Unimed will reassess cancellation of autistic agreements – 06/28/2023 – Market

Unimed Brasil is committed to reassessing cases of people with autism who had their health plans suspended this year.

The promise was made during a hearing at Alesp (Legislative Assembly of São Paulo), which summoned representatives of Unimed Brasil and CNU (Central Nacional Unimed) for clarification on Tuesday (27).

At the meeting, state deputies pointed out that at least 87 people who need treatment for TEA (Autistic Spectrum Disorder) had their plan suspended via legal entity contracts in recent months, something permitted by law.

“A person with autism who goes a month without treatment regresses the equivalent of a year. Our goal is to find ways to reactivate these plans. As much as the legislation allows the cancellation of contracts of legal entities, many of which are MEIs (micro entrepreneurs individual), it is necessary that the associated units have a humanized look”, said state deputy Rafa Zimbaldi (Cidadania-SP), one of those who convened the session.

At the meeting, company representatives said that, from January to May this year, 2,200 Unimed health plan contracts with companies were canceled by the operator unilaterally. This affected approximately 10,000 users. Currently, the network has more than 2 million customers and 339 associated cooperatives.

Unimed representatives also pledged to participate in a new hearing at Alesp’s Commission for Persons with Disabilities to provide new information about assistance to autistic people.

“Unimed Nacional believes in the importance of dialogue and is committed to accepting the list of 87 people, as the Alesp commission reported having received, and analyzing the cases that are from Unimed Nacional. legal and were not discriminatory”, said the company, in a note to the report.

In recent months, as shown by the Sheethundreds of agreements have been unilaterally canceled by health plan operators, in what has been seen by lawyers and authorities as a possible way to “clean up” the base of the most expensive customers.

In May, the MP-SP (Ministério Público de São Paulo) launched an inquiry to investigate cases of cancellation of plans. Only the office of state deputy Andréa Werner (PSB-SP) received 192 complaints between April and May – about 90% of them involving Unimed Nacional

In second place in number of complaints comes Bradesco Saúde, with 5% of the cases. Other occurrences are divided between four more companies, such as Notre Dame, SulAmérica, Interclínica and São Cristóvão.

Health plans are in crisis. In 2022, the sector registered an operating loss of BRL 11.5 billion, the worst result since the beginning of the historical series, in 2001.

This number refers only to the values ​​obtained with the health services themselves. When considering gains from financial operations, operators had a net profit of R$ 2.5 million. The value represents 0.001% of total revenues, which amounted to R$ 237.6 billion.