- Home
- Practice areas
- Healthcare Law
Healthcare Law
Work with health plan operators, providers and medical auditing in a regulated sector where every decision becomes an urgent case.
Brazil's private healthcare sector lives with three simultaneous pressures: regulation by ANS (Brazil's private health insurance regulator), litigation over coverage with urgent injunctions, and the commercial relationship between operators and providers, marked by billing disputes and price adjustments.
We advise health plan operators, hospitals, clinics, cooperatives and medical auditing companies on contracts, regulatory compliance, billing disputes and defence in court and administrative proceedings.
What we handle in Healthcare Law
Choose a matter and see how we work, what you receive and the most common questions.
Healthcare Companies and Institutions
Legal structure for hospitals, clinics, laboratories and healthtechs to operate and grow safely.
See matterHealthcare Regulatory
Compliance with ANS, ANVISA and sanitary authorities, with defense in NIPs, infraction notices and inspections.
See matterHealthcare Contracts
Network agreements, price adjustments, claim denials, medical staff and suppliers with clear rules to get paid.
See matterRelations with Public Authorities
SUS contracting, public procurement, CEBAS and responses to courts of auditors and the Public Prosecutor's Office.
See matterHealthcare Litigation
Defense of health plans, hospitals and clinics in injunctions, off-list coverage, claim denials and civil liability.
See matterHow we work
Defence in coverage claims
Responses to injunctions, statements of defence and appeals in claims about coverage, provider networks, price adjustments and reimbursement, with technical and regulatory grounds.
Healthcare sector contracts
Provider accreditation, hospital services, medical staff, group and corporate plan contracts, with clear rules on billing, auditing and price adjustment.
Regulatory compliance and dealings with ANS
Monitoring of the obligations under Law No. 9,656/1998 (Brazil's private health plans act) and the regulator's rules, defence in administrative proceedings and support during inspections.
Billing disputes and medical auditing
Review and challenge of technical and administrative billing rejections, design of appeal workflows and recovery of amounts owed to the provider.
Civil liability of healthcare providers
Defence of hospitals, clinics and professionals in damages claims and in proceedings before professional councils.
Data protection for health data
Compliance for the processing of patient and member data, classified as sensitive personal data under Law No. 13,709/2018 (LGPD), with documented policy, legal basis and security controls.
Why work with us
Both sides of the chain
We act for operators and for providers in different matters, which helps us anticipate the other side's argument in negotiation and in court.
Regulatory and litigation integrated
The court defence uses the right regulatory argument, and the contract is drafted with an eye on how a judge will read it.
Response that matches the urgency
Healthcare claims move in hours. We organise the team to deal with injunctions within the time they allow.
Frequently asked questions
Must a Brazilian health plan cover a procedure outside the ANS list?
The general rule is coverage of the procedures listed by ANS, with exceptional cases of coverage beyond the list defined by statute and case law. Each case turns on the prescription, the scientific evidence and the absence of a listed alternative, so the analysis is individual and technical.
What is reimbursement to the public health system?
It is the operator's duty to reimburse the government when a plan member is treated by the public network for a procedure covered by the contract, provided for in Law No. 9,656/1998. The charge is made administratively and can be challenged where there is an identification or coverage error.
How can a provider challenge a rejected invoice?
The challenge starts with the billing appeal workflow set out in the accreditation agreement, which has its own deadlines and documentation. Once administrative remedies are exhausted, court recovery is available and depends on well documented medical records, authorisations and invoicing.
Can an operator terminate a corporate group plan?
Yes, subject to the contract terms, prior notice and the ANS rules for group contracts, which follow a different regime from individual plans. The form and timing of the notice are frequently the decisive point in any later court dispute.
Can patient data be shared between provider and operator?
Yes, where there is an adequate legal basis and a defined purpose, because health data is sensitive personal data under Law No. 13,709/2018 (LGPD). Sharing requires a contractual instrument, minimisation to what is necessary and documented security controls.
See also
Operator, hospital or clinic facing an urgent matter?
Talk to our healthcare team about injunctions, billing disputes, contracts and regulatory requirements.