Director of ANS say focus is not to fine health plans, but fines remain

In a hearing held Wednesday (10), the Commission for Consumer Protection of the House of Representatives, Andrew Long, CEO of National Health Agency (ANS), emphasized that the focus of the agency is fining operators plans health. The agency does not believe in the power inductor fine as a solution to change the behavior of operators said.

According to the director, the index of the ANS collection of fine is less than 2% of the value of fines imposed. He said that despite that the agency will not only continue with the system of fines will increase as the value of them. Today, the maximum fines is $ 1 million, with the planned change, the processes will be assessed by subject and by carrier and fines will be semiannual, reaching R $ 16 million.

The director said that the NSA plans to hire 200 people to review pending cases. The director explained that the agency's stance has been more rigorous in the last three years.

At the hearing discussed the fact that the group plans, which do not have the adjustment set by ANS, hold 80% of the beneficiaries of health plans. Some MPs cited the difficulty of hiring an individual plan, as operators of health insurance are interested in offering group plans, which have a greater freedom before the ANS. Andrew Long said the agency has no way of forcing operators to make available individual plans.

He cited another problem is the lack of regulation of the relationship between service providers (health professionals) and operators. The regulatory framework is not perfect, has a number of flaws that need to be discussed, said the director.

At the hearing scheduled to discuss the proposed processes in the face of wrongdoing by health plans against the beneficiaries, the attorney representing the Brazilian Institute for Consumer Defense (IDEC) noted that the health insurance industry is what most receive no complaints 11 years.

In 2012, 78% of complaints related to negative coverage were resolved by mediation of conflict, without opening the case. A lawyer who represented the Brazilian Association of Consumer Protection (Protest), Polyanna da Silva, thinks the reconciliation through the agency is not the best way, because this way operators can move to deny services knowing that will only supply them them to turn to the agency.

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