O impacto da resolução normativa da ANS nº 539/2022 na judicialização do acesso a tratamento multidisciplinar por pessoas com transtorno do espectro autista: pesquisa jurisprudencial no estado da Bahia

Abstract

The present work aims to address the impact of ANS Normative Resolution No. 539/2022 on the judicialization of access to multidisciplinary treatment for people with autism spectrum disorder in the courts of justice in Bahia. The research problem aims to analyze how the resolution influenced the foundations of judicial decisions related to access to multidisciplinary treatment in health plans for people with ASD in the state of Bahia in the last three years. The legal regime for supplementary health in the Brazilian context was presented, with emphasis on the ANS List; the changes introduced by Normative Resolution 539/2022 regarding access to multidisciplinary treatment for people with ASD were analyzed and, finally, the data on the TJBA decisions related to the subject were systematized. The justification for the topic lies in the relevance of implementing and guaranteeing the right to access healthcare for people with disabilities. The methodology used was jurisprudential, bibliographic and documentary analysis, with decisions on the subject being analyzed in the sample space of one year, using the dialectical method. It was observed that the number of decisions following normative resolution more than doubled, however, only the aforementioned normative resolution had a low impact as a decision-making basis. Other data could be obtained, such as the prevalence of proceedings in the Special Court and problems related to the accredited plan network, issues that reflect the supplementary healthcare scenario in Bahia.