Autism is included in the list
On June 23, the Collegiate Board of Directors of the National Supplementary Health Agency (ANS) approved a normative that guarantees the expansion of the rules for health insurance coverage for patients with Global Developmental Disorders (GDD) (ICD F84), among which is the Autism Spectrum Disorder (ASD).
The measure went into effect on July 1, making coverage mandatory for any method or technique indicated by the attending physician for treating the patient affected by one of the developmental disorders.
“§ 4 For the coverage of procedures involving the treatment/management of beneficiaries with global development disorders, including autism spectrum disorder, the operator must offer care by a provider able to perform the method or technique indicated by the attending physician to treat the patient’s disease or condition.”
Global Developmental Disorders refer to a group of disorders characterized by delays in the development of socialization and communication skills. Parents may notice the symptoms as early as infancy, although the common age of onset is before age 3.
According to data from the Center of Diseases Control and Prevention (CDC), it is estimated that up to 2% of the world population has autism; in Brazil, the number of people affected reaches 2 million.
According to Paulo Rebello, president-director of ANS (…) “the technical discussions about therapies for treating the Autism Spectrum Disorder were already happening internally, in a Working Group created in 2021 and formed by representatives from four of the five directorates of the Agency.”
Besides the expansion of coverage, the new normative also adjusted annex II of the list so that the unlimited sessions with speech therapists, psychologists, occupational therapists, and physical therapists encompass all global development disorders.
It is worth noting that the abovementioned working group will continue to monitor and evaluate the question in order to propose improvements in the coverage of health plans.
More details can be found in the video of the 14th ANS Collegiate Board of Directors Meeting, in Technical Note No. 1 and in the Explanatory Memorandum.
Here at Pryor Global, we offer our clients the best products in the corporate benefits and insurance market. We are always aware of the changes in legislation, ensuring solutions of excellence and a unique portfolio.