DPE will investigate failures in health plan assistance

Health

Mothers of children with disabilities and autism spectrum disorder denounce the lack of clinics and specialists

The Consumer Protection Nucleus (Nudecon) of the Public Defender of the State of Amazonas (DPE-AM) instituted a Collective Procedure to investigate a series of irregularities committed by the health plan Hapvida Assistência Médica LTDA against families of children with disabilities and spectrum disorder autistic (ASD).

In early January, at a public hearing, at least 200 mothers denounced difficulties in obtaining specialized services through the health plan, including the absence of enough accredited clinics and professionals to meet the demand, in addition to long waiting times for consultations with specialists such as physiotherapists, speech therapists, nutritionists and the absence of neuropediatricians in the plan’s staff.

The public defender, Christiano Pinheiro, responsible for the procedure, says that the complaints are serious and harm not only the consumer’s right, but the right of access to health for children who are in a vulnerable situation.

“It is worth mentioning that both Law 9.656/98 and the National Supplementary Health Agency ensure the provision of medical consultations in clinics or offices, exams, treatments and other outpatient and hospital procedures. That is, it is the duty of the health plan to provide the service on an ongoing basis in order to guarantee the health care of its clients”, highlighted Pinheiro.

The Collective Procedure against Hapvida was instituted and published in the Electronic Journal of the DPE-AM on January 23rd. Through it, the Ombudsman will investigate complaints filed by mothers of children with ASD and disabilities, as well as request reimbursement of medical expenses.

The DPE-AM will request information from the health plan regarding the complaints and activate the State Public Prosecutor’s Office about the existence of a similar procedure at the Consumer Protection Office. The Procon-AM will also be officiated to take measures.

Complaints

Public defender Christiano Pinheiro stressed that if other people feel aggrieved or are interested in filing individual lawsuits against the health plan for the same problem, they can go directly to Nudecon, at the unit at Avenida André Araújo, 61, Aleixo, on the corner of Avenida Umberto Calderaro.

Denunciations and complaints can also be made to other Consumer Defense bodies such as OAB/Amazonas, Procon and the National Supplementary Health Agency (ANS) on 0800 701 9656 (Dial ANS).

*With advisory information

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