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publicado em 03/07/2012 às 17h11:00
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NSA may suspend the sale of a health plan of 40 operators because of complaints

In all, 162 companies received at least one complaint for breaking terms of consultations, tests and surgeries

 
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The National Health Agency (ANS) evaluates the suspension of the sale of health plans that 40 operators have received complaints from users not comply by the deadline of care. The information was announced today (3) the regulatory agency.

From March 19 to June 18, 4682 ANS received complaints from users because of not meeting deadlines for operators, ranging from three to 21 days depending on medical specialty.

According to ANS, the 1016 health plan operators in the country, 162 received at least one complaint during the evaluation period for breaking the deadlines for consultations, tests and surgeries, set a standard in force since December 2011.

The quarterly survey also found that carriers of the total, 105 complaints received in the two statements made in 2012, and in the case of 40 companies, claims justifying the suspension of products, such as the sale of health plans.

"Forty [medical and hospital operators] fit the criteria for discontinuation of products, which is already being examined by the NSA. Once implemented, the administrative measures will be disclosed to operators and then to society" , said in a statement.

According to ANS, plus 82 carriers were above the acceptable average of 370 complaints and dental plans received only two complaints.

The health plans that violate the deadlines for compliance set by the regulatory agency may have to pay a fine ranging between $ 80,000 and $ 100,000. In the case of recurrence, can also be punished with administrative measures such as suspension of the marketing of products, or undergo an intervention.

The consumer should have access to everything that has contracted with your carrier. Those who miss this deadline may have the legal sale of discontinued plans, said through a statement, chief executive of ANS, Mauricio Ceschin.

Source: AGÊNCIA BRASIL
   Palavras-chave:   Health plan    NSA    Claims    Compliance    Health Insurance   
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