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Covenants in crisis

This article was translated by an automatic translation system, and was therefore not reviewed by people.


 


33% of plans have SP problems, according to ANS, 207 are carriers of health facing difficulties to meet clients and therefore need the intervention of the agency

Of the 611 operators of health plans based in the state, 207 (or 33% of the total) are in financial trouble, according to the National Agency for Supplementary Health (ANS). These companies are struggling to meet the insured and need the interference of the regulatory agency.

125 are in the Recovery Plan, ie, trying to resolve issues identified by the financial agency. A further 39 were prescribed for Fiscal Managers, that is, may at any time receive interference from the agency to regulate financial and administrative problems. And 14 of them are already in supervisory or Technical Director - is already a representative of the NSA in the operator acting to try to resolve economic issues.

The NSA does not disclose the names of companies to avoid that customers are alarmed and begin to migrate to other agreements, further hampering recovery efforts. Consumers can check the website or Dial ANS if your carrier is under receivership.

"Companies are required to present a series of documents to demonstrate that they are complying with legislation and industry that can afford to maintain. The NSA analyzes the documentation and, if pending, sends letter to the operator who in turn it has to work the correction or detail of information, "said Luciana Silveira, Deputy Director of Standards and Qualification of Operators of ANS during the 4th Day Law Supplemental Health held yesterday in Sao Paulo by the Brazilian Medical Group (Abramge).

"It's a painstaking process and sometimes slow, but necessary to protect the beneficiaries. If after the third attempt, the company can not fit the standards, it can enter into a process of fiscal management, it means that after several attempts did not pass through Riddle of ANS. "

According Arlindo de Almeida, president of Abramge, most companies have some kind of financial problem is small. "They are operators with up to 50 thousand beneficiaries. Even the NSA says that most consumers are in health plans healthy."

According to ANS, 71% of beneficiaries of health plans in Brazil (37,310,867 people) are carriers with full license to operate and financially healthy.

For Juliana Ferreira, lawyer of the Brazilian Consumer Defense (IDEC), the fact that the NSA did not disclose the names of companies that are undergoing intervention is lack of transparency. "The consumer has a right to know everything about your health care provider and need to guard against through what customers are going avimedi" he says. (See right). "The NSA can not deny this information to the public," he adds.

When the plane begins to take ill, the consumer may already be aware. This suggestion is Maria Inês Dolci, an institutional representative of the Brazilian Consumer Protection (Pro Test).

"When the standard of service drops and no exchange of suppliers and service providers with more flights, the customer already noted that the situation is under control and can try to portability or even research if there are complaints bodies of consumer .

UNDERSTAND DIFFERENCES

125 operators
Plans are in recovery, trying to resolve disputes

14 companies
already have a representative of the NSA acting internally to recovery

RECOVERY PLAN
It is applied in two situations:

a) When, after a routine monitoring by the NSA, the regulatory agency detects economic and financial failures and calls for restoration work of the accounts of the operator

b) When the operators do not meet the economic and financial resources to receive the operating license. In these cases, the recovery plan is the last opportunity for the operator to regularize their situation according to the rules of the ANS. When the operator has the recovery plan request, the NSA can review and approve it or reject it.

It is for the operator to sign a commitment to meet the recovery plan approved by the regulator which, in turn, will make a follow-up.

The recovery plan is a stage prior to the special.

TECHNICAL DIRECTION AND / OR TAX

They are administrative procedures that can be used by NSA operators to correct the abnormalities in administrative and / or economic and financial events that may jeopardize the quality and continuity of care to consumers

Also called special regimes, the direction of fiscal and technical supervision may be initiated concurrently

CANCELLATION OF REGISTRATION

Can only occur when the operator no longer is bound by beneficiaries. 
  

Source: Jornal da Tarde

This article was translated by an automatic translation system, and was therefore not reviewed by people.

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