Invest in Brazilian healthcare knowing the regulatory and litigation risk before you sign.

We see the risk from the inside

For more than ten years we have defended health plan operators, self-managed plans and providers in Brazil, with more than 12,000 active health lawsuits. That docket tells us which claims operators lose, what injunctions cost and how courts are applying the Supreme Court's rules on coverage outside the ANS list (ADI 7265). We bring that evidence into every due diligence.

Academic grounding in regulation

Our regulatory team holds master's degrees and is pursuing doctoral studies in Regulation Law from FGV Law School (Rio de Janeiro), and our lead partner coordinates FGV's Supplementary Health Committee. We publish peer-reviewed research on ANS rules, financial regulation mechanisms and health data interoperability.

Inside the regulatory process

We prepare technical contributions to ANS public consultations and to the agency's regulatory agenda on behalf of industry stakeholders. Investors get advice from lawyers who follow new rules while they are still being drafted.

• ANS registration, operating authorisation, product registrations and financial guarantee requirements
• History of ANS complaints (NIP), sanctioning proceedings, fines and reimbursements to the public health system (SUS)
• ANS quality index (IDSS) and supervisory measures, including special regimes such as fiscal direction
• Litigation exposure of the portfolio: volume, recurring claims, success rates, injunction costs and adequacy of provisions

Market entry and structuring

• Rules on foreign investment in healthcare services and health plans
• Choice of vehicle and licensing path for a new operator, administrator or provider
• Regulatory requirements for distribution, networks and partnerships with providers

Transactions and regulatory approvals

• Prior ANS approval for transfers of control, portfolio transfers and corporate reorganisations
• Acquisition of portfolios from operators in financial difficulty, including technical review of pricing
• Coordination with competition filings and with deal counsel in Brazil and abroad

Regulatory monitoring and strategy

• Daily regulatory intelligence and analysis of new ANS rules, public consultations and court precedents
• Contributions to public consultations and dialogue with regulators
• Risk scenarios for pending bills and judicial trends affecting the target's business

Post-deal support

• Integration of compliance routines, ANS reporting and complaint handling
• Defence strategy for administrative and judicial claims, including Supreme Court complaints to enforce ADI 7265

One regulator for health plans

Private health plans are governed by Law 9,656/1998 and supervised by the National Supplementary Health Agency (ANS), which licenses operators, approves products, sets solvency rules and sanctions conduct.

Foreign capital is allowed, with political risk

Foreign investment in health plan operators is permitted, and Law 13,097/2015 opened hospitals, clinics and other health services to foreign capital. Bills to restrict it have advanced in congressional committees before, so the topic deserves monitoring.

Changes of control need ANS approval

Transfers of control, portfolio transfers and corporate reorganisations of operators depend on prior ANS approval, in addition to merger control by CADE when thresholds are met.

Coverage is set by the ANS list, under judicial scrutiny

Mandatory coverage follows the ANS List of Procedures and its utilisation guidelines. Since Law 14,454/2022 and the Supreme Court's decision in ADI 7265, courts may order treatments outside the list only when strict technical requirements are met, including a prior opinion from the courts' technical support units (NATJUS).

Prices are partly regulated

The ANS caps annual adjustments for individual plans; group plan adjustments are negotiated but monitored.

Complaints become enforcement

Consumer complaints filed with the ANS (NIP) can lead to sanctioning proceedings and fines, and operators must reimburse the public health system (SUS) when their members use it.

Litigation is a cost line

Health plan litigation is a structural feature of the market. Its volume, the injunctions it generates and the quality of an operator's defence directly affect margins and valuation.