- Início
- Livros E Revistas
- Contratos de Planos de Saúde
- Anexo. Legislações Específicas Sobre Os Planos de Saúde
Resolução Normativa - RN nº 19, de 11 de dezembro de 2002
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 | 344-346 |
Page 344
Dispõe sobre a Revisão Técnica dos planos privados de assistência à saúde e dá outras providências.
A Diretoria Colegiada da Agência Nacional de Saúde Suplementar - ANS, no uso da competência a ela conferida pelo inciso II, do art. 10 e em conformidade com o disposto no inciso XVIII, do art. 4º, ambos da Lei nº 9.961, de 28 de janeiro de 2000, e considerando que a definição de mecanismos para correção de situações de desequilíbrio das carteiras mantidas pelas operadoras de planos privados de assistência à saúde representa um instrumento da mais alta importância para uma efetiva regulação do setor de assistência suplementar à saúde, em reunião realizada em 22 de outubro de 2002, adotou a seguinte Resolução, e eu, Diretor--Presidente, determino a sua publicação.
Art. 1º A Revisão Técnica dos planos privados de assistência à saúde mantidos pelas operadoras definidas no art. 1º, da Lei nº 9.656, de 3 de junho de 1998, que tenham sido contratados até 1º de janeiro de 1999, deverá observar o disposto nesta Resolução.
Parágrafo único. Esta resolução aplica-se aos planos individuais ou familiares e àqueles operados por entidades de autogestão cujo financiamento se dê exclusivamente por recursos de seus beneficiários. (Redação dada pela RN nº 148, de 2007)
Art. 2º Define-se por Revisão Técnica a correção de desequilíbrios constatados nos planos privados de assistência a saúde a que se refere o art. 1º, mediante reposicionamento dos valores das contraprestações pecuniárias, mantidas as condições gerais do contrato.
Parágrafo único. O reposicionamento dos valores das contraprestações pecuniárias deverá considerar os níveis de custo de assistência à saúde observados no contexto nacional, bem como estímulos à eficiência na prestação de serviços.
Art. 3º Para solicitação de Revisão Técnica a operadora deverá, na forma a ser definida por Instrução Normativa:
I - quando o objeto da solicitação se referir à totalidade da carteira dos planos de que trata o art. 1º, comprovar o desequilíbrio entre os compromissos correntes e futuros, vinculados aos serviços de assistência à saúde, e os pagamentos das contraprestações pecuniárias da totalidade da carteira de planos;
II - quando o objeto da solicitação se referir à parte da carteira dos planos de que trata o art. 1º, comprovar o desequilíbrio entre os compromissos correntes e futuros, vinculados aos serviços de assistência à saúde, e os pagamentos das contraprestações pecuniárias dos planos que forem...
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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