Clipping of news on Brazilian Culture, Law and Citizenship
03/27/2015
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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Until March next year, Unimed-Rio's finances will be closely monitored by the National Health Agency (ANS). The so-called fiscal direction, which does not affect the cooperative management of medical, occurs due to "administrative abnormalities and / or severe economic and financial" and comes after months of financial problems reports that since 2014 affect care 1.1 million customers. Although the regulatory stress that this is not an intervention, by not hold any power over the management of the operator, experts point out that, in practice it is an intervention and that it comes late. During this period, consumer services must be rendered normally and contracts must be fully maintained, including the quality and quantity of the accredited network.
According to ANS, fiscal management is a face tracking done by an agent appointed by the regulator, to monitor and support the solution of financial problems, without the operator's administration lose its power management. The tax director will be within the Unimed-Rio, auditing accounting, indicating corrections and pointing any capital contribution requirements. After this step, it will examine the set of measures to be adopted to solve their problems. The action of ANS in Unimed-Rio will last 365 days, but can be renewed one or more times.
Ligia Bahia, health economics professor at the UFRJ, said that the action of ANS is an intervention yes and something serious, since the assets of the directors come to be unavailable. And assumes that the company will have to show that there is a way out.
- It is a statement about it and yes there is no doubt. The case of Unimed-Rio is very important. Has folkloric aspects, such as high investment company in Fluminense (for 15 years, the operator sponsored the club and the end of the deal was announced last December), the high salaries of the board, but also has other problems such as a relationship complicated between the board of the Regional Council of Medicine (CRM) and enterprise, where most of the advice was also on the board of Unimed. The company has a solution, but we must settle overdue debts and the collection of resources with doctors, which is not something simple - said the expert.
A month ago, nine plans sales ban
Posted on Wednesday, the decision was approved unanimously by the ANS, after the operator has had the opportunity to regularize their situation. If problems persist, Unimed-Rio will have to transfer your wallet to another carrier. In a statement, the union says it sees as the natural procedure and that since the end of 2014 initiated a management plan to reverse a financial imbalance, "based on the review of internal processes and the implementation of administrative measures to generate more operational efficiency ".
ANS The action on Unimed-Rio also comes just over a month after the ban on sale, Agency, nine of his plans for poor service. Among the major carriers, the cooperative has the second worst rate of complaints, behind Unimed North / Northeast. In February, the average rate of complaints in the country was 0.99. The Unimed-Rio was 5.35, according to the ANS site. And the chart shows high claims from the purchase of the portfolio of 160 thousand individual customers Golden Cross in September 2013.
Consumer is concerned
The news left the food engineer Valeria Borges worried. Customer Unimed-Rio ten years ago, she was diagnosed with kidney inflammation last July and ended up being the victim of financial problems already reflected in attendance. Driven by daughter, Nívia, the Unimed bar at the time, the engineer of 56 years could not immediate hospitalization, despite medical advice. And fears that problems happen again:
- It was a very unpleasant experience. Paid the second best plan Unimed and use very little. When needed, this happened. I'm worried about this situation. I do not know what I'll do.
Attorney Renata Vilhena Silva says that the NSA is not fulfilling its objectives and that the agency was slow to act, with many people having difficulties of medical care. How Unimed-Rio bought from national portfolios of other plans, problems affect other states:
- The NSA could not have authorized Unimed-Rio to buy the national portfolio of Golden Cross. The problems are immense.
Jorge Darze, president of the Association of Physicians of Rio de Janeiro, said the NSA, created to make the dialogue between operators, users and service providers (doctors and hospitals), is concerned only with operators.
- We are not talking about a simple problem, but a social problem that affects thousands of people seeking health services.
The NSA says it acted in time, in compliance with the laws, using the preventive monitoring tools and the declaration of fiscal direction.
Cooperative says adjustments already give positive effects
Unimed-Rio changed its management team in November last year and since then has been undergoing a financial rearrangement, with downsizing costs and lengthening of debts to banks, says Mozart de Oliveira Junior, health care superintendent cooperative. He is a professional who arrived late last year to form a new executive board, chaired by Celso Barros, re-elected last year to the post he has held since 1998.
The cooperative, says Oliveira, entered this year paying on time members, and the service was normalized in all segments. He said the financial problems were caused by the increase in medical costs (27% on average) higher than the high income (12%). In a statement, Unimed-Rio said that "even with experienced financial difficulties during the year, were carried 31.5 million procedures, including consultations, examinations and admissions.
Loss of R $ 198 million
With a history of sound financial health, the cooperative closed the year with losses of R $ 198 million, the first negative result since 2002. As was just over £ 100 million in cash, were missing £ 90 million. Being a cooperative, the amount will have to be divided among the members according to medical billing, just as occurs when there is profit. If all pay the same amount, the invoice would be R $ 16,071.43 for professional.
- The values should be retained in payments that will receive the cooperative in the coming months - Oliveira said.
How happen this contribution, however, is not yet defined. The annual meeting of members, in which the issue would be decided this month, stopped because participants demanded time to analyze the balance. It is expected that the meeting will be resumed in mid-April. Until then, the balance sheet, with audit Ernst & Young, have already been published - the deadline is the 31st of this month.
Source: The Globe
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This article was translated by an automatic translation system, and was therefore not reviewed by people.