HEALTH AND BRAZIL’S NATIONAL HEALTH AGENCY

With experience in the areas of health plans and medical, hospital, and sanitary law, MARCELO TOSTES ADVOGADOS acts proactively by conducting audits of private healthcare plans and operators and recommending internal preventive measures to mitigate possible risks of economic-financial imbalance. In addition, we have worked out administrative and judicial defenses for health plan operators, as well as hospitals and self-employed professionals.
Among the main demands we are required to deal with, the following stand out: administrative defense of health plan operators before Brazil’s National Regulatory Agency for Private Health Insurance and Plans (ANS), including administrative proceedings and preliminary mediation notices, an ongoing concern about the acceptance of our positions in lawsuits vis-à-vis the most recent court decisions, legality of the supplementary health fee, follow-up of measures taken by the Courts’ Executive Health Committees throughout the country, monitoring of judicialization of the relationship between health plan operators and plan holders, issuance of technical opinions, and drafting, analysis, and review of health plan contracts.

OUR SERVICES INCLUDE:

  • Preventive, advisory, and litigation counseling related to private and hospital healthcare plans;
  • Follow-up and guidance on changes and innovations in supplementary healthcare plans, sanitation law, and medical law;
  • Issuance of legal opinions on controversial subjects related to healthcare plans, Act No. 9.656/98, and ANS regulations;
  • Guidance on the conduction of Preliminary Mediation Notices (PIN);
  • Follow-up of administrative proceedings at the ANS;
  • Administrative and judicial representation relative to the Unified Healthcare System’s (SUS) healthcare cost reimbursement requirement;
  • Judicial representation relative to the collection of the Supplementary Health Fee;
  • Filing and follow-up of authorization applications for the operation of private healthcare plans and registration of products before the ANS;
  • Clarification on questions related to supplementary health legislation;
  • Filing and follow-up of applications to transfer controlling interests of private healthcare plan operators;
  • Analysis of contractual clauses, drafting of legal instruments and contract amendments;
  • Assistance in administrative proceedings relative to fines imposed by the regulatory agency, including filing of annulment actions and tax debt declaratory actions;
  • Filing and follow-up of declaratory actions relative to the SUS’s healthcare cost reimbursement collection;
  • Advice and follow-up on processes for the disposal of private healthcare plans’ beneficiary portfolios.