The Consumer Protection Institute (IDEC) submitted a public civil lawsuit against the National ANS and the suggestion of establishing health insurance that cubes are only consultations and optional exams.
According to IDEC, it allows you to adopt a “experimental organizational environment” – called the Organizational Sand Fund and the Low Cover Plans Suggestion Base – approved by violations. In the procedure, which was presented last week, the institute calls for the cancellation of normative decision No. 621, which regulates the sand fund.
The answer states that he has not been notified and does not comment on lawsuits. The agency says that if it is notified, “it will provide the information necessary to show the absolute fairness of its decisions.”
cancellation
IDEC states that AS agreed to organize the sand fund in a hurry, and to exempt the organizational impact analysis (AIR), “the basic and mandatory procedure to understand the impact that the new regulations will cause on the sector”, especially the risks to consumers who employ health plans.
“The law that allows organizational agencies to open the regulatory sand fund operations determines that innovation is an indispensable condition. However, the type of plan proposed by AS does not bring any innovation to the health plans sector. In fact, he deals with old health operators,” IDEC adds in a statement.
The institute argues that the proposal violates the Health Plans Law (Law 9.656/1998), especially Articles 10 and 12, which provides for procedures that should not or should be covered, and determining the priorities of corporate interests.
“Tables such as these create the misleading expectation of meeting their health needs. In practical practice, the proposal will expand the problems already exist today, such as negative coverage, uncontrolled modifications, cancellation without reason, and exacerbation of the accredited network and the quality of services,” says Lucas Andrea, IDEC coordinator, in a note.
“Efficiency to make decisions”
The answer states that it is brief to take a decision regarding the creation of storage operations in the types of plans specified in Law 9.656/1998, “The proposal to evaluate the product with consultations and optional exams accurately does not violate the health plans law.”
The agency argues that it consulted the Federal Prosecutor’s Office and that “there are no legal obstacles regarding the possibility of organizing the donkey.”
ANS also indicates that this procedure is innovative in reaching a new part of the market, “disciplining economic agents who have not been achieved before”, and that the proposal is still receiving contributions through general advice.
