The requirements blocking foreign physicians, companies and medical institutions from providing their services in Brazil directly to patients remain in effect. Yet, foreign players should consider the fine print of the new Brazilian rules. In brief, there is space for them.
Opportunities for Swiss companies
First, the highly specialized Swiss IT and health technology companies may consider supporting the development of the Brazilian telemedicine environment, mainly by offering and marketing their technology that aim at improving patient experiences, managing costs, as well by improving communications APIs, screen sharing, audio-video Drivers. SIP interconnection, filing and archiving. Innovation is key to Brazil, a country with continental dimensions and over 200 million people.
Second, health care entities (HCE) are testing and tasting telemedicine. The experience has been widely acclaimed and may become the new reality, mainly for health care centers and entities. Remote second opinions, peer-to-peer liaisons, market survey, I.A. Private HCEs are abundant in Brazil and so is their need to adapt to the post-COVID19 era.
Unless securing Brazilian certification, Swiss-trained MDs are still barred from practicing medicine in Brazil, telemedicine included. Nonetheless, new telemedicine regulation invites foreign companies to consider one of the largest healthcare markets in the World.
New regulations in place
With the COVID-19 public health emergency, CFM (Conselho Federal de Medicina) and the Ministry of Health understood that CFM Resolution 1643 was insufficient to regulate telehealth in Brazil. In response, CFM recognized (as an exceptional measure, and only during the COVID-19 public health emergency) teleorientation, telemonitoring and teleinterconsultation services. Similarly, the Ministry published Ordinance 467 which, also as an exceptional and temporary measure, allows for telehealth pre-clinical care, assistance, support, consultation, monitoring and diagnosis in Brazil’s Unified Health System, as well as by supplementary and private health care providers.
Certain permits and licenses still necessary
As the supplementary rules on telehealth in Brazil were not adjusted, foreign physicians and companies seeking to provide telehealth services (“Services”) in Brazil must still obtain certain permits and licenses. This requirement poses an obstacle to foreign companies, medical institutions and physicians, unless they partner-up with a national company in possession of such licenses.
A physician seeking to undertake Services in Brazil must be duly certified by the Regional Council of Medicine (“Council”). Similarly, a company seeking to provide Services in Brazil must be registered with the Council, which requires the appointment of a supervising physician and a list of physicians on staff. Once the Brazilian authorities issue the proper permits and licenses, the physician or company may render the Services.
On March 31, 2020, the Brazilian Senate approved Bill 696, which regulates the use of telehealth during the COVID-19 public health emergency. The Bill broadly defines telehealth as “the exercise of medicine facilitated by technology for assistance, research, disease and injury prevention, as well as for health promotion”.
The Bill also requires the physician to inform the patient of all telehealth-related limitations, including the impossibility of an in-person physical examination. While the Bill acknowledges CFM’s authority to regulate telehealth, it remains silent on foreign physicians, companies and medical institutions seeking to render the Services in Brazil, and still requires presidential approval.
Despite the Bill’s recognition of the CFM's authority to regulate telehealth in Brazil, caution dictates that current telehealth standards must still be observed, including the need to obtain licenses and authorizations for the Services. As a result, the new rules of the CFM, the Ministry and the Bill only expanded Services rendered by Brazilian physicians, companies or medical institutions.