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Health Coverage for Neurodivergents: Congressional Hearing & STJ Ruling

by Dr. Michael Lee – Health Editor

House Commission to Hold Hearing on Health Plan Coverage for Autism, Neurodiversity

BRASÍLIA – The House of Representatives’ Health Commission will convene a public hearing next Tuesday, October 23rd, to address the critical issue of health plan coverage for individuals with autism and other neurodevelopmental conditions. The interactive session, scheduled for 5 pm in Plenary 7, comes at a pivotal moment as the Superior Court of Justice (STJ) prepares to rule on a case with perhaps far-reaching consequences for thousands of Brazilian families.

The debate centers on the rights of neurodivergent individuals to access necessary multidisciplinary therapies prescribed by medical professionals. Currently, health plans are facing legal challenges regarding their ability to limit or deny coverage for these treatments, especially for those diagnosed with global developmental disorders, including autism spectrum disorder. The STJ’s upcoming decision in repetitive theme 1.295 will establish a binding legal precedent, obligating all judges to adhere to its ruling in similar cases nationwide.

The hearing was initiated by members of the Subcommittee on the Rights of Persons with Autistic Spectrum Disorder,including President Deputy Iza Arruda (MDB-PE),Rapporteur Deputy Dr.Alessandra Haber (MDB-PA), vice-President Deputy amom Mandel (Citizenship-AM), and subcommittee member Deputy Geraldo Resende (PSDB-MS). Parliamentarians emphasize the significant impact the STJ’s judgment will have on access to vital care.

Recent data from the Brazilian Institute of Geography and Statistics (IBGE)’s 2022 Census indicates that Brazil is home to at least 2.3 million individuals with an autism diagnosis. Experts suggest this figure likely underestimates the true prevalence, as many cases remain undiagnosed or unreported. The outcome of the STJ case and the discussions at Tuesday’s hearing will directly influence the quality of life and well-being of this growing population and their families.

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