{"id":2091,"date":"2017-08-11T08:00:08","date_gmt":"2017-08-11T11:00:08","guid":{"rendered":"https:\/\/segurosinteligentes.com.br\/oldrh\/_old\/?p=2091"},"modified":"2021-06-22T16:37:45","modified_gmt":"2021-06-22T19:37:45","slug":"fiscalizacao-das-operadoras-pode-mudar","status":"publish","type":"post","link":"https:\/\/segurosinteligentes.com.br\/oldrh\/fiscalizacao-das-operadoras-pode-mudar\/","title":{"rendered":"Fiscaliza\u00e7\u00e3o das operadoras pode mudar"},"content":{"rendered":"

[et_pb_section admin_label=”section” transparent_background=”on” background_color=”#ffffff” allow_player_pause=”off” inner_shadow=”off” parallax=”off” parallax_method=”off” padding_mobile=”on” make_fullwidth=”off” use_custom_width=”off” width_unit=”on” make_equal=”off” use_custom_gutter=”off” custom_padding=”0px||50px|”][et_pb_row admin_label=”row” make_fullwidth=”off” use_custom_width=”on” width_unit=”off” use_custom_gutter=”off” padding_mobile=”on” allow_player_pause=”off” parallax=”off” parallax_method=”off” make_equal=”off” parallax_1=”off” parallax_method_1=”off” parallax_2=”off” parallax_method_2=”off” column_padding_mobile=”on” custom_padding=”50px|35px|50px|35px” background_color=”#ffffff”][et_pb_column type=”2_3″][et_pb_text admin_label=”tag e data” background_layout=”light” text_orientation=”left” text_font=”|on|||” text_font_size=”16″ text_text_color=”#9ec31e” text_line_height=”1.5em” use_border_color=”off” border_color=”#ffffff” border_style=”solid” custom_margin=”||0px|”]<\/p>\n

ANS DE OLHO | 11.AGOSTO.2017<\/p>\n

[\/et_pb_text][et_pb_text admin_label=”t\u00edtulo” background_layout=”light” text_orientation=”left” text_font=”|on|||” text_font_size=”32″ text_text_color=”#495358″ text_line_height=”1em” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n

Fiscaliza\u00e7\u00e3o das operadoras pode mudar<\/p>\n

[\/et_pb_text][et_pb_text admin_label=”conte\u00fado” background_layout=”light” text_orientation=”left” text_font=”Open Sans||||” text_font_size=”16″ text_text_color=”#748690″ text_line_height=”1.5em” use_border_color=”off” border_color=”#ffffff” border_style=”solid”]<\/p>\n

A ANS acaba de colocar em consulta p\u00fablica a proposta de um novo sistema fiscalizat\u00f3rio. Com as mudan\u00e7as, a ag\u00eancia pretende melhorar a qualidade das pr\u00e1ticas regulat\u00f3rias, reduzir falhas e eliminar ru\u00eddos na rela\u00e7\u00e3o entre operadoras e benefici\u00e1rios.<\/p>\n

O tema estava em discuss\u00e3o desde setembro de 2016 pelo grupo t\u00e9cnico de reformula\u00e7\u00e3o do processo fiscalizat\u00f3rio. Ap\u00f3s uma s\u00e9rie de debates, que contaram com a participa\u00e7\u00e3o de representantes do setor, ANS, Minist\u00e9rio P\u00fablico e Defensoria P\u00fablica do Rio de Janeiro, foi formulado um novo c\u00f3digo de fiscaliza\u00e7\u00e3o.<\/p>\n

\n

O que muda com um c\u00f3digo \u00fanico de fiscaliza\u00e7\u00e3o?<\/p>\n

A ideia \u00e9 construir um material \u00fanico, uma esp\u00e9cie de \u201cc\u00f3digo de infra\u00e7\u00f5es do setor\u201d. Para isso, a ANS pretende juntar a RN 388\/05, que trata dos procedimentos das a\u00e7\u00f5es fiscalizat\u00f3rias, e a RN 124\/06, sobre as penalidades. O novo sistema inclui a organiza\u00e7\u00e3o das operadoras por faixa de desempenho, definidas por meio de indicadores de atendimento, resolu\u00e7\u00e3o pr\u00e9via de conflitos, cumprimento da regula\u00e7\u00e3o e envio de informa\u00e7\u00f5es \u00e0 ANS.<\/p>\n

Serr\u00e3o cinco faixas (A, B, C, D, e E) e a cada ciclo, que leva seis meses, as operadoras ser\u00e3o classificadas com base nos indicadores. Quanto pior o desempenho, mais rigorosas ser\u00e3o as a\u00e7\u00f5es e medidas adotadas. As multas ser\u00e3o proporcionais ao porte econ\u00f4mico (faturamento anual) e ao dano causado ao benefici\u00e1rio. Haver\u00e1 incentivos para que as operadoras melhorem suas posi\u00e7\u00f5es.<\/p>\n

Os atuais tipos infrativos tamb\u00e9m ser\u00e3o reformulados e as infra\u00e7\u00f5es que hoje s\u00e3o classificadas de forma ampla, ser\u00e3o mais detalhadas. Temas recorrentes, como cobertura assistencial e reajuste, tamb\u00e9m ter\u00e3o novas tipifica\u00e7\u00f5es.<\/p>\n

Atendendo aos pedidos dos \u00f3rg\u00e3os de defesa do consumidor, as demandas continuar\u00e3o recebendo tratamento individual. Essa metodologia, inclusive, garante alta resolutividade das NIPs<\/a>. Afinal, definir um n\u00famero m\u00ednimo de reclama\u00e7\u00f5es para uma operadora ser multada, seria o mesmo que afirmar que ela pode deixar de prestar o atendimento correto sem ser punida, prejudicando o benefici\u00e1rio.<\/p>\n

A expectativa da ANS \u00e9 que as altera\u00e7\u00f5es reduzam o prazo m\u00e1ximo de dura\u00e7\u00e3o dos processos de 250 para 180 dias. Se aprovadas, as mudan\u00e7as devem entrar em vigor em julho de 2018. Mais informa\u00e7\u00f5es sobre a proposta est\u00e3o dispon\u00edveis no site da ANS<\/a>.<\/p>\n

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Para otimizar o processo fiscalizat\u00f3rio, ANS prop\u00f5e a cria\u00e7\u00e3o de um novo c\u00f3digo de infra\u00e7\u00f5es da sa\u00fade suplementar.<\/p>\n","protected":false},"author":1,"featured_media":2092,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_links_to":"","_links_to_target":""},"categories":[13],"tags":[175],"_links":{"self":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2091"}],"collection":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/comments?post=2091"}],"version-history":[{"count":4,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2091\/revisions"}],"predecessor-version":[{"id":10393,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/posts\/2091\/revisions\/10393"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media\/2092"}],"wp:attachment":[{"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/media?parent=2091"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/categories?post=2091"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/segurosinteligentes.com.br\/oldrh\/wp-json\/wp\/v2\/tags?post=2091"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}