By Brazil Stock Guide – Brazil’s private health regulator, the National Supplementary Health Agency (ANS), put into effect on May 1 a new oversight model for health plan operators in the country. The change prioritizes preventive measures, risk-based analysis and the identification of recurring problems among operators.
Under the new rules, ANS will continue to receive complaints from beneficiaries through its Preliminary Intermediation Notification system, known as NIP. However, not every complaint will be reviewed individually. Some cases will still be analyzed one by one, while others will be used to identify patterns and guide broader enforcement actions.
According to the agency, complaints selected for individual review must be concluded within 45 days after being assigned to technical staff. The goal is to reduce the backlog of cases, speed up responses and use complaint data to guide action on recurring problems in the sector.
Planned oversight
The new model also gives greater weight to planned oversight actions. These measures will be defined according to the severity of the problems identified and the performance of health plan operators, including indicators such as the General Complaints Index.
The actions may include preventive and guidance measures, closer monitoring of operators with signs of recurring irregularities, and structured enforcement actions in more complex cases.
In serious situations, ANS may impose fines of up to R$1 million for each unmet regulatory order, in addition to other sanctions provided under the rules. Daily fines may also apply in cases of serious non-compliance with a significant impact on beneficiaries.
New rules
The changes are part of a set of regulatory resolutions approved by ANS. They include RN 656/2025, which changes penalty calculation rules; RN 657/2025, which updates oversight procedures; RN 658/2025, which defines planned oversight actions; and RN 659/2025, which adjusts penalty rules for health plan operators.
The new model marks a shift in the agency’s approach. Oversight will now rely less on the individual review of every complaint and more on the identification of risks, conduct patterns and repeated problems among operators.
What changes in practice
For consumers, the main change is that filing a complaint no longer necessarily means the case will be individually reviewed by the regulator. Some complaints will instead be used to identify broader problems. This may accelerate responses in recurring cases, but it could also reduce direct regulatory treatment of isolated situations.
For health plan operators, the model increases the importance of aggregate indicators and complaint history. Companies with higher volumes of complaints or recurring problems are more likely to face closer monitoring and targeted enforcement actions.
For ANS, the change allows resources to be concentrated on cases considered more relevant and enables more targeted oversight. The model’s effectiveness will depend on the agency’s ability to correctly identify risk patterns and act on them.
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