Clipping of news on Brazilian Culture, Law and Citizenship
07/04/2012
This article was translated by an automatic translation system, and was therefore not reviewed by people.
SAO PAULO - The NSA (National Agency of Supplemental Health) examines the suspension of the marketing of products from 40 providers of health plans. Companies should suffer punishment for not offering guarantees of service rules established by resolution 259, which entered into force in December 2011, according to data released by the NSA on Tuesday (3).
According to monitoring operators together health plans, made by NSA every three months, 4,682 complaints were made by beneficiaries of health plans for the failure to meet established deadlines. The analysis occurred in the period between 19/03/12 and 18/06/12.
Complaints
1016 operators of existing medical, hospital, 162 received at least one complaint. Of these, 82 were above the median of complaints, considering the size and type of care provided. Among the existing dental operators 370, two receiving complaints.
In this monitoring, it was found that 105 operators were medical and hospital claims in the two periods of assessment and of these, 40 fit the criteria for discontinuation of products. According to a spokesperson for the agency, operators will be notified and only after this procedure the company names will be disclosed.
Punishment
The surgery that do not meet the deadlines set by the NSA are subject to fines of r$ 80,000 or r$ 100mil for urgent and emergency situations. And in cases of noncompliance listed, may suffer administrative measures such as suspension of the marketing of part or all of their products and the enactment of the special technical direction, including the possibility of removal of company directors.
"Consumers should have access to everything that has contracted with your health insurance carrier. Those who miss this deadline may have the legal sale of discontinued plans, "says the chief executive of ANS, Mauricio Ceschin.
After trying to schedule the service with professionals and health facilities accredited by the plan and not achieve within the maximum time allowed, the recipient must contact the carrier's plan for an alternative to the requested service. In this contact, the consumer should not forget to write down the number of protocol, which will serve as proof of the request made.
If the carrier does not provide solution to the case, the beneficiary shall, taking in hand the protocol number, make a complaint to the NSA through a channel service: Dial ANS (0800 701 9656), Customer Service at the site of Agency (www.ans.gov.br) or, in person, in one of 12 Centers of ANS in the main Brazilian capitals. See the addresses: http://www.ans.gov.br/index.php/aans/nossos-enderecos.
Source: ANS
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This article was translated by an automatic translation system, and was therefore not reviewed by people.