On September 18, 2025, the Federal Supreme Court concluded the judgment of ADI 7265, a lawsuit filed by UNIDAS, which questioned the constitutionality of provisions of Law No. 14,454/22, a rule that amended the Health Plan Law to allow coverage of tests and treatments not yet included in the ANS list.
The STF's decision, which recognized the partial constitutionality of the law, establishes that the absence of the technology on the ANS list prevents its concession, except when the following requirements are met:
- prescription by a physician or dentist;
- no express refusal or pending evaluation by the ANS on a proposal to update the list;
- absence of an adequate therapeutic alternative for the patient's condition on the ANS list;
- proof of the treatment's effectiveness and safety, based on evidence-based medicine or Health Technology Assessment (HTA), necessarily supported by high-level scientific evidence (randomized clinical trials, systematic review, or meta-analysis); and
- existence of registration with Anvisa (when applicable).
This material provides a detailed analysis of the approved thesis, the ministers' voting scores, points of attention, processes, and bills related to the topic.
