CBHPM

As determined by article 17-A, caput, item II and §§ 2 and 3, of Law 9.656 / 98, amended by Law 13.003 / 14, in turn regulated by the Normative Resolutions of the National Supplementary Health Agency (ANS) numbers 363 , 364 and 365, from the same agency, based on § 4 of RN No. 364 above, the Brazilian College of Radiology and Diagnostic Imaging announces that, as of April 1, 2019, it will use the index defined by ANS, the Index National Consumer Price Index (IPCA), for the adjustment of the reference value of the square meter of the film / documentation of the Radiology and Diagnostic Imaging procedures

The IPCA accumulated in the last 12 (twelve) months, based on February 2019, was 3.8903%. Thus, the new reference value is set at R$ 28.87 per square meter.

São Paulo, April 1, 2019

Dr. Alair Augusto Sarmet Moreira Damas dos Santos

CBR President

The printed version (brochure) of CBHPM 2014 - Brazilian Hierarchical Classification of Medical Procedures, published every two years by the Brazilian Medical Association (AMB), is now available for purchase. New procedures were incorporated and others extinguished, given the dynamics of medical practice. “The work of the National Commission of Medical Fees, the CBHPM Technical Chamber and the Specialty Societies will enable this revised edition to exponentially expand its dissemination and implementation,” said AMB President Dr. Florentino Cardoso and Director of Professional Defense, Dr. Emilio Cezar Zilli, in the preface to the publication.

For Radiology and Diagnostic Imaging, the main news is that the staggered discount rules applied improperly by health insurance companies on imaging exams have been removed. Such rules - expressed in codes 4.08.99.00-4 item 12, 4.09.99.00-9 item 5, 4.10.99.00-1 item 4 and 4.11.99.00-6 item 3 - in previous versions - had been created at the time of design. CBHPM - with the objective of contemplating surgical events in which, from the opening of a single access route, more than one organ was operated, for example, representing a “saving” of time that would justify the payment of lower values for the second one. or third procedure, and so on.

The problem is that, even without adopting CBHPM, many operators have come to point out these staggered discount rules as justification to further reduce the values of imaging exams done on the same patient, in the same care and with the same method. This was done in a leonine way, against the will of doctors and clinics.

In practice, the procedures were being glossed over for several months, and no solution was envisioned. Now, as these rules are no longer part of CBHPM and operators will no longer be able to use this argument, the issue needs to be overcome. “The CBR strongly recommends that, at the moment of updating the contracts between clinics and operators to comply with Law 13.003 / 14, doctors and clinics do not accept the formalization of abusive discounts clauses of this nature. “No discounts should be accepted. It is necessary to contest and block any attempts to include these mechanisms in the new contracts, ”warns the College's economic advisor, Carlos Moura. More information on the practical application of Law 13.003 / 14 here.

The CBR never accepted this practice of discounts. Since the rules were introduced, the College has fought for their exclusion. In the new edition of CBHPM, this historical correction is finally effective. "Classification is a dynamic instrument and the main reference for the market, hence the importance of correcting what has become, in practice, a serious distortion", says the 1st secretary of the Brazilian Medical Association, Dr. Aldemir Humberto Soares, former president of the college.

“We hope that operators, just as they used CBHPM as a source for adopting the fateful staggered discount now that it has been withdrawn, will also exclude it from their systems,” says CBR President Dr. Antonio Carlos Matteoni de Athayde.