said so The agreement was made verbally.

The project rapporteur also said that Lira is committed to putting the project to a vote this semester.

“For this first conversation, the cancellation suspension was already very helpful for us. The sectors and companies failed to meet their demands. An X-ray more appropriate to the situation,” Lira said.

The head of the chamber stressed that although “the largest life insurance companies in the world” have left the country, they “cannot help but be by the side of those in need.”

“Rapporteur Rep. Duarte Jr. was listening to the meeting. We will prepare a report weighing the new milestones and positions that need to be discussed.

Autism's battle with health insurance

Among other points, the proposal prohibits unilateral termination of contracts, unless the delay in monthly payment exceeds 60 consecutive days. It also sets rules to avoid arbitrary modifications to group health plans.

In the document, Senacon reported an increase in the registration of Notices to Initial Mediation (NIPs) – a tool of the National Health Agency (ANS) to mediate disputes between plans and beneficiaries.

Currently, legislation regulating health plans prohibits contract termination only while the contract holder is hospitalized and in the event of nonpayment for more than 60 days.

The National Federation of Complementary Health (FenaSaúde), which represents, for example, the operators of Bradesco Saúde and SulAmérica, confirmed the agreement to abolish unilateral tears.

He also stated that the operators discussed “issues affecting the sustainability of health plans.”

He participated in the meeting with Lira and Duarte Jr. this Tuesday:

  • Paulo Rebelo, CEO of ANS
  • Gustavo Ribeiro, President of the Brazilian Association of Health Plans
  • Alessandro Acayaba, President, National Association of Benefits Administrators (ANAP)
  • Renato Casarotti, Vice President of Corporate Relations at Amiel
  • Manuel Pérez, CEO of Bradesco Saúde
  • Luiz Paulo Tostes Coimbra, President of Central Nacional Unimed
  • Vera Valiente, Executive Director of the National Federation for Complementary Health (FenaSaúde)
  • Raquel Reyes, CEO of SulAmérica Saúde & Odonto
  • Luiz Paulo Tostes Coimbra, President of Central Nacional Unimed
  • Jorge Oliveira, Commercial Director at Central Nacional Unimed
  • Marcos Paulo Novaes, Executive Supervisor of Aprogram
  • and Pablo Meneses, Vice President of Rede D'Or

Health plans are more expensive and restrictive

The plans and ANS confirm the agreement

The National Agency for Complementary Health (ANS), which regulates the sector, also confirmed the content of the meeting. Reading positions:

  • Programs – Brazilian Association of Health Plans

Tuesday's meeting (28/05), called by the President of the House of Representatives, Arthur Lira, was proof that the challenges of access to complementary health care in Brazil are best solved through dialogue between the sector, society and public authorities. .

The outcome of the meeting is a reflection of the sensitivity and concern of Mayor Arthur Lira, the health plans of the beneficiaries and the sector itself. Our role now is to continue the dialogue with the aim of ensuring that millions of Brazilians have access to quality care in the complementary health care system.

Under the signed agreement, the cancellation of services for people undergoing treatment for serious illnesses and autism spectrum disorder will be reviewed. New unilateral cancellations for group membership plans have also been suspended.

  • National Federation of Complementary Health (FenaSaúde)

FenaSaúde (National Federation of Complementary Health), representative of an important group of healthcare providers in the country, informed that its members have decided to suspend any cancellations for beneficiaries undergoing ongoing treatment and to maintain existing group membership plans. The commitment was signed at a meeting held this Tuesday morning (5/28) in Brasilia with Chamber President Arthur Lira.

At the meeting, problems affecting the sustainability of health plans were also discussed, such as the approval of the law that is now considered a standard ANS list of procedures, the establishment of unlimited coverage for treatments and the occurrence of fraud.

The National Agency for Complementary Health (ANS) reports that it participated, this Thursday (28) morning, in a meeting coordinated by the Federal Representative and President of the House of Representatives, Arthur Lira. On the agenda is canceling health plan contracts.

In addition to the Director of the President of the National News Agency, Paulo Rebelo, the meeting was attended by Federal Representatives Duarte Junior – Rapporteur of Bill No. 7419, on Health Plans – and Mario Herringer; Entities representing health plan operators and benefits managers – Brazilian Association of Health Plans (Abramge), National Federation of Complementary Health (Fenasaúde), and National Association of Benefits Managers (Anab); Representatives of operators Bradesco Saúde, Amil, SulAmérica and Unimed Nacional.

On this occasion, Congressman Arthur Lira asked attendees to commit to suspending plan cancellations, reintegrating patients with autism spectrum disorder into already canceled plans, maintaining care for hospitalized patients, and adhering to procedures scheduled prior to termination.

It was also agreed that the sector would submit proposals for legislative measures focused on improving consumer access to the health insurance sector.

“Problems are solved through dialogue, and bringing all these people together to discuss the issue of canceling plans was a very important action at this time. We will evolve with the discussions so that everyone in the sector – consumers, providers and operators – has greater security and predictability. She continues The National Ports Agency formulates proposals to improve the regulation of the sector through this comprehensive view,” explained Paulo Rebelo.

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