Clipping of news on Brazilian Culture, Law and Citizenship
24/04/2014
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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RIO - Since November, consumer complaints against operators of health plans reported monthly decline , according to the Index of Claims of the National Health Agency ( ANS ) . The decline was recorded in the plans of small, medium and large . In the latter , the average claims fell after a string of high started in February last year . Brazilian Institute for Consumer Defense ( IDEC) , however , the data does not mean that the abuses of the companies also retreated , and the lack of coordination between the agency and the defense agencies precludes broader sanctions .
The monthly index is based on the average number of complaints received by service channels in previous ANS for each set of 10 000 beneficiaries operators six months.
In March , the average claims of large companies closed at 0.97 . This means that were received by the agency, between October 2013 and March this year , 0.97 complaints for every group of 10,000 customers of the carriers of this size , we have a hundred thousand or more customers . In November 2013 , when the index began a downward trend , the average was 1.09 compared to a 1.14 in October.
Plans Midsize - with 20,000 or more beneficiaries - after the high of 0.96 in October , the average was 0.91 in November and reached the last month at 0.81 . In companies whose clients chart is below 20 thousand, ie , small , average claims dropped from 1.02 in October to 0.92 in November 2013 . In March , the number closed at 0.72 .
According to ANS , the fall of the index reflects the inspections program for Monitoring Service Guarantee . The first cycle was conducted in the first quarter of 2012, but from April to August of that year the average claims increased from 0.50 to 0.66 for large plans . In September , the number fell from 0.66 to 064 , and from October to December ranged between 0.70 and 0.71 .
In 2013 , the only recorded fall - before the recent decline started in November - was in February : 0.68 compared to 0.70 in January. Since then until October , the average increased from 0.73 to 1.14 .
Recurrence and rigor in audits
Although the average calculated by ANS registering complaints downtrend , Idec remember that receives thousands of complaints about abuses of operators and the index of the agency is not decreasing abuse by plans . The institute said the plans have occupied for the first 12 years of his rank of care . The recurrence of irregular plans is another reason to charge higher efficiency in services .
- In the last period of suspension of the sale of plans by ANS recurrence was 25 % of the plans , which is alarming and demand more stringent and effective measures by the agency to guarantee healthcare coverage to consumers - underscores the lawyer Idec Joana Cruz .
Joan still charges the NSA advances through a joint between it and the organs of consumer protection , so that the sanctions " were extended to a number that was not so short of reality." More effective surveillance also contribute to the reduction of complaints .
- The significant number of repeat plans shows that often the application of the penalty of suspension of sales is not sufficient to ensure compliance within the terms of the NSA .
The monitoring program
Through the program , the agency suspends the sale of plans with high claims for noncompliance with deadlines , and denials of coverage to consumers . Since the early cycles , 783 plans 105 operators had suspended sales . In February , when the NSA announced the suspensions of the eighth period , 111 plans were on the list , which included 47 operators .
Source : The Globe - Online
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This article was translated by an automatic translation system, and was therefore not reviewed by people.