- Home
- Practice areas
- Healthcare Law
- Healthcare Contracts
Healthcare contracts lawyer in Brazil: clear rules to bill and get paid
A weak contract means claim denials, lost price adjustments and termination without notice. We write contracts that work in billing and hold up in court.
A healthcare contracts lawyer in Brazil drafts, reviews and negotiates the instruments that support the relationship between health plan operators, hospitals, clinics, laboratories, physicians and suppliers. Seek this support before signing a network agreement, when discussing price adjustments or claim denials, when structuring the medical staff and whenever you receive a termination or removal notice.
A healthcare contracts lawyer in Brazil takes care of the document that defines how much, when and how a provider gets paid. In a network agreement, a hospital contract or an arrangement with the medical staff, every clause directly affects billing, audits and continuity of care.
The law requires minimum form and content. Law No. 13,003/2014 added article 17-A to Law No. 9,656/1998 (the Health Plans Law) and made a written contract between operator and provider mandatory, with price adjustment criteria negotiated in the first 90 days of each year. ANS RN 503/2022 (a normative resolution of the National Supplementary Health Agency) details these rules, and ANS is discussing its replacement in Public Consultation No. 170/2026. Article 17 of the same law governs the replacement of hospitals in a network, with prior notice to beneficiaries and to ANS.
Our approach starts from the operation. Before discussing wording, we understand the authorization, billing, audit and payment flow. The contract must mirror that flow, provide for claim denial appeals and give the client evidence to collect or to defend itself.
When to call a lawyer
Recurring claim denials without clear rules
The operator denies items (glosas) using criteria the contract does not define, and the provider does not know how to appeal or by when.
Price adjustments that never happen
The contract has no index, method or frequency for adjustments, and rates fall behind year after year.
Notice of removal or termination
The provider receives a termination notice and must assess timing, form, pending payments and patients in treatment.
Medical staff without a well-defined relationship
Physicians work at the hospital without a contract covering liability, compensation, schedules and use of the facilities, which increases labor and civil risk.
What happens when you leave it for later
- Accumulated claim denials that strain cash flow and become hard to recover without evidence and without an appeal clause.
- Difficulty demanding price adjustments when there is no written contract with defined criteria.
- Removal from the network without transition, with lost revenue and conflict with patients in treatment.
- Recognition of an employment relationship or joint liability due to flaws in the medical staff arrangement.
How we work
Understanding the operation
We learn how authorization, billing, audit and payment work before touching the text, so the contract reflects real routine.
Portfolio diagnosis
We review current contracts, identify missing clauses or clauses contrary to regulation and prioritize by financial impact.
Drafting and negotiation
We draft or renegotiate network agreements, hospital contracts, medical staff and supplier contracts, with objective criteria for adjustments, claim denials and termination.
Claim denial and collection workflow
We structure the claim denial appeal procedure and the documentation that supports administrative or judicial collection.
Contract management
We track terms, adjustment windows and notice deadlines, and revise contracts when the rules change.
What you receive
- Diagnostic opinion on the contract portfolio with priorities
- Standard templates for network agreements, medical staff and suppliers
- Adjustment, claim denial and termination clauses aligned with Law No. 9,656/1998
- Documented claim denial appeal workflow
- Calendar of terms, adjustments and contractual deadlines
Why the firm
Contracts designed for billing
We write each clause with the hospital bill and the audit in mind, not just the signature.
Negotiation grounded in regulation
We bring ANS rules on written contracts and adjustments to the table, which makes the conversation objective.
Continuity with litigation
If the dispute reaches the courts, the same team that knows the contract handles the defense.
Illustrative scenario
Hypothetical scenario, for illustration only. A mid-sized hospital keeps old network agreements with several health plan operators, some without an adjustment clause and without claim denial appeal rules. Denials grow and billing does not add up. The analysis starts with the portfolio: which contracts carry the most volume, which fall short of written contract rules and which denials can still be appealed. The hospital begins negotiating amendments with objective criteria, organizes proof of the care provided and creates an internal appeal workflow. Contracts without agreement move on to an assessment of the available measures. Each negotiation has its own outcome, with no guaranteed result.
A hypothetical scenario, shown only to illustrate our method. Every case depends on its own facts.Frequently asked questions
When should I hire a healthcare contracts lawyer in Brazil?
Before signing or renewing a network agreement, and whenever claim denials, adjustments or termination turn into conflict. Reviewing the contract upfront costs less than disputing a poorly written clause later. It is also worth reviewing the portfolio when ANS changes its contracting rules.
What should a health plan network agreement include?
Scope, services and rates, method and frequency of adjustments, billing and payment routines, claim denial and appeal criteria, term and termination rules. Law No. 9,656/1998, as amended by Law No. 13,003/2014, and ANS RN 503/2022 set minimum content. Vague clauses on these points tend to become denials or litigation.
How can a hospital recover denied claims?
Through the claim denial appeal set out in the contract, with well-documented medical records, authorizations and bills. Repeated denials on the same item can be negotiated in bulk with the operator. If the administrative route fails, judicial collection is possible and depends on evidence gathered from the moment of care.
Can a health plan remove a hospital from its network at any time?
Not without complying with the law and the contract. Article 17 of Law No. 9,656/1998 allows a hospital to be replaced by an equivalent one, with notice to beneficiaries and to ANS 30 days in advance, except in cases of fraud or sanitary or tax violations. The contract may also require prior notice and transition rules.
What if the contract has no adjustment clause?
The provider can demand formalization, because the law requires a written contract with adjustment criteria. Under Law No. 9,656/1998, negotiation must take place in the first 90 days of the year, and ANS has rules for when there is no agreement. Documenting the attempt to negotiate is essential.
Is a medical staff physician an employee of the hospital?
It depends on how the relationship works in practice, not only on the name of the contract. Subordination, regularity and fixed pay may establish an employment relationship. A well-structured contract, consistent with the real routine, reduces that risk.
Related matters
Do your contracts protect your revenue?
Schedule a conversation to review network agreements, adjustments and claim denials and decide what to negotiate first.