634th Ordinary Meeting of the ANS Board of Directors

Decisions and analysis

1) APPROVAL of the draft minutes of the 3rd Extraordinary Meeting of the Board of Directors, of Feb 13, 2026; the 633rd Ordinary Meeting of the Board of Directors, of Feb 23, 2026; and the 4th Extraordinary Meeting of the Board of Directors, of Mar 3, 2026.

The draft minutes of the 3rd Extraordinary Meeting of the Board of Directors, of Feb 13, 2026, the 633rd Ordinary Meeting of the Board of Directors, of Feb 23, 2026, and the 4th Extraordinary Meeting of the Board of Directors, of Mar 3, 2026, were approved.

2) DIFIS ITEM – REPORT on the publication of the Excellence and quarterly IGR Reduction targets for the second evaluation cycle of RN No. 623/2024. Case No. 33910.060457/2025-26.

Within DIFIS, a report was given on the publication of the Excellence and quarterly IGR Reduction targets for the second evaluation cycle of RN No. 623/2024. As stated at the meeting, the evaluation will be made available on the ANS website today or, at the latest, next Monday. In the evaluation period from October to December 2025, the average IGR was 47.97 for medical-hospital OPS and 0.90 for exclusively dental OPS. The excellence target provided for in art. 33, § 1-A, of RN No. 623/2024 was set at 2.4 for medical-hospital OPS and at 0.6 for exclusively dental OPS. It was also noted that this will be the first time ANS publishes the IGR reduction targets provided for in art. 33, § 1-B, of the same regulation.

3) DIDES ITEM – REPORT on the communication of the decision denying the request to withdraw the reconsideration petition filed by companies of the HAPVIDA group. Case No. 33910.008275/2025-44.

A report from DIDES was also presented to the Board on the communication of the decision that denied the request to withdraw the reconsideration petition filed by companies of the Hapvida group. The matter had already been addressed at the 631st DICOL Meeting. In short, the operator sought to withdraw an administrative appeal in which it intended to have the discounts eventually obtained under the Programa Desenrola recognized in its 2024 financial statements. DIDES denied the request on the basis of an opinion from the Legal Counsel’s Office (Procuradoria), which considered it untimely.

4) DIDES ITEM – APPROVAL of (i) the ARR Report, (ii) the Technical Note on AIR Waiver and (iii) the authorization to open a public consultation. Unification and updating of the rules for the execution of contracts between operators and health providers, replacing Normative Resolutions – RN No. 503 and RN No. 512. Case No. 33910.000171/2025-91.

One of the most relevant points of the meeting was the approval of the ARR Report, the Technical Note on AIR Waiver and the authorization to open a public consultation on the unification and updating of the rules applicable to contracts entered into between operators and providers, replacing RN No. 503 and No. 512. The proposal, as presented, seeks to consolidate and update the currently fragmented regulation. Among the changes of greatest practical interest are: (i) the admission of electronic contracts; (ii) the requirement of express provision for the inclusion and exclusion of plans or products; (iii) the possibility of using clinical and non-clinical quality and outcome indicators; (iv) the requirement that amounts be expressed in national currency, even where inputs are purchased in foreign currency; (v) strengthened transparency in price adjustment clauses and the provision of self-composition channels. This is the item with the greatest potential contractual and operational impact for operators and the provider network, which is why the forthcoming public consultation deserves close monitoring.

5) DIFIS ITEM – APPROVAL of the Technical Cooperation Agreement between ANS and the Public Defender’s Office of the State of Alagoas – DP/AL, under the Programa Parceiros da Cidadania. Case No. 33902.096580/2017-74.

Also on the DIFIS agenda, a Technical Cooperation Agreement between ANS and the Public Defender’s Office of the State of Alagoas was approved, under the Programa Parceiros da Cidadania.

6) DIFIS ITEM – APPROVAL of the Technical Cooperation Agreement between ANS and the Public Prosecutor’s Office of the State of Pernambuco – MP/PE, under the Programa Parceiros da Cidadania. Case No. 33902.078630/2017-31.

Along the same lines, a Technical Cooperation Agreement between ANS and the Public Prosecutor’s Office of the State of Pernambuco was approved, also under the Programa Parceiros da Cidadania.

7) DIPRO ITEM – APPROVAL of the proposed Normative Resolution on the technical-care visit, which revokes IN/DIPRO No. 53/2017. Case No. 33910.011545/2023-32.

In the care-related field, a proposed Normative Resolution on the technical-care visit was approved, revoking IN/DIPRO No. 53/2017. The topic is part of the 2023–2025 Regulatory Agenda and had already been submitted to Public Consultation No. 156. Among the points highlighted at the meeting are: (i) the formal replacement of the current normative instruction by an RN; (ii) the extension of the period for notifying the OPS of the technical-care visit, from 10 to 15 days; (iii) and the setting of a 10-day period for the operator to submit the information requested by DIPRO during the visit.

8) OFF-AGENDA DIPRO ITEM – DECISION on the health technologies positively recommended by the National Commission for the Incorporation of Technologies into 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.

Lastly, in an off-agenda item, DICOL decided on health technologies positively recommended by CONITEC for incorporation into SUS, for the purpose of analyzing their possible impact on the List of Health Procedures and Events (Rol). Seven Recommendation Reports were examined. As stated, in the cases of approval or updating of a PCDT, no elements were identified that would change the care coverage currently provided for in the Rol. Regarding RR 1070/2025, 1071/2025 and 1072/2025, it was noted that these concern pneumococcal vaccines, which are not part of the mandatory list because they fall within SUS’s public immunization policy. As for RR 1065/2025, 1080/2025 and 1081/2025, it was recorded that the corresponding procedures are already assured in the Rol, with no additional measure required. In RR 1066, the conclusion was split: in the case of tranexamic acid, as it is a medication for home use with no indication related to oncological treatment, it was understood that no measure needs to be taken, by reason of the statutory exclusion; as for the levonorgestrel-releasing IUD, it was established that, because the indication of use incorporated into SUS differs from that approved in the package insert by ANVISA, any coverage in supplementary health will depend on prior updating of the respective PCDT by the Ministry of Health.