The Federal Supreme Court (STF) began on Thursday (10) the trial that will define the validity of the law that forced health plans to cover procedures that are not on the list of the National Agency for Supplementary Health (ANS).
In today’s session, the support of the parties involved in the process were heard. The voting date will be scheduled later.
The Court judges an action filed by the National Union of Health Self -Management Institutions (United) against excerpts from Law 14,454/2022.
The standard has defined that operators should fund treatments and examinations that are not foreseen in the so -called ANS list, the list of procedures that must be covered by plans.
The law was sanctioned after the decision of the Superior Court of Justice (STJ) which defined, in June 2022, that operators are not required to cover medical procedures that are not provided for in the ANS list.
The STJ understood that the list of procedures defined by the agency is exhaustive, that is, users are not entitled to exams and treatments that are off the list.
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After the entry into force of the legislation, the list became exemplary, not exhaustive.
In addition, the standard has defined that the list is a basic reference for private health care plans hired from January 1, 1999.
Thus, procedures that are authorized by doctors or dentists must be authorized by the plans, provided that there is proof of the effectiveness of treatment or recommended by the National Commission for Incorporation of Technologies in the Unified Health System (Conitec).
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Support
According to the defense of Unidas, the plans seek economic balance for the provision of services. Lawyer Luiz Inacio Adams estimated that about one third of Brazilians have health plans.
“Uncertainty increases the risk and, by increasing the risk, has to contribute more resources, which ends up reverberating those that offer the service. The pressure on the system is very real,” he said.
The representative of the Brazilian Committee of Organizations of People with Disabilities defended the maintenance of the law. According to lawyer Camila Cavalcanti Junqueira, operators make bankruptcy “alarmist discourse” so as not to ensure access to health.
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“It is unfortunate that health operators move the largest cut in this country, trying to replicate their modus operandi, which is to create terror, fear,” he said.
During the session, the president of the Supreme Court, Luis Roberto Barroso, said the issue is complex and will be guided to trial later.
“On the one hand, the right to health of an important portion of the population, on the other, the principles governing free initiative. Therefore, a delicate question that deserves the attention of the court. It seemed well to hear all the arguments and guide the trial session,” he said.
