The new National Agency for Complementary Health (ANS) normative decision that established the end of limiting the number of consultations and sessions with psychologists, speech therapists, occupational therapists and physiotherapists begins as of day (1) for all organized health plans, chartered after Law 9.656 / 1998 or adapted by law , which includes outpatient clinics, i.e. consultations and exams.
The decision was made on July 11 at an extraordinary meeting of the agency’s board of directors.
With this action, health plan operators are now required to cover all consultations or sessions with specialists in these four categories that a physician prescribes for patients with any disease or health condition listed by the World Health Organization (WHO), such as autism spectrum disorder and cerebral palsy. , lowestsaid Paulo Rebelo, director of the President of the American News Agency (ANS).
According to Rebello, this year, there were 22 inclusions of procedures, among the tests, treatments and medications, on the ANS’ list of mandatory procedures.
consumer
For health program coordinator at the Brazilian Institute for Consumer Defense (Idec), Ana Carolina Navarrete, this decision comes after intense demands from various institutions from patients and consumers who have already drawn attention to the “abuse” of limiting the number of inquiries with these groups.
Prior to that, this list limited the number of consultations with these professionals to 12 a year. If they need more, Anna Carolina said, the consumer will pay or go to court, which, in most cases, limits health plan coverage.
The expert recalls that if the plan refuses coverage or imposes any restrictions on consultations and sessions with the four professional categories, the consumer must first try to resolve it with the operator. “If that doesn’t work, you should file a complaint with the head of your state or municipality or directly to the ANS itself.”