Lawyer Fabricio Posocco reveals that the right is guaranteed for health plan beneficiaries and SUS users
The cancer patient can receive state-of-the-art treatments, which have not yet arrived in Brazil, through the health plan. This is because the law 14.454, which entered into force on September 21, 2022, authorized the coverage of an international procedure prescribed by a medical assistant or a dentist when there is proof of effectiveness, based on scientific evidence and on a therapeutic plan.
The legislation provides that the treatment must be accepted by the plan when there are recommendations from the National Commission for the Incorporation of Technologies in the Unified Health System (Conitec) or, at least, from an internationally renowned health technology assessment body, such as the US FDA (Food and Drug Administration) or EMA (European Medicines Agency).
University professor and lawyer Fabricio Posocco, of the Posocco & Advogados Associados firm, explains that in order to access the new exam, medicine or therapy, the need must be demonstrated. “The report must detail the methods that have already been applied and which have not had the desired effect. And underline why the alternative recently launched on the foreign market can improve the patient’s health and life.”
Law 14.454 also requires private health plans to cover examinations or treatments that are not included in the list of procedures and health events of the National Integrative Health Agency (ANS). “The list updated by ANS only serves as a reference basis for private healthcare services contracted after 1 January 1999 and for contracts adapted to this law. In the event of denial of service, coverage can be obtained with the help of the Judicial Power”, informs Posocco.
Public health
Lawyer Fabricio Posocco states that, in the Unified Health System (SUS), law 14.313/2022 authorizes the use of medicines and products recommended by Conitec and purchased through international multilateral organizations, such as the Pan American Health Organization (OPAS).
In addition, the patient may request a treatment not on the SUS list when other tried and tested procedures prove ineffective. “A person who has been diagnosed with a serious disease, such as cancer, who does not have the economic conditions to sustain expensive therapies for a long time, must receive free from the state. This right derives from the guarantees provided by the federal constitution”, says Posocco.
more rights
Prevention, early detection and early treatment of cancer can save lives. All of these procedures are available to the health plan beneficiary and the SUS patient.
The person diagnosed with cancer can take out a health plan at any time. “He must communicate the condition of the pre-existing disease at the time of signing the contract. The refusal of the plan or its administrator may constitute discrimination and be liable to compensation for non-pecuniary damage”, says the lawyer.
The SUS patient has the right to start treatment within 60 days from the date of the report with the diagnosis or a shorter period, depending on the therapeutic need of the case recorded in the medical record. “After this period, i.e. from the 61st day onwards, the patient must go to the Health Department of his municipality of residence and request the start of treatment, guaranteed by Law 12.732/2012. If failure to comply with the Normally, the person with a diagnosis of malignant neoplasm can contact the Judiciary, through the Office of the Public Defender, the OAB, or a trusted lawyer, to perform surgery, radiotherapy or chemotherapy”, concludes Fabricio Posocco, of Posocco & Advogados Associates Office.
To find out more, just visit the website: https://posocco.com.br
Website: https://posocco.com.br/
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Source: Terra
Camila Luna is a writer at Gossipify, where she covers the latest movies and television series. With a passion for all things entertainment, Camila brings her unique perspective to her writing and offers readers an inside look at the industry. Camila is a graduate from the University of California, Los Angeles (UCLA) with a degree in English and is also a avid movie watcher.
