PROVISIONAL MEASURE NO. 2,097-39, OF April 26, 2001

Changes to Law No. 9,656 of June 3, 1998, which provides on private health care plans and gives others providences.

THE PRESIDENT OF THE REPUBLIC, in the use of the assignment that confers it on art. 62 of the Constitution, adopts the following Provisional Measure, with force of law:

Art. 1º The devices listed below in Law No. 9,656 of June 3, 1998, go on to invigorate with the following amendments:

Art. 1º Submit to the provisions of this Act private law legal persons who operate health care plans, without prejudice to compliance with the specific legislation governing their activity, falling ill, for the purposes of applying the standards here established, the following definitions:

I-Private Health Assistance Plan: continued provision of services or coverage of assistive costs at pre- or post-set price, by indefinite deadline, with the purpose of ensuring, without financial limit, health assistance, by the faculty of access and fulfillment by professionals or health services, freely chosen, members or non-accredited network, contracted or referenced, targeting the medical, hospital and dental care, to be paid in full or partially at the expense of the contracted carrier, upon reimbursement and direct payment to the provider, on account and order of the consumer;

II-Plan Operator of Health Assistance: legal person constituted under the modality of civil or commercial, cooperative, or self-management entity, which operates product, service or contract of which it treats the inciso I of this article;

III- Portfolio: the set of contracts for coverage of assistetive costs or health care services in any of the modalities of which they treat inciso I and § 1º of this article, with all the rights and obligations contained therein.

§ 1º It is contingent on the standards and supervision of the National Supplemental Health Agency-ANS any modality of product, service and contract that presents, in addition to the guarantee of financial coverage of medical assistance risks, hospital and dental, other characteristics that differentiate you from uniquely financial activity, such as:

a) expense costing;

b) accredited or refereed network;

c) reimbursement of expenses;

d) regulation mechanisms;

e) any contractual, technical, or operational restriction for the coverage of procedures requested by provider chosen by the consumer; and

f) binding financial coverage to the application of medical concepts or criteria-assistement.

§ 2º Include in the comprehensiveness of this Law the cooperatives that operate the products of which treat inciso I and § 1º of this article, as well as the entities or companies that maintain health care systems, by the modality of self-management or administration.

§ 3º The resident physical or legal persons or overseas domiciliated may constitute or participate in the capital, or the raising of capital, of legal persons of private law constituted under the Brazilian laws to operate private health care plans.

§ 4º It is vetted to the physical people the operation of the products of which they treat inciso I and § 1º of this article. " (NR)

Art. 8º To obtain the operating permit, the carriers of private health care plans must meet the following requirements, regardless of whether others come to be determined by ANS:

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single paragraph. They are waived from the fulfilment of the conditions laid down in the incisies VI and VII of this article, the entities or companies that maintain systems of private assistance to health in the modality of self-management, cited in Paragraph 2º of the art. 1º. " (NR)

Art. 9º After decorations one hundred and twenty days ' duration of this Act, for carriers, and two hundred and forty days for the administrators of health care plans and until they are defined by ANS, the general standards of registration, the companies that operate the products of which they treat inciso I and § 1º of the art. 1º of this Act, and observed what has the art. 19, they will only be able to commercialize these products if:

I-the carriers and administrators are provisionally enrolled in ANS; and

II-the products to be marketed are registered at ANS.

§ 1º The fulfillment of the formalities provided for in this article, in addition to setting infringement, constitutes aggravating in the application of penalties for infringing of the other standards provided for in this Act.

§ 2º The ANS will be able to request information, determine changes and promote the suspension of the whole or part of the conditions of the submitted plans. " (NR)

Art. 10. It is instituted the plan-reference of health care, with medico-hospital assisteous coverage, comprising parts and treatments, carried out exclusively in Brazil, with pattern of infirmary, intensive therapy centre, or similar, when needed the hospital internation, from the diseases listed in the International Statistical Classification of Diseases and Related Health Problems, from the World Health Organization, respected the minimum requirements set out in the art. 12 of this Act, except:

I-clinical or experimental surgical treatment;

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VII-supply of prostheses, ortheses and their accessories not connected to the surgical act;

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§ 1º The constant exceptions of the incisions of this article will be the object of regulation by ANS.

§ 2º The companies marketing products of which they treat inciso I and § 1º of the art. 1º of this Act will necessarily offer as of December 3, 1999, the plan-reference that it treats this article to all its current and future consumers.

§ 3º Excludes from the mandatory referred to in § 2º of this article the entities or companies that maintain health care systems by the self-management modality and the companies that exclusively operate dental plans.

§ 4º The breadth of the covers, inclusive of transplants and of high complexity procedures, will be defined by norms edited by ANS. " (NR)

Art. 11. The exclusion of coverage of preexisting diseases and injuries from the date of contracting of the products of which they treat inciso I and § 1º of the art is vetted. 1º of this Act after twenty-four months of the duration of the rented contractual instrument, by having the respective carrier the burden of proof and demonstration of the prior knowledge of the consumer or beneficiary.

Single paragraph. It is vehementing the suspension of consumer health assistance or beneficiary, holder or dependent, up to the proof that it treats the caputin the form of the regulations to be edited by ANS. " (NR)

Art. 12. The offer, the contracting and the duration of the products of which they treat the inciso I and the § 1º of the art are provided. 1º of this Act, in the segmentations provided for in the incisors I to IV of this article, respected the respective coverage amplitudes set out in the plan-reference of which it treats art. 10, according to the following minimum requirements:

I-.........................................................................

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b) coverage of diagnostic support services, treatments and too many ambulatory procedures, requested by the assistant physician;

II-.......................................................................

a) coverage of hospital internations, vetoed to term limitation, maximum value and quantity, in basic and specialized clinics, recognized by the Federal Council of Medicine, admitting to the exclusion of the obstinate procedures;

b) coverage of hospital internations in intensive care center, or similar, vedated the limitation of time limit, maximum value and quantity, at the discretion of the assistant physician;

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d) supplementary examination coverage indispensable for the control of disease evolution and elucidation diagnostics, supply of medications, anaesthetics, medical gases, transfusions and chemotherapy sessions and radiotherapy, as per prescription assistant physician, performed or delivered during the period of hospital internation;

e) coverage of any and all taxa, including materials used, as well as the removal of the patient, demonstrably necessary, to another hospital establishment, in Brazilian territory, within the limits of geographical inclusiveness provided for in the contract; and

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III-......................................................................

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b) enrollment assured to the newborn, natural or adoptive child of the consumer, as dependant, exempt of the fulfilment of the grace periods, provided that the enrolment occurs within a maximum of thirty days of the birth or adoption;

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V-.......................................................................

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c) maximum period of twenty-four hours for the coverage of the cases of urgency and emergency;

VI-reimbursement, in all kinds of products from which they treat inciso I and § 1º of the art. 1º of this Act, in the limits of contractual obligations, of the expenses incurred by the beneficiary with health assistance, in cases of urgency or emergency, when it is not possible to use the own services, contracted, accredited or referred by the carriers, in accordance with the price ratio of medical and hospital services practiced by the respective product, payable within a maximum of thirty days after the delivery of the appropriate documentation;

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§ 1º After one hundred and twenty days of the term of this Act, the offer of products of which treat inciso I and § 1º of the art. 1º of this Law outside the segmentations of which it treats this article, observed their respective conditions of comprehensiveness and hiring.

§ 2º As of December 3, 1999, of the documentation concerning the contracting of products of that treat the inciso I and the § 1º of the art. 1º of this Act, in the segmentations of which it treats this article, should appear in a separate statement from the consumer, of which he is aware of the existence and availability of the reference plan, and that this has been offered to him. " (NR)

Art. 13. The product contracts of which treat the inciso I and § 1º of the art. 1º of this Act have automatic renewal from the expiry of the initial term of the duration, failing to collect the collection of fees or any other value in the act of renewal.

Single paragraph. The products of which it treats the caput, hired individually, will have minimum duration of one year, being vetted:

I-the recount of caries;

II-the suspension or unilateral termination of the contract, saved by fraud or non-payment of the tuition for a period of more than sixty days, consecutive or otherwise, in the last twelve months of the contract, provided that the consumer is demonstrably notified of up to the fifty day of default; and

III-the suspension or unilateral termination of the contract, in any hypothesis, during the occurrence of internation of the holder. " (NR)

Art. 14. On the grounds of the age of the consumer, or the condition of a disabled person, no one can be barred from participating in private health care plans. " (NR)

Art. 15. The variation in the pecuniary contrcharges set out in the contracts of products of which they treat inciso I and § 1º of the art. 1º of this Act, on the grounds of the age of the consumer, may only occur if they are provided for in the initial contract the age ranges and the percentage of the readjustments incidents in each of them, as per standards dispatched by the ANS, resale the provisions of the art. 35-E.

Single paragraph. It is vented the variation to which you rent the caput for consumers over sixty years of age, who participate in the products of which they treat inciso I and § 1º of the art. 1º, or successors, more than ten years ago. " (NR)

Art. 16. Of the contracts, regulations or general conditions of the products of which they treat the inciso I and the § 1º of the art. 1º of this Act must appear devices that indicate with clarity:

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V-the conditions of loss of the quality of beneficiary;

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VII-the regime, or type of hiring:

a) individual or family;

b) corporate collective; or

c) collective by accession;

VIII-the franchise, financial limits or the percent of co-participation of the consumer or beneficiary, contractually foreseen in the expenses for medical, hospital and dental care;

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X-the geographic area of comprehensiveness;

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XII-registration number at ANS.

§ 1º Every consumer holder of individual or family plan will be compulsorily delivered, when of their enrolment, copy of the contract, the regulation or the general conditions of the products of which they treat inciso I and the § 1º of the art. 1º, in addition to explanatory material that describes, in simple and precise language, all of its characteristics, rights and obligations. " (NR)

Art. 17. The inclusion as contractors, referred to or accredited from the products of which they treat inciso I and § 1º of the art. 1º of this Act, of any hospital entity implies commitment to consumers as to their maintenance over the duration of the contracts.

§ 1º It is provided for the replacement of hospital entity referred to in the caput of this article, provided that by another equivalent and upon communication to consumers and to ANS thirty days in advance, redeeming of this minimum time limit the cases arising from termination for fraud or infringement of health standards and Tax in force.

§ 2º In the hypothesis of the replacement of the hospital establishment referred to in the preceding paragraph occurs by the operator's will during period of consumer internation, the establishment obliges to maintain the internation and the operator, to pay the expenses up to the high hospital, at the medical discretion, in the form of the contract.

§ 3º Exceed from the foregoing in the preceding paragraph the cases of replacement of the hospital establishment by infringement of the health standards in force, during period of internation, when the operator will arm with the liability for the immediate transfer to another equivalent establishment, ensuring continuation of assistance, with no additional burden on the consumer.

§ 4º In case of reshaping the hospital network by reduction, companies should ask the ANS express permission for so much, informing:

I-name of the entity to be excluded;

II-operational capacity to be reduced with the exclusion;

III-impact on the assisted mass, from parameters defined by the ANS, correlating the need for beds and the remaining operational capability; and

IV-justification for the decision, noting the mandatory to maintain coverage with equivalent quality standards and no additional burden to the consumer. " (NR)

Art. 18. The acceptance, on the part of any service provider or health professional, of the condition of contract, accredited or co-operative of a product carrier of which they treat inciso I and § 1º of the art. 1º of this Act, it will entail the following obligations and rights:

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III-the maintenance of relationship of hiring, accreditation or referencing with unlimited number of carriers, being expressly vetted to carriers, independent of their constitutive legal nature, impose exclusivity or constraint contracts on professional activity.

Single paragraph. As of December 3, 1999, service providers or health professionals will not be able to maintain contract, accreditation, or referencing with carriers who do not have records for operation and marketing as scheduled in this Law, under penalty of liability for irregular activity. " (NR)

Art. 19. To apply for the definitive authorization of operation, legal persons who already acted as operators or administrators of the products of which they treat inciso I and § 1º of the art. 1º of this Act, they will have a period of one hundred and eighty days, starting from the publication of the specific regulations by the ANS.

§ 1º Until the registration standards are dispatched, provisional registrations of the companies and the products at ANS, with the purpose of authorizing the marketing or operation of the products to which you rent the caput, as of January 2, 1999.

§ 2º For the provisional registration, the carriers or administrators of the products to which you rent the caput should submit to the ANS the required information and the following documents, regardless of others that come to be required:

I-registration of the company's constitution document;

II-fantasy name;

III-CNPJ;

IV-address;

V-telephone, fax and e-mail; and

VI-leading company leaders and name of the posts that occupy.

§ 3º For provisional registration of the products to be marketed, the following data should be submitted to ANS:

I-social reason of the operator or of the administrator;

II-CNPJ of the operator or the administrator;

III-product name;

IV-segmentation of assistance (outpatient, hospital with obstetrics, hospital without obstetrics, dental and reference);

V-type of hiring (individual/family, business collective and collective by adherence);

VI-geographic scope of coverage;

VII-age and respective tracks prices;

VIII-hospital network of its own by Municipality (for hospital segmentations and reference);

IX-hospital network contracted or refereed by Municipality (for hospital segmentations and referencing); e

X-other documents and information that are requested by ANS.

§ 4º Administrative procedures for provisional registration of the products will be dealt with in specific standard of ANS.

§ 5º Irrespective of the fulfilment, on the part of the operator, of the formalities of the provisional registration, or of the conformity of the texts of the general conditions or contractual instruments, are guaranteed, to all users of products the one renting the caput, hired as of January 2, 1999, all the benefits of access and coverage provided for in this Act and its regulations, for each segmentation set out in the art. 12.

§ 6º The non-compliance of the provisions of this article implies the payment of daily fine in the amount of R$ 10,000.00 (ten thousand reais) applied to the carriers of the products of which they treat the inciso I and § 1º of the art. 1º.

§ 7º Legal persons who are to initiate the marketing operation of private health care plans, as of December 8, 1998, are subject to the records of which it treats § 1º of this article. " (NR)

Art. 20. The product carriers of which treat the inciso I and § 1º of the art. 1º of this Act are obliged to provide, periodically, to the ANS all information and statistics relating to their activities, included those of a cadastral nature, especially those that allow for identification of consumers and their dependent, including their names, inscriptions on the Physical Persons Cadastro of the holders and Municipalities where they reside, for the purposes of the provisions of the art. 32.

§ 1º The agents, specially designated by the ANS, for the exercise of the surveillance activities and on the limits established by the CONSU, have free access to the carriers, and may requisition and seize proceedings, contracts, operating routine manuals and too many documents, relating to the products of which they treat inciso I and § 1º of the art. 1º of this Law.

§ 2º Characterizes as an embarrassment to the audit, subject to the penalties provided for in the law, the imposition of any difficulty in achieving the objectives of the audit, that it treats § 1º of this article. " (NR)

Art. 21. ..............................................................

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II-with company of to participate in the persons referred to in the previous incistion, provided that they are, together or in isolation, considered as controlling the company of the company. " (NR)

Art. 22. ..............................................................

Single paragraph. The independent audit may also be required as to the actuarial calculations, elaborated by the second standards set by the CONSU. " (NR)

Art. 23. The carriers of private health care plans may not file for bankruptcy and are not subject to bankruptcy, but they are-only to the extrajudicial settlement scheme.

§ 1º The carriers will subject to the scheme of judicial settlement when, in the course of the extrajudicial settlement, one of the following hypotheses is verified:

I-the asset of the liquidated mass is not sufficient for the payment of at least half of the credits quirographers; or

II-the realizable asset of the liquidanda mass is not sufficient, even, for the payment of the administrative and operational expenses inherent in the regular processing of the extrajudicial settlement.

§ 2º For the purpose of this Act, it defines itself to be achievable as being all active that can be converted into current currency by compliant payment of the administrative and operational expenses of the liquidated mass.

§ 3º In ascertaining the hypothesis provided for in the inciso II of § 1º of this article, ANS will request the adjudication of the judicial settlement, by staying the extrajudicial settlement suspended until the decision of the judgment.

§ 4º A suspension of the extrajudicial settlement will produce the following effects:

I-the exoneration of the liquidator by the ANS;

II-the assumption, by the ANS, of exclusive competence, in relation to the liquidanda mass, of being the faithful custodian of its assets and documents;

III-the maintenance of the unavailability of the assets of the administrators, managers, advisors and assesters, until further judicial determination; and

IV- avoidance of judgment issuing the first order in relation to the request for conversion of the scheme.

§ 5º The ANS will send the judgment preemptively the rol of the ongoing legal actions whose progress will be suspended until the competent judge name the judicial liquidator. " (NR)

Art. 24. Where detected in the carriers subject to the discipline of this Law insufficiency of the guarantees of the financial balance, economic-financial or administrative abnormalities that put at risk the continuity or quality of the care to health, ANS will be able to determine the divestment of the portfolio, the tax or technical direction regime by not more than one hundred and eighty days, or the extrajudicial settlement, as per the seriousness of the case.

§ 1º The disservice of the determinations of the tax director or technician, and of the liquidator, by leaders, administrators, advisers or employees of the operator of private health assistance plans shall entail the immediate removal of the offender, by decision of the ANS, without an injury to the criminal penalties, secured the right to the adversarial, without this involving the suspensive effect of the administrative decision that determined the removal.

§ 2º TO ANS, ex officio or on the recommendation of the technical or tax director or liquidator, may, in duly motivated administrative act, determine the removal of the directors, administrators, managers and members of the tax board of the operator under direction regime or in liquidation.

§ 3º Within the time assigned to you, the tax director or technician will carry out the analysis of the administrative organization and the economic-financial situation of the operator, as well as the quality of the service to the consumers, and propose to the ANS the appropriate measures.

§ 4º The tax director or technician will be able to propose the transformation of the steering regime into extrajudicial settlement.

§ 5º The ANS will promote, within the maximum of ninety days, the divest-disposal of the carriers ' portfolio of private health care plans, in case they do not take effect of the measures by it determined to remedy the irregularities or in the situations that involve risk to the participating consumers of the wallet. " (NR)

Art. 24-A. The administrators of the operators of private health assistance plans in tax direction regime or extrajudicial settlement, regardless of the legal nature of the carrier, will stay with all their unavailable goods, not by any form, direct or indirect, to alienate or burden them, until ascertaining and final settlement of their responsibilities.

§ 1º The unavailability provided for in this article stems from the act that enact the tax direction or the extrajudicial settlement and reaches out to all those who have been in the exercise of the duties in the twelve months prior to the same act.

§ 2º In the tax direction regime hypothesis, the unavailability of goods referred to in the caput of this article might not reach the assets of the administrators, by express deliberation of the NSA's Colegiated Directorate.

§ 3º A ANS, ex officio or on the recommendation of the chief tax officer or the liquidator, may extend the unavailability provided for in this article:

I-to the assets of managers, advisers and those of all those who have agreed, in the period provided for in § 1º, for the decrement of the tax direction or the settlement extrajudicial;

II-to the purchased goods, to any title, by third parties, in the period provided for in § 1º, of the persons referred to in the previous inciso, provided that it has set up fraud on the transfer.

§ 4º No whether they include in the provisions of this article the goods deemed to be inalienable or impending by the legislation in force.

§ 5º The unavailability also does not reach the subject goods of contract of divestness, of promise of purchase and sale, of assignment or promise of assignment of rights, provided that the respective instruments have been brought to the competent public record, previously at the date of the decrement of the tax direction or the extrajudicial settlement.

§ 6º The administrators of the operators of private health care plan operators respond in solidarity with the obligations by them assumed during their management up to the amount of the damage caused, regardless of the nexus of causality. " (NR)

Art. 24-B. The Collegiate Board will define the assignments and competencies of the technical director, chief tax officer and the portfolio disposal officer, and may extend them, if necessary. " (NR)

Art. 24-C. The credits arising from the provision of private health care services prefer to everyone else, except for those of a Labour and a tax nature. " (NR)

Art. 24-D. It applies to the out-of-court settlement of the carriers of private health care plans, in what couber and not collide with the precepts of this Act, the provisions of the Laws No. 6,024, of March 13, 1974, and 6,435, of July 15, 1977, and in the Decree-Law No. 73, of November 21, 1966, as per the expenditance of ANS. " (NR)

Art. 25. The infractions of the devices of this Law and its regulations, as well as the devices of the contracts firmed up, at any time, between carriers and users of private health care plans, subject the operator of the products they treat the inciso I and the § 1º of the art. 1º of this Act, its trustees, members of administrative, deliberative, advisory, tax advice, and assesment of the following penalties, without prejudice to others set forth in the prevailing legislation:

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IV-temporary inabilitation for exercise of positions in operators of health care plan;

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VI-cancellation of the authorization of operation and disposal of the operator's portfolio. " (NR)

Art. 26. The administrators and members of the administrative, deliberative, advisory, tax and assorted boards of the carriers of which it treats this Law respond in solidarity with the damages caused to third parties, including to shareholders, cotists, cooperates and consumers of private health assistance plans, as the case may be, in consequence of the failure to comply with laws, standards and instructions regarding the operations provided for in the legislation and, in particular, for the lack of constitution and coverage of the mandatory guarantees. " (NR)

Art. 27. The fine of which treats art. 25 shall be fixed and applied by the ANS within its remit, with value not less than R$ 5,000.00 (five thousand reais) and not more than R$ 1,000,000.00 (one million reais) according to the economic size of the operator or service presmaker and the gravity of the infraction, re-salvaged the provisions of § 6º of the art. 19. " (NR)

Art. 29. The infractions will be ascertained upon administrative procedure that is based on the infringement self, the representation or positive denunciation of the irregular facts, with the ANS having about standards for the establishment, resources and their effects, instances and deadlines.

§ 1º The administrative procedure, before applied for the penalty, may, exceptionally, be suspended, by the ANS, if the operator or service presser signs an end of commitment to conduct adjustment, in the face of collegiate board, which will have extrajudicial executive title effectiveness, obliging itself to:

I-cease the practice of activities or acts objects of the apuration; and

II-correct the irregularities, inclusive indemnifying the damages of them arising.

§ 2º The term of conduct adjustment commitment will necessarily contain the following clauses:

I-obligations of the commitment to make the practice cease object of the apuration, within the established period;

II-value of the fine to be imposed in the case of defulfillment, not less than R$ 5,000.00 (five thousand reais) and not more than R$ 1,000,000.00 (one million reais) according to the waybill economic of the carrier or the service-maker.

§ 3º The signing of the term of commitment of adjustment of conduct does not matter confession of the compromisee as to the matter of fact, nor recognition of ilicitude of the conduct in ascertaining.

§ 4º The failure to comply with the expiry of the conduct adjustment commitment, without prejudice to the application of the fine referred to in the inciso II of § 2º, carries the revocation of the suspension of the proceedings.

§ 5º Fulfilled the obligations assumed in the term of commitment to conduct adjustment, will be extinguished the process.

§ 6º Suspend the prescription during the term of the conduct-adjustment commitment term.

§ 7º It will not be able to be signed term of a commitment to conduct adjustment when there has been disfulfillment of another term of commitment of conduct adjustment pursuant to this Act, within the term of two years.

§ 8º The term of commitment to conduct adjustment is to be published in the Official Journal of the Union.

§ 9º The ANS will regulate the application of the provisions of § § 1º to 7º of this article. " (NR)

Art. 30. To the consumer who contributes to products of which they treat the inciso I and § 1º of the art. 1º of this Act, due to employment linkage, in the case of termination or exoneration of the contract of employment without just cause, is ensured the right to maintain its condition of beneficiary, under the same conditions of assistential coverage of which enjoyed when the duration of the employment contract, provided that you assume your full payment.

§ 1º The period of maintenance of the beneficiary condition to which the caput refers will be one-third of the time of stay in the products of which they treat inciso I and § 1º of the art. 1º, or successors, with a guaranteed minimum of six months and a maximum of twenty-four months.

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§ 5º The condition provided in the caput of this article will cease to exist when the admission of the holder-holder in new employment.

§ 6º In the collective plans borne in full by the company, it is not considered a contribution to co-participation of the consumer, unique and exclusively, in procedures, as a factor of moderation, in the use of health care services or hospital. " (NR)

Art. 31. To the retiree who contribute to products of which they treat inciso I and § 1º of the art. 1º of this Act, due to employment linkage, by the minimum ten-year period, is secured the right of maintenance as a beneficiary, under the same conditions of assistive coverage enjoyed when the term of the contract of employment, since that assumes your full payment.

§ 1º To the retiree who contributes to collective health care plans per period lower than that set out in the caput is secured the right of maintenance as a beneficiary, to the reason of one year for each year of contribution, provided that it assumes the full payment of the same.

§ 2º For enjoyment of the right secured in this article, the same conditions as set out in § § 2º, 3º, 4º, 5º and 6º of the previous article. " (NR)

Art. 32. They will be ressarated by the carriers of the products of which they treat inciso I and § 1º of the art. 1º of this Act, in accordance with standards to be defined by ANS, the health care services provided for in the respective contracts, provided to their consumers and their dependents, in public or private institutions, convenienced or contractors, members of the Single Health System-SUS.

§ 1º The revival referred to in the caput will be effected by the carriers to the service-providing entity, when this possesses legal personality own, and to SUS, upon table of procedures to be approved by the ANS.

§ 2º For the effectivation of the mishandling, SUS managers will make available to the carriers the discrimination of the procedures performed for each consumer.

§ 3º The operator will effectuate the ressarcement until the fifteenth day after the submission of the collection by ANS, crediting the corresponding figures to the prescarving entity or the respective health fund, as per the case.

§ 4º The ressaration not effected within the period set out in the preceding paragraph shall be charged with the following accruals:

I-late payment interest counted from the month following that of maturity, to the reason of a per per cent to the month or fraction;

II-fine of mora of ten per cent.

§ 5º The values not collected within the time specified in § 3º shall be enrolled in active debt of the ANS, which shall compete for the judicial collection of the respective credits.

§ 6º The proceeds from the raising of the interest and the fine of mora will be reverted to the National Health Fund.

§ 7º The ANS will set standards applicable to the gloss or impugning process of the forwarded procedures, as provided for in § 2º of this article.

§ 8º The values to be ressarcated will not be lower than those practiced by SUS and nor higher than those practiced by the product carriers of which they treat the inciso I and the § 1º of the art. 1º of this Law. " (NR)

Art. 34. Entities carrying out other activities other than those covered by this Act should, in the form and deadline set by ANS, constitute independent legal persons, with or without profit, specifically to operate private plans of health assistance, in the form of the legislation in force and in particular of this Act and its regulations. " (NR)

Art. 35. The provisions of this Act apply to all contracts concluded from its duration, assured to consumers with previous contracts, as well as those with contracts concluded between September 2, 1998 and 1º January 1999, the possibility to opt for the adaptation to the system provided for in this Act.

§ 1º Without prejudice to the provisions of the art. 35-E, the adaptation of the contracts of which it treats this article, should be formalised in a term of its own, signed by the contractors in accordance with the standards to be defined by the ANS.

§ 2º When the adjustment of contracts includes increase in pecuniary contravement, the composition of the calculation base should be restricted to items corresponding to increased coverage, and will become available for verification by ANS, which could determine its change when the new value does not is properly justified.

§ 3º The adaptation of the contracts does not imply new count of the grace periods and the time limits of acquisition of the benefits provided for in the arts. 30 and 31 of this Act, observed, as to the latter, the coverage limits provided for in the original contract.

§ 4º No contract could be adapted by unilateral decision of the operator company.

§ 5º A maintenance of the original contracts by the non-optant consumers has personalsimo character, and must be guaranteed only to the incumbent and to their already enrolled dependents, permitted inclusion only of new spouse and children, and vetted transfer of the its title, under any pretext, to third parties.

§ 6º The products of which treat the inciso I and § 1º of the art. 1º of this Act, hired until 1º January 1999, is expected to remain in operation, for indefinite time, only for consumers who do not opt to adapt to the new rules, being considered extinct for end to commercialization.

§ 7º The ANS will set out in a standard of its own the formal procedures that should be adopted by the companies for the adaptation of the contracts of which it treats this article. " (NR)

Art. 2º The Law No. 9,656 of June 3, 1998, passes the increased vigour of the following articles:

Art. 35-A. The Supplemental Health Council-CONSU, collegiate body integral to the regimental structure of the Ministry of Health, with competence to:

I-establish and supervise the implementation of general policies and guidelines of the supplementary health sector;

II-approve the ANS management contract;

III-supervise and follow up the actions and operation of the ANS;

IV-set general guidelines for constitution, organization, operation and surveillance of the operating companies of products of which they treat inciso I and § 1º of the art. 1º of this Act, including:

a) content and assistive models;

b) suitability and use of technologies in health;

c) economic aspects-financial;

d) norms of accounting, actuarial and statistics;

and) parameters as to the capital and minimum net worth, as well as to the forms of their underwriting and realization when it comes to anonymous society;

f) criteria for constituting guarantees of maintenance of the economic balance-financial, consistent in goods, furniture or real estate, or special funds or secured insurances;

g) fund creation, guarantee insurance contracting or other instruments that judge appropriate, with the aim of protecting the consumer from private health care plans in the event of insolvency of operating companies;

h) fiscal or technical direction;

i) extrajudicial settlement;

j) financial recovery procedures of the carriers;

l) penalty application standards;

V-deliberation on the creation of technical chambers, of advisory character, so as to subsidize its decisions.

Single paragraph. ANS shall set the standards on the subjects provided for in the inciso IV of this article, and shall appropriate them, if necessary, when there are general guidelines established by the CONSU. " (NR)

Art. 35-B. The CONSU will be integrated by the following Ministers of State:

I-Head of the Civil House of the Presidency of the Republic, as President;

II-of Health;

III-da Fazenda;

IV-of Justice; and

V-of Planning, Budget and Management.

§ 1º The Council will deliberate upon resolutions, by a majority of votes, by having the President the prerogative of deliberating in the cases of urgency and relevant interest, ad referendum of the remaining members.

§ 2º When deliberating ad referendum of the Council, the President will submit the decision to the Colegiate at the first meeting that follows that deliberation.

§ 3º The President of the Council may invite State Ministers, as well as other representatives of public bodies, to participate in the meetings, not being allowed the right to vote.

§ 4º The Council shall meet whenever it is convened by its President.

§ 5º The internal regiment of the CONSU shall be approved by decree of the President of the Republic.

§ 6º The activities of administrative support to the CONSU will be provided by ANS.

§ 7º The President of the ANS will participate, as Secretary, of the meetings of the CONSU. " (NR)

Art. 35-C. It is mandatory to cover the care in the cases:

I-of emergency, as such defined those entailing immediate risk of life or irreparable injury to the patient, characterized in a statement by the attending physician; e

II-of urgency, thus understood those resulting from personal accidents or complications in the gestational process.

Single paragraph. ANS will make publishing regulatory standards for the provisions of this article, observed the terms of adaptation provided for in the art. 35. " (NR)

Art. 35-D. The fines to be applied by the ANS in connection with the supervisory and normative competence set out in this Act and in its regulations will be collected to the account of that Agency, up to the limit of R$ 1,000,000.00 (one million reais) per infraction, re-salvaged the provisions of § 6º of the art. 19 of this Law. " (NR)

Art. 35-E. As of June 5, 1998, it is established for contracts entered into earlier than the effective date of this Act that:

I-any variation in the pecuniary contraption for consumers with more than sixty years of age will be subject to the prior permission of ANS, heard the Ministry of Finance;

II-the allegation of preexisting illness or injury will be subject to the prior regulation of the matter by ANS;

III-is vedated the suspension or unilateral termination of the individual or family contract of products of which they treat the inciso I and § 1º of the art. 1º of this Law on the part of the operator, save the provisions of the inciso II of the single paragraph of the art. 13 of this Act;

IV-is vetted the interruption of hospital internation in clinical, surgical or intensive care centre or similar therapy, save at the discretion of the assistant physician.

§ 1º The contracts prior to the duration of this Act, which establish readjustment by change of age group with initial age in sixty years or more, should be adapted, by October 31, 1999, for repacing of the readjustment clause, observed the following provisions:

I-the repactuation will be guaranteed to consumers that it treats the single paragraph of art. 15, for changes of age ranges occurring after the duration of this Act, and shall be limited to the dilution of the application of the previously scheduled retrofit, in annual partial readjustments, with adoption of fixed percent which, applied each year, allow to reach the full readjustment at the beginning of the last year of the age bracket considered;

II-for application of the dilution formula, consider ten years the age ranges that have been stipulated without higher limit;

III-the new clause, containing the application formula of the readjustment, should be forwarded to consumers, together with the bolt or collection title, with the statement of the originally contracted value, of the repaced value and of the percentage of fixed annual readjustment, clarifying, yet, that your payment will formalize this repactuation;

IV-the original readjustment clause must have been previously submitted to ANS;

V-in the lack of prior approval, the operator, so that it can apply readjustment by age group to consumers with sixty years or more of age and ten years or more of contract, should submit to ANS the contractual conditions accompanied by technical note, for once passed the clause and the percent of readjustment, adopt the dilution provided for in this paragraph.

§ 2º In the individual contracts of products of which they treat inciso I and § 1º of the art. 1º of this Act, regardless of the date of its conclusion, the application of readjustment clause of the pecuniary controvers will depend on prior approval of the ANS.

§ 3º The provisions of the art. 35 of this Act applies without prejudice to the established in this article. " (NR)

Art. 35-F. The assistance to which you rent the art. 1º of this Act comprises all actions necessary for the prevention of disease and the recovery, maintenance and rehabilitation of health, observed the terms of this Act and the contract struck between the parties. " (NR)

Art. 35-G. They apply in a subsidiary to contracts between users and operators of products of which they treat inciso I and § 1º of the art. 1º of this Act the provisions of Law No. 8,078, 1990. " (NR)

Art. 35-H. The expedients that up to this date have been protocolized on SUSEP by the product carriers of which they treat inciso I and § 1º of the art. 1º of this Act and which are forwarded to ANS in consequence of this Act, shall be accompanied by an opinion of that Autarary's conclusive opinion. " (NR)

Art. 35-I. They will respond in a subsidiary to the contractual and legal rights of consumers, service providers and suppliers, in addition to the tax and labor debits, the personal assets of the directors, administrators, managers and members of boards of the operator of private health care plan, regardless of their legal nature. " (NR)

Art. 35-J. The arts. 24-A and 35-I apply, when couber, the willing in the arts. 37 and 38 of Law No. 6,024 of March 13, 1974. " (NR)

Art. 35-L. The technical or tax director or the liquidator is obliged to maintain secrecy regarding the information of the operator to which they have access on the grounds of the exercise of the charge, under penalty of incurring administrative improbity, without prejudice to the civil and criminal responsibilities. " (NR)

Art. 3º The arts. 3º, 5º, 25, 27, 35-A, 35-B, 35-D and 35-E of Law No. 9,656 of June 3, 1998, come into force on June 5, 1998, resguarded to the legal persons of which it treats art. 1º the deadline date of December 31, 1998 for adaptation to what the arts have available. 14, 17, 30 and 31.

Art. 4º The Executive Power will make it published in the Official Journal of the Union, within thirty days, after the conversion of this Provisional Measure into law, consolidated text of Law No. 9,656, of 1998.

Art. 5º The arts. 4º, 20, 21 and 33 of the Law No. 9,961 of January 28, 2000, they go on to invigorate with the following amendments:

Art. 4º ................................................................

................................................................................................

XXXIV-proceed to liquidation extrajudicial and apply for the judicial settlement of the operators of private health care plans;

XXXV-determine or promote the disposal of the portfolio of private health care plans of the carriers;

................................................................................................

XXXIX-celebrate, in the conditions that establish, term of commitment adjustment of conduct, and scrutinize your compliance;

XL-define the assignments and competencies of the technical director, chief tax officer, the liquidator and the responsible for the portfolio disposal.

§ 1º The refusal, omission, falsity or the unwarranted retardation of information or documents requested by ANS constitutes infringement punishable with a daily fine of R$ 5,000.00 (five thousand reais), and may be increased by up to twenty times, if necessary, to ensure its effectiveness in reason of the economic situation of the operator or service provider.

.................................................................................... " (NR)

Art. 20. ..............................................................

................................................................................................

§ 6º The operators of private plans of health care that falls within the self-management segments by department of human resources, philanthropy and dentistry and which plummets, in their own network, more than sixty percent of the assisted-cost pertaining to spending on hospital services regarding your Private Health Care Plans and who pay at least thirty percent of your activity to the Single Health System-SUS, will jus at a thirty percent discount on the amount due, as expenditure to ANS.

§ 7º Operators with number of beneficiaries lower than twenty thousand users will be able to opt for the one-time parcel pick-up in the month of March, making jus at a discount, on the amount due, from five per per cent, as we dispose of ANS.

§ 8º The values set out in Schedule III of this Act are reduced by thirty per cent, in the case of companies with number of beneficiaries lower than twenty thousand users. " (NR)

Art. 21. ..............................................................

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§ 1º The debits concerning the Health Rate Supplementary may be parceled, the judgement of the ANS according to the criteria set out in the tax legislation.

§ 2º In addition to the additions provided for in the incisies I and II of this article, the non-pick-up of the Health Rate Supplementary will imply the loss of the discounts provided for in this Act. " (NR)

Art. 33. ANS will be able to designate server or employee of the Federal Public Administration, direct or indirect, to exercise the charge of tax director, technical director or liquidator of private health care plan operator with equivalent remuneration to that of the office in Executive Management commission, level III, symbol CGE-III. " (NR)

Art. 6º Ficam convalidated the acts practiced on the basis of the Provisional Measure No. 2.097-38, of March 27, 2001.

Art. 7º This Provisional Measure comes into effect on the date of its publication.

Art. 8º Ficam revoked the arts. 2º, 3º, 4º, 5º, 6º and 7º, the inciso VIII of the art. 10, the § 3º of the art. 12, the § 2º of the art. 16, the single paragraph of the art. 27, and the art. 28 of Law No. 9,656, of June 3, 1998.

Brasilia, April 26, 2001; 180º of Independence and 113º of the Republic.

FERNANDO HENRIQUE CARDOSO

Pedro Parente