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publicado em 03/01/2012 às 11h19:00
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Idec directs users to charge new procedures of health plans

From day 1, more than 69 procedures were included in the list of appointments, tests, surgeries and treatments defined by ANS

 
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The health plan operators that fail to meet any of the new procedures that have joined the mandatory list of services established by the National Health Agency (ANS) will be fined $ 80 thousand. Since Sunday (1), plus 69 procedures were included in the list of appointments, tests, surgeries and drug therapies special health plans.

In case of denial by the operator, the lawyer of the Brazilian Institute for Consumer Defense (Idec), Joan Cross, alert the user to search the health plan first. If you do not get the service, the company must report to ANS by phone 0800 701 9656 or at one of 12 centers of the agency, which is responsible for overseeing the sector. Ultimately, the consumer can go to court.

A lawyer defends an even broader coverage, citing the liver and lung transplants, which are still off the list. The plans should meet more. Failure to meet, have to go to court, said Joan Cross.

Among the new services to be offered by health plans, is stomach-reduction surgery (bariatric) for video, which is less invasive than the conventional method. According to the Brazilian Society for Bariatric and Metabolic Surgery, the inclusion of the technique meets a long-standing demand of patients and professionals. Of the 60,000 bariatric operations done in the country in 2010, 35% used the technique of laparoscopy.

Instead of opening the patient's abdomen, the doctor needs to make small incisions for the passage of the cannula and the video camera. In addition, surgery is all recorded. According to the medical society, the cost of surgery is greater for video, but reduces the length of stay and reduces the risk of postoperative complications such as infection and the appearance of hernia.

Another novelty is the special drug treatment for those suffering from rheumatoid arthritis. The remedies are indicated for patients who have not responded to conventional treatment. It is estimated that 30 million Brazilians suffer from rheumatic diseases, 10% of rheumatoid arthritis.

The institutional coordinator of the National Association Rheumatic Patient Groups (ANAP), Lauda Santos welcomed the entry of drugs in the coverage of health plans. She regrets, however, they are not yet available in SUS. Only a small portion will have access, he said, adding that there is a struggle for inclusion of medicines in public since 2006. The cost of special treatment ranges from $ 8,000 to $ 20,000 per month.

The Agency Brazil tried to contact the Brazilian Association of Medical Group (Abramge) and also with the National Federation of Health Insurance (FENASAÚDE), which represents the 15 largest carriers, to comment on the entry into force of the new list of mandatory coverage. However, unable to contact.

Last August, when the NSA released the list, Abramge said the high cost of new services companies in the industry can lead to bankruptcy. The operators said FENASAÚDE affiliates will strictly comply with the legislation.

At first, there will be no adjustment of fees because of the new procedures. During this year, the NSA will monitor the operators to detect possible financial consequences. Should this occur, the additional cost will be included in the adjustment of fees from 2013.

A lista completa dos 69 novos procedimentos está disponível na página da ANS na internet.

Source: AGÊNCIA BRASIL
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