Profissão

26 de outubro de 2012

Prazo para planos de saúde reajustarem os contratos

No dia 17 de novembro se encerrará o prazo concedido às operadoras de planos de saúde para a adequação dos contratos firmados com os prestadores de serviços, a fim de que tais contratos prevejam forma de reajuste dos valores pagos.


OFÍCIO-CIRCULAR/CREFITO-4/Nº 002/2012

No dia 17 de novembro se encerrará o prazo concedido às operadoras de planos de saúde para a adequação dos contratos firmados com os prestadores de serviços, a fim de que tais contratos prevejam forma de reajuste dos valores pagos.

Esse prazo foi concedido pela IN n.º 49, de 17 de maio de 2012, do Diretor responsável pela Diretoria de Desenvolvimento Setorial da Agência Nacional de Saúde Suplementar - DIDES/ANS (Disponível em: http://www.crefito4.org/maisinfo.php?sec=cnj&id=145), que assim prevê:

“Art. 3º A forma e a periodicidade do reajuste devem ser expressas no instrumento jurídico de modo claro, objetivo e de fácil compreensão”.

Art. 4º As partes deverão escolher uma das seguintes formas de reajuste:
I - índice vigente e de conhecimento público;
II - percentual prefixado;
III - variação pecuniária positiva;
IV - fórmula de cálculo do reajuste.
Parágrafo único. Será admitida a previsão de livre negociação no instrumento jurídico, desde que fique estabelecido que em não havendo acordo até o termo final para a efetivação do reajuste, aplicar-se-á automaticamente uma das formas listadas nos incisos de I a IV deste artigo, que deverá ser expressamente estabelecida no mesmo instrumento.

Art. 5º É vedada cláusula de reajuste baseada em:
I - formas de reajuste condicionadas à sinistralidade da operadora;
II - fórmula de cálculo do reajuste ou percentual prefixado que o valor do serviço contratado seja mantido ou reduzido”.

Por conta dessa exigência da ANS, boa parte das operadoras de planos de saúde precisará adequar seus contratos, haja vista a ausência de previsão de reajuste naqueles instrumentos.

Os profissionais devem atentar para essa ocasião e verificar com a máxima atenção se a forma de reajuste que lhe está sendo oferecida é a mais adequada para a sua necessidade/realidade. A ANS não determina o indicador a ser utilizado, apenas a necessidade de que seja evidenciado no contrato, qual será utilizado.

Estamos diante de uma situação ímpar, a partir da qual podem ser exigidas alterações nos contratos com as operadoras, e neste momento, os profissionais devem estar unidos para negociar com as operadoras.

A ANS chancelou em maio deste ano, a pedido do Sistema COFFITO/CREFITOs, modelos de contratos para prestação de serviços de fisioterapia e de terapia ocupacional e, estes estão no site do CREFITO-4, dentro do link pareceres (Disponíveis em: http://www.crefito4.org/maisinfo.php?sec=par&id=146 e http://www.crefito4.org/maisinfo.php?sec=par&id=147).

No último dia 19 de outubro, com a publicação do Padrão TISS - Versão 3.0 (Disponível em: www.ans.gov.br), após grande pleito e trabalho do Sistema COFFITO/CREFITOs, as nomenclaturas de Fisioterapia e Terapia Ocupacional foram incluídas na TUSS, contemplando todos os capítulos do Referencial Nacional de Honorários de Fisioterapia e do Referencial Nacional de Honorários de Terapia Ocupacional, não restando agora, dúvidas de que tais referenciais não só podem, como devem ter seu cumprimento exigido às operadoras de planos de saúde, pelos profissionais e prestadores.

Maiores esclarecimentos podem ser encontrados no site do CREFITO-4 (www.crefito4.org).

CONSELHO REGIONAL DE FISIOTERAPIA E TERAPIA OCUPACIONAL DO ESTADO DE MINAS GERAIS ? 4ª REGIÃO



Comentários ()

05 de outubro de 2017 às 20:51

polo ralph lauren disse:

Thank you a lot for providing individuals with remarkably nice chance to read in detail from here. It can be very enjoyable plus jam-packed with amusement for me personally and my office co-workers to visit your blog at minimum thrice weekly to read through the newest secrets you have got. Of course, I'm so always motivated considering the impressive things you serve. Some 4 areas in this article are particularly the most beneficial I have had.
05 de outubro de 2017 às 06:19

new england patriots jerseys disse:

I and also my guys appeared to be following the nice procedures located on your web page and then all of the sudden got an awful suspicion I never thanked you for those secrets. These people are actually for this reason passionate to read them and already have honestly been having fun with these things. Thank you for genuinely indeed kind as well as for making a decision on these kinds of remarkable subject matter most people are really eager to know about. My very own honest regret for not expressing appreciation to sooner.
04 de outubro de 2017 às 15:53

coach outlet disse:

I am only writing to make you know of the extraordinary discovery my child developed studying the blog. She figured out a good number of issues, with the inclusion of what it is like to have a great coaching spirit to let men and women completely grasp specified specialized subject areas. You actually surpassed her expectations. Thank you for distributing these helpful, healthy, informative and also unique tips about that topic to Tanya.
03 de outubro de 2017 às 23:39

polo ralph lauren disse:

I definitely wanted to develop a brief remark to be able to appreciate you for those wonderful advice you are placing on this site. My time intensive internet research has at the end of the day been paid with reputable tips to exchange with my colleagues. I would state that that many of us readers are really fortunate to exist in a great website with very many awesome professionals with insightful techniques. I feel pretty privileged to have come across your weblog and look forward to plenty of more exciting minutes reading here. Thanks once again for a lot of things.
03 de outubro de 2017 às 09:27

cleveland browns jerseys disse:

I want to show some thanks to you just for rescuing me from such a problem. As a result of researching through the search engines and meeting things that were not pleasant, I thought my entire life was gone. Existing without the solutions to the problems you have resolved through this guide is a critical case, and the ones which could have negatively damaged my entire career if I hadn't encountered your website. That understanding and kindness in maneuvering a lot of things was vital. I am not sure what I would've done if I hadn't come across such a stuff like this. I'm able to at this moment look ahead to my future. Thanks for your time so much for this skilled and result oriented guide. I will not think twice to recommend the blog to any person who would like care about this subject.
02 de outubro de 2017 às 19:05

canada goose sale disse:

I together with my pals were found to be going through the excellent guides found on your website and then quickly came up with an awful suspicion I had not thanked the web site owner for those secrets. The boys were definitely as a consequence excited to study them and have now truly been loving these things. Many thanks for simply being quite accommodating and then for opting for these kinds of decent subject matter most people are really needing to discover. Our own sincere apologies for not expressing gratitude to you earlier.
02 de outubro de 2017 às 02:04

san francisco 49ers jerseys disse:

I have to voice my admiration for your kind-heartedness in support of people who absolutely need assistance with this important idea. Your personal commitment to passing the solution all over was certainly informative and have in most cases encouraged people like me to achieve their aims. Your entire useful tips and hints entails a lot a person like me and further more to my office workers. Thanks a lot; from all of us.
01 de outubro de 2017 às 14:00

skechers outlet disse:

My wife and i felt quite happy that Raymond could round up his analysis from your precious recommendations he acquired through your blog. It is now and again perplexing to just find yourself freely giving ideas which often other people might have been selling. So we figure out we now have the website owner to appreciate for this. The illustrations you made, the simple website menu, the friendships you can make it possible to foster - it's got everything great, and it's leading our son and us believe that the idea is cool, which is rather mandatory. Thank you for the whole lot!
01 de outubro de 2017 às 00:07

oklahoma city thunder disse:

I wish to point out my gratitude for your kind-heartedness giving support to men and women who require guidance on in this study. Your real dedication to getting the message all through came to be extraordinarily advantageous and has enabled men and women just like me to realize their dreams. Your new useful key points signifies a whole lot to me and a whole lot more to my colleagues. Thanks a lot; from everyone of us.
29 de setembro de 2017 às 22:20

michael kors handbags disse:

I truly wanted to post a small remark to thank you for these stunning techniques you are showing here. My time intensive internet investigation has finally been rewarded with useful facts and techniques to talk about with my great friends. I would admit that most of us website visitors are extremely blessed to dwell in a perfect site with very many brilliant individuals with great hints. I feel somewhat blessed to have come across your entire website and look forward to so many more amazing moments reading here. Thank you once again for all the details.
29 de setembro de 2017 às 10:42

packers jerseys disse:

I definitely wanted to compose a brief comment to say thanks to you for those superb strategies you are posting on this website. My extensive internet search has at the end been compensated with reasonable ideas to go over with my family and friends. I would believe that many of us visitors actually are unequivocally fortunate to exist in a good network with very many awesome individuals with very beneficial suggestions. I feel extremely fortunate to have discovered your web pages and look forward to really more awesome minutes reading here. Thank you again for everything.
21 de setembro de 2017 às 23:17

longchamp outlet disse:

I intended to write you that very little word to say thanks as before for all the precious pointers you have discussed here. It is really incredibly open-handed of you to deliver unhampered all most people might have marketed as an electronic book to generate some dough on their own, principally now that you might have tried it in the event you decided. The ideas likewise served to be a great way to fully grasp the rest have a similar keenness just as my own to see a little more with regards to this issue. I believe there are some more enjoyable opportunities up front for people who examine your blog.
30 de dezembro de 2016 às 02:38

pSiccHWQKF disse:

Emily iubita, ma bucur ca ti-au atras atentia colaceii facuti de mie.le.Formn.e sant facute de mine, sant din materiale reciclabile si totul despre ele. gasesti chiar in introducerea retetei.pupici
27 de maio de 2013 às 18:58

fabiana disse:

EU GOSTARIA DE SABER O QUE ACONTECE COM UMA OPERADORE DE SAUDE QUE NAO REPASSA AUMENTO NENHUM A SEUS PRESTADORES A MAIS DE DEZ ANOS? tEM ALGUMA FISCALIZACAO ? ELES PODEM SER EXIGIDOS A FAZER ESTES REAJUSTES ASSIM COMO A DE UM FUNCIONÁRIO QUE TEM SEUS DIREITOS DE TRABALHADOR , REAJUSTES ETC ..E NÓS COMO FICAMOS NESTA SITUACAO?
04 de maio de 2013 às 20:05

Jonathan Ferreira Araújo disse:

Boa noite!

Isso vale para o crefito 6, região do ceara....


Deixe seu comentário

Seu Nome:

Seu Email:




Leia mais

Aplicativo Android para fisioterapeutas



Dilma sanciona lei que altera o Simples Nacional

Sistema COFFITO-CREFITOs comemora mais uma conquista para a Fisioterapia e a Terapia Ocupacional

Fisioterapia é eficiente: saiba como identificar se está sendo bem feita

Descubra quando não está recebendo um tratamento fisioterapêutico adequado e assim reivindique todo o seu direito de ser bem atendido



a Fisioterapeuta .com
Tendências da profissão de Fisioterapia. Debates e comentários sobre teorias, salários, especializações, vagas, empregos, concursos e muito mais
Projetado por Ronnan del Rey