Congress discusses measures to change rule on tax coverage of health plans

The National Congress should start discussion from next week on legislative proposals that intend to change the rule that limits the coverage of procedures and treatments by health plans.

The expectation is that the topic will be addressed at a meeting of the college of leaders of the Chamber of Deputies, next Tuesday (14). The idea is to bring together the different initiatives presented so far in a single proposal.

On Wednesday (8), the Superior Court of Justice (STJ) understood that the list of mandatory coverage procedures for health plans, governed by the National Supplementary Health Agency (ANS), is “taxable”, that is, which obliges the coverage of the foreseen treatments only.

This week, the mixed parliamentary front in defense of human rights presented a bill that determines that the list of procedures be exemplary, not exhaustive.

The president of the Mixed Budget Commission (CMO), Celso Sabino (União Brasil – PA), also filed a legislative decree to try to partially annul the effects of the STJ’s understanding.

Federal deputy Roberto Lucena (Republicans-SP), president of the mixed parliamentary front in defense of human rights, informed the CNN Brazil who also requested an audience with the director-president of ANS, Paulo Rebello Filho.

“Our effort is to try to include treatments for pathologies such as Alzheimer’s, autism or coronavirus sequelae in the list of health plans”, he said. According to him, the idea is also to take the issue to the president of the Federal Supreme Court (STF), Luiz Fux.

The ANS list consists of a list of “procedures considered essential for the diagnosis, treatment and monitoring of diseases and health events” that the country’s medical assistance plans are required to offer.

The mandatory procedures, however, vary according to the type of plan signed: outpatient, hospital – with or without obstetrics –, referral or dental.

The current list was approved by the ANS in February 2021 and went into effect in April of the same year. The more than 3,000 procedures listed can be consulted on the agency’s website.