ANS – REFUND TO SUS X HEALTH PLAN OPERATORS

Abstract

This article questions the charging of reimbursement to the SUS by health plan operators, analyzing its origin and the plan's contracting process. It is argued that this charge is unconstitutional, as the 1988 Federal Constitution guarantees citizens the right to use the SUS, regardless of having a health plan. Although the STF ruled on the constitutionality of the charge, this decision compromises fundamental rights and the principle of individual freedom. The research problem lies in the fact that the State would be benefiting from illicit enrichment by charging this reimbursement to the SUS. It aims to demonstrate the existence of health care systems, addressing both the Public Health System – SUS, and the private system, represented by health plan operators, regulated by Law No. 9,656, of June 3, 1998. This involves descriptive, qualitative and quantitative research, using the bibliographic method in the study of constitutional and infra-constitutional legislation on the subject. It is concluded that the question about the constitutionality of charging reimbursement to the SUS is valid, as all arguments used by the Federal Supreme Court can be questioned by appropriate means.