- Início
- Livros E Revistas
- Contratos de Planos de Saúde
- Anexo. Legislações Específicas Sobre Os Planos de Saúde
Resolução de Diretoria Colegiada - RDC nº 39, de 27 de outubro de 2000
Autor | Josiane Araújo Gomes |
Ocupação do Autor | Mestra em Direito Público pela Universidade Federal de Uberlândia (UFU). Especialista em Direito das Famílias pela Universidade Federal de Uberlândia (UFU). Servidora do Tribunal de Justiça do Estado de Minas Gerais (TJMG) |
Páginas | 340-343 |
Page 340
Dispõe sobre a definição, a segmentação e a classificação das Operadoras de Planos de Assistência à Saúde.
A Diretoria Colegiada da Agência Nacional de Saúde Suplementar - ANS, no uso das atribuições que lhe confere o inciso X do art. 4º da Lei nº 9.961, de 28 de janeiro de 2000, em reunião realizada em 19 de outubro de 2000 e considerando o disposto no inciso VI do art. 8º da Lei nº 9.656, de 03 de junho de 1998, adotou a seguinte Resolução de Diretoria Colegiada e eu, Diretor-Presidente determino a sua publicação:
CAPÍTULO I
DA DEFINIÇÃO
Art. 1º Definem-se como Operadoras de Planos de Assistência à Saúde as empresas e entidades que operam, no mercado de saúde suplementar, planos de assistência à saúde, conforme disposto na Lei nº 9.656, de 1998.
Parágrafo único. Para efeito desta Resolução, define-se operar como sendo as atividades de administração, comercialização ou disponibilização dos planos de que trata o caput deste artigo.
Art. 2º Para fins desta Resolução, define-se como rede própria:
I hospitalar: todo e qualquer recurso físico hospitalar de propriedade:
-
da operadora;
-
de entidade ou empresa controlada pela operadora;
-
de entidade ou empresa controladora da operadora;
II médica ou odontológica: a constituída por profissional assalariado ou cooperado da operadora.
CAPÍTULO II
DOS TIPOS DE ATENÇÃO
Art. 3º Os tipos de atenção prestados pelas Operadoras de Planos de Assistência à Saúde, dividem-se em:
I médico-hospitalar: os oferecidos por entidades ou empresas que operam planos médico-hospitalares ou médico-hospitalares e odontológicos, podendo oferecer, adicionalmente, prestação de serviços médico-hospitalares ou odontológicos a terceiros não contratantes do plano; ou
II odontológico: os oferecidos por entidades ou empresas que operam exclusivamente planos odontológicos, podendo oferecer, adicionalmente, prestação de serviços odontológicos a terceiros não contratantes do plano.
Parágrafo único. Não se aplica a disciplina deste artigo às autogestões e às administradoras.
Page 341
CAPÍTULO III
DA SEGMENTAÇÃO
Art. 4º As Operadoras de Planos que, na forma do artigo anterior, atuam no tipo de atenção médico-hospitalar segmentam-se em:
I segmento primário principal - SPP: as que despendem, em sua rede própria, mais de 60% (sessenta por cento) do custo assistencial relativo aos gastos em serviços hospitalares referentes a seus Planos Privados de Assistência à Saúde;
II segmento primário principal / SUS SPP/SUS: as que...
Para continuar a ler
PEÇA SUA AVALIAÇÃO- Contratos de Planos de Saúde
- Anexo. Legislações específicas sobre os Planos de Saúde
- Lei nº 9.656, de 3 de junho de 1998
- Resolução do Conselho de Saúde Suplementar - CONSU nº 06 de 3 de novembro de 1998
- Resolução do Conselho de Saúde Suplementar - CONSU nº 13 de 3 de novembro de 1998
- Resolução de Diretoria Colegiada - RDC nº 39, de 27 de outubro de 2000
- Resolução Normativa - RN nº 19, de 11 de dezembro de 2002
- Resolução Normativa - RN nº 63 de, 22 de dezembro de 2003
- Resolução Normativa - RN nº 124, de 30 de março de 2006
- Resolução Normativa - RN nº 162, de 17 de outubro de 2007
- Resolução Normativa - RN nº 171, de 29 de abril de 2008
- Resolução Normativa - RN nº 172, de 8 de julho de 2008
- Resolução Normativa - RN nº 186, de 14 de janeiro de 2009
- Resolução Normativa - RN nº 195, de 14 de julho de 2009
- Resolução Normativa - RN nº 196, de 14 de julho de 2009
- Resolução Normativa - RN nº 363, de 11 de dezembro de 2014
- Resolução Normativa - RN nº 387, de 28 de outubro de 2015
- Referências
- Índice Alfab ético Remissivo
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