Thursday , December 9 2021

Unimed / BH to return $ 200 million to SUS for misuse of health insurance – Horizontes


The Attorney General (AGU) formalized an agreement with Unimed / BH to end the litigation and ensure the return of approximately R $ 200 million to the Integrated Health System (SUS).

According to the AGU, this amount relates to the misuse of the public system by beneficiaries of the health plan, including kidney transplants, treatments for bacterial diseases and multiple surgeries, in addition to medium and high complexity outpatient visits.

According to the AGU, more than three hundred lawsuits will be resolved through this agreement. The signing of the protocol of intentions for the General Coordinator of Collection and Credit Recovery, Fábio Munhoz, opens a new way of relationship with the regulated sector. “It is a commitment to a more effective legal solution that is compatible with the public interest.”

Moreover, “the inclusion of R $ 200 million in this critical moment of the pandemic we are experiencing is good news and shows that consensual solutions can be effective in recovering public credit,” Munhoz concluded.

Upon signing the memorandum of understanding, the company immediately made an administrative payment of R $ 19,149,353.94 in 12 months.

Reimbursement to the SUS created by Article 32 of Law 9,656 / 1998 and regulated by the ANS rules, is a legal obligation for operators of private health plans to reimburse the expenses of the Integrated Health System if they are its beneficiaries. which are covered by the corresponding plans.

The report contacted Unimed and is awaiting the company’s position.

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