December 31st, 2022 was the deadline for health operators with more than 20 thousand beneficiaries to adopt the guidelines of Normative Resolution 518, of April 29th, 2022, from the Brazilian Health Agency (ANS). Since January of this year, all operators are obliged to observe the parameters established in the rule, that is, to implement minimum practices of governance processes, risk management, and internal controls in the operation.

It has also become mandatory to annually send the Previously Agreed Procedures Report (PPA) to the ANS, a publication issued by an independent auditor, which details the adoption of the minimum practices of the previous year. The report will be evaluated to verify compliance with the requirements in the resolution. The PPA report must be sent attached to the Health Plan Operators’ Periodic Information Document (DIOPS) for the 1st quarter of the following year. But it is worth pointing out that sending the PPA is optional for small operators and self-management plans operated by a human resources department.

Updating the rule

RN 518 is an update to 2019’s RN 443, a change that aims to promote market improvement as a whole. The operators themselves, as well as the regulatory agencies, understand that good management will bring benefits to the entire sector, promoting gains in the system’s sustainability. In other words, the change adds the criteria for transparent and effective management, and reinforces the importance of compliance programs. The operators that do not comply with the RN 518 requirements will be subject to sanctions, especially the failure to send the PPA may generate penalties in the terms of RN 489/2022 and questionings by the ANS. The Agency is making available a publication with all the details about RN 518, which can be downloaded by clicking here.