Clipping of news on Brazilian Culture, Law and Citizenship
04/04/2013
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Standard ANS will be published tomorrow in the Federal Gazette
BRASILIA - The operators of health plans will be required to create ombudsmen linked to their organizational structures to reduce conflicts with consumers. Determination is the National Health Agency (ANS), in which standard will be published on Thursday in the Official Gazette
The information was released early on Wednesday by Health Minister Alexandre Padilha, during a public hearing in the House of Representatives. The deadline for the creation of the ombudsman is 180 days for carriers to number less than 100 000 beneficiaries and 365 days for those with less than 100 000 beneficiaries. Carriers with less than 20 thousand beneficiaries and dental exclusively (up to 100 thousand beneficiaries), in turn, need not create the ombudsman.
Padilha said that the supplementary health sector increased "sharply" in recent years, but "low engine" of regulation. Therefore, the government has taken measures such as the suspension of health plans that do not meet deadlines for compliance. He denied that there is a proposal being studied to relieve the industry of health plans or agreements to create "poor", with minimum coverage.
- We need to seriously discuss the sustainability of the sector's expansion of health insurance supplement in the country - said the minister, noting that 60 million Brazilians have been using this service.
Treatment
Stael Riani, ombudsman of National Health Agency (ANS), says that last year desdeo the matter has been discussed in technical councils with the participation of companies, procons, class associations. In the Ombudsman's view, the idea of creating a new instance of resolving consumer complaints resume credibility is lost by consumer care services companies:
- We have to change the process of care. The SAC is an instance already fully decayed, that does not count more with consumer confidence. With the requirement of ombudsmen want to give back to the giver problem because today many complaints come directly to the NSA without spending by companies, by disbelief in the possibility of a solution. Moreover, there's more to judicialize sector.
The ombudsman should have structure composed and deputy designated specifically for this purpose, besides having contact channels specific care protocols and teams able to respond to demands for a maximum of seven days. They also must submit statistical reports and recommendations to the legal representative of the carrier and the ombudsman of ANS. The agency noted that the creation of these structures is already an obligation required by the Central Bank and the Superintendence of Private Insurance (Susep).
- The reports shall be confronted with indicators complaint that the agency already has and thus can better monitor and conflicts resolvable index of ombudsmen - highlights Stael.
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This article was translated by an automatic translation system, and was therefore not reviewed by people.