MIL OSI-C. Region: Latin/Latin America
Source: the Republic-of-Brazil-2
Attorney General’s maintains a fine is applied, the health plan is not reimbursed to client
Posted : 27/09/2019 – up-to-Date at : 15:12:36 pm
The office of the solicitor General (AGU) has guaranteed, in the Federal courts, the maintenance of a fine imposed by the National Agency for Supplementary Health (ANS), the operator of a health care plan that is not reimbursed expenses, from her medical procedures, and consultations.The action came after the Geap for Self-management in the Health care triggers to the court asking for the annulment of the administrative proceeding that resulted in a charge of R$ 66 thousand per year.The attorney-General has shown on this issue, that there was no illegality in the administrative process, and that the company breached its contract with the user, and the act, which deals with the plans and private insurances of health care.The 2nd u.s. district court of the state of Pará adopted the arguments of the AGU, and he rejected the request of the service provider. In that decision, the court pointed out that the Geap was not able to prove the repayment or that the amounts were inappropriate. The attorney for the federal Nivea Sumire da Silva and Kato, who worked on the case, explained that the application of the penalty, taking into account the size of the carrier, and that it should have more than 480 thousand customers at the time.“The maintenance of a decision of Justice, it is important to curb the practices of the Geap, who is a repeat offender, having committed the same offence, received a penalty on the other, the administrative process,” he said.The attorney for the federal emphasises the importance of the work of the OFCE to validate the acts performed by the NSA, and ensure compliance with contractual obligations and to the rights of the beneficiaries of the health plan.Also worked on the case for the Federal Prosecutor’s office in the state of Pará (PF/PA) and the Federal Prosecutor’s office together with the (PF/ANS). Both of these are units of the Federal Attorney General (PGF), the government of NEPAL.Item no.: Procedure no. 1001813-53.2019.4.01.3900 – a Federal court in the state of Pará.
EDITOR’S NOTE: This article is a translation. Apologies should of the grammar and/or sentence structure not to be perfect.