São Paulo micro-entrepreneur Maria de Fátima da Silva, 50, is relieved. A customer of the health plan operator Amil, she learned from the report on Sheet of the decision of the ANS (National Supplementary Health Agency), released on Friday (29), which prohibited the company from selling its portfolio of individual and family plans to APS.
The sale of the portfolio to APS (of the UnitedHealth group itself, which owns Amil) had been carried out in December and, subsequently, a newly created investment fund, Fiord Capital, became the owner of APS in the business, which involves 330 thousand plans in the states of São Paulo, Rio and Paraná. Shortly before the announcement, customers were already observing changes, for the worse, in the accredited network, which even led to an increase in the number of complaints at the ANS.
In the assessment of the agency, the new managers are not able to “continue the health care of consumers” and the portfolio should stay with Amil.
“I thought it was excellent, I hope that Amil goes back to the way it was before”, says Maria de Fátima, who was uncomfortable with the recent change in the network of accredited laboratories promoted by Amil. She is being treated by an endocrinologist and gynecologist and has always had tests done at the Lavoisier laboratory, which has more than ten units in the west of São Paulo alone, the region where she works.
“But Amil removed Lavoisier from the accredited network and, in his place, put in a small laboratory, Carezzato, which has only one unit in the entire West Zone and only performs exams on Mondays. It’s a big difference compared to Lavoisier. “
Also micro-entrepreneur Carlos Alberto Lopes Gonçalves, 60, felt more confident when he learned that the ANS barred the sale of Amil’s portfolio.
“It’s spectacular, perfect news,” says he, who has to undergo hiatal hernia surgery and was distressed by recent changes to the accredited network.
With the announcement of the change in control of Amil, he even researched other options for family health plans, without success. “I can get a similar price for myself, but not for my 82-year-old mother, who has high blood pressure and diabetes,” he says.
Business administrator Benjamin Wainberg, 68, says he is relieved but fearful. For him, the determination of the ANS temporarily resolves the case. “It’s like morphine at the time of pain, you get relief, but you’re not cured yet,” says he, who is due to undergo surgery soon and will begin a series of preoperative tests.
“There are speculations that UnitedHealth wants to leave Brazil, so maybe the sale of Amil as a whole is a matter of time”, he says.
Amil would pay BRL 2.3 billion to get rid of loss-making plans
In a statement released on Friday (29), ANS declared the share purchase agreement between Amil and Fiord Capital, Seferin & Coelho and Henning Von Koss to be null and void. The agreement provided for an investment of R$ 2.34 billion by Amil in APS – both belong to the American UnitedHealth. That is, because it is a loss-making portfolio, which does not make a profit, Amil would pay to pass the business forward.
In January, a change in control of APS was announced, transferred to a group of three partners: Fiord Capital, an investment manager created in November by businessman Nikola Lukic; Seferin & Coelho, a company from Rio Grande do Sul with businesses in telemedicine, a nursing home and owner of the Life Plus hospital network; and Henning von Koss, a former executive of companies in the sector, such as Amil and Hapvida.
In February, the ANS barred this operation, due to the “absence of information about the alleged acquisition of corporate control of APS by a financial restructuring company”. The agency requested documents from the new owners of APS, which were only delivered in mid-March.
In early April, the ANS determined the suspension of the sale of the portfolio of individual and family customers, as it found that “buyers of APS shares do not have sufficient financial capacity to guarantee the economic-financial balance of APS”.
Amil and APS had ten days to manifest. The ANS, then, at the meeting of the collegiate board on Friday, decided to definitively annul the authorization for the transfer of portfolio.
In a note to the report, Amil stated that, “despite differing from the technical arguments that supported the ANS decision”, the company will accept the agency’s decision.
“Amil’s priority continues to be ensuring that its beneficiaries have full access to the healthcare they need,” he said.
Amil and APS must now, within five working days from the 29th, proceed with the annulment of the “contract for partial assignment of portfolio and other covenants”, registered between them on December 27, 2021, says a statement from the agency.
“The action taken on this day shows that the ANS remains attentive to its role as a regulator of the supplementary health sector, ensuring the balance of the relationship between operator and consumer”, said the agency’s president, Paulo Rebello, in a video released by his advisory press.
The executive seeks, in this way, to respond to criticisms from experts in health legislation, that the ANS would have been silent in the case, which could give rise to a new failure of the health plan, as happened with Unimed in the 1990s.
Customer fears abusive increase in the readjustment of health plans
Amil is the second largest health plan in the country in terms of revenue, only behind Bradesco Saúde. But the vast majority of its 3.4 million beneficiaries belong to business plans, which are profitable. Its parent UnitedHealth reported net income of $5.03 billion in the first quarter of 2022, up 3.5% from the same period in 2021.
Behind-the-scenes information reveals that UnitedHealth plans to leave the country, but in order to sell its assets well, it would first need to get rid of the loss-making customer base.
Deficit because the readjustment of these plans does not follow inflation and is regulated by the ANS. In 2021, for example, the agency indicated a negative adjustment of 8.2%, that is, individual plans had to decrease prices.
The new increase in individual and family plans should be announced by June by the ANS. The expectation is that a two-digit readjustment will be approved, the Sheetto compensate precisely for the negative readjustment of the last year.
Carlos Alberto Gonçalves fears that the discharge is abusive. “I’m afraid that the ANS will allow an increase above inflation,” he says.
“A high readjustment at this moment would only take me and my family to the SUS, which no longer takes care of so many people”, he says, for a family plan of five people, for a monthly fee of R$ 6,300.
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