MPF says health plans are required to cover autism treatment

The National Agency for Complementary Health (ANS) Has up to 10 days to notify healthcare plans of the obligation to pay comprehensive treatment for autismas recommended by Federal Public Prosecution Office (MPF) Released this Monday (20/6).

Some plans are beginning to not cover the value of sessions with psychologists, occupational therapists, speech therapists, or physical therapists indicated for patients with autism spectrum disorder (ASD).

Recommendation based on Decision of the Supreme Court of Justice (STJ), which approved the comprehensive list of health procedures for the ANS – In practice, the court ruled, and Health plans do not need to cover medical treatments and services Which is not on the mandatory list of the agency.

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The National Agency for Complementary Health (ANS) is the entity responsible for regulating adjustments implemented by health plan operatorsBrazil Agency

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MPF . Building

Federal Public Prosecution Office (MPF)reproduction

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However, the MPF points out that the STJ decision is not an obligatory precedent. In addition, the decision does not include treatment of people with autism.

The recommendation also highlights that STJ’s decision provides for exceptions from the comprehensive list, “provided that there is evidence of the effectiveness of the indicated treatment and recommendations from technical bodies.”

Prosecutors are complaining about “mass disinformation promoted by the publication of a misinterpretation of the meaning and scope of the trial,” something that must now be rectified by the National Security Agency.

Limiting the number of therapy sessions for people with autism has been discussed in court since 2019, when the first public civil lawsuit was proposed against her. Similar cases were filed in the states of Acre, Alagoas, Bahia, Ceará, Pará, Pernambuco and São Paulo.

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