Children

Mothers of autistic children regret the ANS role decision

The suffocating voice captures the cries of government employee Diane Suarez from Mato Grosso (MT) as she regrets the STJ (Superior Court of Justice) decision that allows health plans to deny coverage of unlisted treatments. The list is called ANS (National Supplementary Health Agency).

Adrian’s mother, 3, who has autism, Dionysus was one of the mothers and fathers of autistic children who followed the trial both inside and outside the courtroom. The night before, he had taken part in a sit-in with other protesters in front of the court headquarters and had hoped for a positive decision by then.

Within 3 to 6 votes, however, the 2nd Division realized that the plans could play a more complete, more limited role. In practice, operators may refuse procedures that are not provided by ANS. Hope has given way to solitude.

“It’s heartbreaking that so many families are crying today, not knowing what tomorrow will bring. The plan is to knock on the door and take care of the house, the baby’s breathing.” UOL.

Sad to say, but it’s death. There are many children who die one day without treatment and those who are not on the ANS list die. ”
Diony Shuja, Adrian’s mother, who has autism

The ruling has been closely followed by civil society, mothers of autistic children and families of people with disabilities, as well as healthcare providers, and was one of STJ’s most stressful cases this semester.

In February, a group of more than a hundred mothers and fathers of children with disabilities chained themselves to a court bar against their role in imposing taxes. Today, a section of the party returned to the area with banners and posters against the role of the taxpayer.

In the afternoon, celebrities like former BBBs Gil do Vigor and Juliette, as well as actress Paolla Oliveira shared the tag #RolTaxativoMata, which has become one of the most talked about topics on Twitter. On Instagram, presenter Marcos Mayon, the father of an autistic child, released a video to rally against the taxing role.

There is a fear among journalist Andrea Werner, founder of the Instituto Lagarta Vira Pupa and one of the organizers of the law, mothers of autistic and disabled children that health plans will immediately start working to reverse decisions that previously favored system coverage. Provided for ANS list.

While it is not binding, that is, it does not oblige other courts to follow the same understanding, STJ’s decision will serve as a reference for lower courts when dealing with similar cases.

This decision will kill people. It will leave disabled, serious illnesses and rare diseases unreasonable And if you make a fuss, the plans will charge people for what they’ve paid so far It’s a huge tragedy that happened in this country today and I hope everyone is well aware of it. “
Andrea Warner, journalist and founder of the Instituto Lagarta Vira Pupa

Following the trial, protesters left the STJ with an atmosphere of insecurity about the next step. The case is likely to be taken to the Federal Supreme Court, if there are any constitutional issues involved. But there is no timeline for when this will happen.

Lawyer Nubia Vieira, who is the mother of an autistic child, said she left the STJ disappointed with the outcome of the trial, as the court was “always sensitive” to the cause.

“Our children are losing the opportunity to be productive and even to survive. There are many children with cerebral palsy who are going to be harmed. They do not have time to wait for the Supreme Court decision or the law to help them. It is desperate,” he said.

Taxes, with exceptions

STJ today decided that the role of ANS is complete, that is, there is no need to pay for health plans for treatments that are not listed by the agency.

The agreement was followed by six ministers: the Reporter, Minister Luis Felipe Salomao, Minister Villas Bose Cueva, Raul Araujo, Marco Buji, Marco Aurelio Belize, and Minister Isabel Galotti.

Cueva voted first in this Wednesday’s session (8) and presented exceptions that could be included in the full list. One example is the possibility of asking for an amendment to a contract agreement to expand patient coverage and to include a specific treatment.

In cases where there is no alternative to the necessary medical procedures for the patient, the Minister decides that the treatment may be exclusively included in the coverage, provided that it has not previously been rejected by the ANS, if there is medical evidence of treatment. And if there are recommendations from national or international technicians.

Cueva justified his vote by saying that the tax list guarantees more legal certainty and avoids major rearrangements, since the loss ratio would be more predictable for operators.

“Establishing a mandatory minimum list provides predictability for calculations that support monthly fees capable of maintaining a medium- and long-term sustainable health plan, as exaggerated price increases will hamper contractual maintenance and even shift the pressure on public health users.” Said.

Operators deny that the changes promoted by STJ will lead to further restrictions on the method and coverage of treatment.

What the operators are saying

In a statement, FenaSaud (National Federation of Supplementary Health), which represents 15 groups of operators, said plans would continue to cover all diseases listed by the World Health Organization’s ICD (International Statistical Classification of Diseases and Related Health Problems). Health (WHO), including the full role.

“Contrary to the publicity claims, in fact, the entire list guarantees access to safe treatment, evaluated and recognized by regulators and agencies responsible for healthcare, which occurs worldwide. “The lawyer, Marcio Vieira Suto Costa, is a partner in Sergio Bermudas’ office, which represents Fenasoud.

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