637th Ordinary Meeting of the ANS Board of Directors

Decisions and analysis

1. APPROVAL of the draft minutes of the 6th Extraordinary Meeting of the Board of Directors, of Apr 17, 2026, and of the 636th Ordinary Meeting of the Board of Directors, of Apr 24, 2026

2. DIDES ITEM – REPORT on the 3rd Call for Proposals of the Comprehensive Health Care Project – Development and Implementation of the Network-Coordinated Care Model (MACOR).

Case No. 33910.014193/2025-39: On Monday, May 18, ANS will publish the call for proposals for the Third Cycle of the Certification of Good Practices in ATS. Unlike the previous Cycles, the Third Cycle does not aim at the formal certification of operators, but at a material improvement of the supplementary health system. In concrete terms, this means that ANS will no longer analyze whether the OPS meet certain operational requirements, but rather the clinical outcomes achieved, in line with the idea of value-based medicine. Finally, in this 3rd Cycle, it is foreseen that the OPS will be assessed jointly with an ATS-based health service from its provider network.

3. PRESI ITEM – CONSIDERATION of Conclusive Report No. 2/2026/COINQ/SECEX/PRESI on the former operator ASSOCIAÇÃO AUXILIADORA DAS CLASSES LABORIOSAS.

Case No. 33910.016100/2024-20: DICOL resolved to forward the extrajudicial liquidation report, which found indications of unlawful conduct by former administrators, to the Bankruptcy Court and to the State Public Prosecutor’s Office, all pursuant to Law No. 6,024/74.

4. PRESI ITEM – CONSIDERATION of Conclusive Report No. 3/2026/COINQ/SECEX/PRESI on the former operator ASSOCIAÇÃO DE SAÚDE DOS POLICIAIS E BOMBEIROS MILITARES DO ESPÍRITO SANTO – ASPBMES.

Case No. 33910.023676/2023-62: DICOL resolved to forward the extrajudicial liquidation report, which found indications of unlawful conduct by former administrators, to the Bankruptcy Court and to the State Public Prosecutor’s Office, all pursuant to Law No. 6,024/74.

5. DIPRO ITEM – APPROVAL of the proposal for the temporary suspension of the processing of the Care Risk Mapping due to its methodological restructuring. Case No. 33910.011437/2026-11.

At the 9th Extraordinary Meeting of DICOL, held in July 2025, the discontinuation of the Product Information System – SIP as of March 2026 was decided. From then on, the Care Risk Mapping would be fed by data obtained from the TISS Standard. However, in order to promote the transition between the SIP and the TISS, DICOL resolved at this 637th Ordinary Meeting to temporarily suspend the processing of the Mapping for the period necessary for the transition of the systems.

6. DIPRO ITEM – APPROVAL of the Regulatory Outcome Analysis – ARR concerning Normative Resolution – RN No. 438/2018 and of the authorization to hold a Public Hearing. Case No. 33902.461712/2016-62.

The ARR conducted by DIPRO found repeated noncompliance with RN No. 438/2018 by the OPS. To address this problem, the ARR lists a series of possible measures, such as: a. creation of mandatory digital channels by the OPS; b. creation of an exclusive website to deal with portability by large OPS; c. obligation for the OPS to inform ANS whether or not portability was carried out; d. permission for the legal entity contracting a corporate plan with fewer than 30 lives to carry out the portability of the beneficiaries; e. permission for the policyholder and dependents to carry out joint portability; f. waiver of the obligation to provide the Plan Guide report when there is no price compatibility requirement; g. inclusion in the portability rule of the rules of normative súmula 21, which deals with changing plans within the same operator with the possibility of an upgrade; and h. reassessment of the sanctioning mechanisms, with the collaboration of DIFIS.

The indication of proposals in the body of the ARR caused surprise among the directors of DIGES, DIFIS and DIOPE, which led the director of DIPRO to clarify that any change to the portability rules will be preceded by a Regulatory Impact Assessment. These questions may have been raised because of the controversy surrounding CP 170, whose comment period would end tomorrow (see item 15 below), in which ANS waived the AIR and proposed changes to the rules governing the relationship between OPS and providers based solely on an ARR. In the end, DICOL only: (i) decided on the ARR and (ii) authorized the holding of a public consultation.

7. DIGES ITEM – APPROVAL of the proposed Administrative Resolution governing the Special Accounts Audit (Tomada de Contas Especial) – in response to ANS’s Internal Audit. Case No. 33910.040748/2023-36.

The Special Accounts Audit is an administrative proceeding to determine liability for damages caused to the Administration by its employees. The proposed change stems from an amendment to TCU Normative Instruction No. 98. The amendment is therefore interna corporis in nature and has no repercussions on the regulation of the sector.

8. DIGES ITEM – APPROVAL of the proposed Internal Rules Resolution amending RR No. 21/2022 and its annexes, in accordance with Decree No. 12,934/2026. Case No. 33910.048330/2025-39.

As a result of the issuance of Decree No. 12,943/2026, the draft of which was considered at the 15th Extraordinary Meeting of DICOL on Dec 19, 2025, the new wording of ANS’s Internal Rules was approved, to enter into force on Jun 15, 2026.

9. DIFIS ITEM – APPROVAL of the proposal for a declaration of compliance with Conduct Adjustment Commitment Agreement – TCAC No. 1/2024 by the company PRESERVE SAÚDE ASSISTÊNCIA MÉDICA LTDA, ANS registration No. 42.295-9. Case No. 33910.035871/2023-35.

The technical area attests to compliance with TCAC No. 1/2024, with the termination of the respective sanctioning proceedings.

10. DIFIS ITEM – APPROVAL of the proposal to enter into a Conduct Adjustment Commitment Agreement – TCAC between ANS and ASSOCIAÇÃO COMERCIAL E EMPRESARIAL DO ESPÍRITO SANTO – ACEES, not registered with ANS, registered under CNPJ No. 03.077.236/0001-14. Case No. 33910.029234/2025-91.

DICOL approved the execution of the TCAC, under the terms proposed by the technical area.

11. DIFIS ITEM – APPROVAL of the proposal to enter into a Conduct Adjustment Commitment Agreement (TCAC) between ANS and ASSOCIAÇÃO DAS EMPRESAS E FUNCIONÁRIOS DO COMÉRCIO DE BENS E SERVIÇOS NO ESTADO DO ESPÍRITO SANTO – ACS/ES, not registered with ANS, registered under CNPJ No. 14.145.515/0001-94. Case No. 33910.029011/2025-24.

DICOL approved the execution of the TCAC, under the terms proposed by the technical area.

12. OFF-AGENDA DIPRO ITEM – DECISION on the administrative appeal filed by EDWARDS LIFESCIENCES COMÉRCIO DE PRODUTOS MÉDICO-CIRÚRGICOS LTDA regarding the non-incorporation into the List of Health Procedures and Events (Rol) – UAT No. 160. Case No. 33910.030610/2025-91.

DICOL upheld the decision issued at the 14th Extraordinary Meeting and dismissed the appeal filed against the decision not to incorporate the technology into the List of Health Procedures and Events (Rol).

13. OFF-AGENDA DIPRO ITEM – DECISION on a health technology positively recommended by the National Commission for the Incorporation of Technologies in the Unified Health System – CONITEC, for incorporation into the Unified Health System – SUS. Technology for incorporation into the List of Health Procedures and Events (Rol). Case No. 33910.000122/2026-30.

DICOL resolved not to incorporate the technologies covered by RR 1089/26 and 1087/26; and, with respect to RR 1083/26, to update DUT No. 124, in order to remove the seasonality rule for premature babies with a gestational age of less than 37 weeks.

14. OFF-AGENDA DIPRO ITEM – DECISION on the proposal to update the List of Health Procedures and Events (Rol). Outcome of the Public Consultation. Consideration of the Final Recommendation Technical Note – NTRF concerning UAT No. 193. Case No. 33910.003276/2026-83.

After negotiating a purchase discount for the drug with the manufacturer, ANS changed its preliminary recommendation of non-incorporation and ordered the inclusion of Olaparib, UAT 193, in the List of Health Procedures and Events (Rol).

15. OFF-AGENDA DIDES ITEM – APPROVAL of the extension of the deadline of Public Consultation No. 170, which addresses the proposal for a new RN on Contracting between private health care plan operators and health care service providers. Case No. 33910.000171/2025-91.

DICOL accepted the proposal put forward by the technical area of DIDES and extended the CP 170 deadline by 45 days.

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