Fenasaúde, an entity representing health operators such as Bradesco Saúde and SulAmérica, has filed a lawsuit in the Federal Court to annul a resolution by the CFM (Federal Council of Medicine) that alters how medical audits are conducted. Medical audits evaluate whether the procedures billed to health plans, including surgeries and hospitalizations, are technically supported, clinically necessary, and appropriately priced. The resolution in question is seen as overstepping the CFM's authority, potentially infringing on contractual regulations related to healthcare provision.

The importance of this legal action lies in its implications for both healthcare operators and patients. The auditing process, which is crucial for determining the legitimacy of payments made to healthcare providers, could be affected by this resolution. If upheld, the changes could lead to increased costs for health plans and may alter how healthcare services are authorized before treatments are provided.

This case highlights the ongoing tensions between medical regulatory bodies and health insurance operators in Brazil. The outcome could set a precedent for how health services are audited and added to ongoing discussions about the balance of power between healthcare providers and insurance companies, thus influencing future health policy and regulations in the country.