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Cade fines medical agencies for preventing the use of discount cards in appointments


The Tribunal has concluded the practices of the Federal Medicine Council and the Regional Medicine Council of the State of São Paulo caused losses to users of the discount card Cartão de Todos in the state of São Paulo
published: Jun 03, 2020 10:13 PM last modified: Jun 03, 2020 10:13 PM
by International Unit

At a judgment session held this Wednesday, 3 June, the Administrative Council for Economic Defense (Cade) ordered the defendants, the Federal Medicine Council (CFM) and the Regional Medicine Council of the State of São Paulo (Cremesp), to pay a fine of BRL 900,000 for anti-competitive practices. The Tribunal found the agencies restrained health care professionals and establishments from accepting medical discount cards for consultations, to the detriment of consumers.

Owners of the medical discount card Cartão de Todos pay a monthly fee to receive discounts on medical appointments provided by participating clinics and practitioners. According to the National Agency for Private Health Insurance (ANS), this kind of card cannot be categorised as an insurance plan and, provided the consumer is aware of this fact, there is no legal impediment to their commercialisation.

According to the vote of the rapporteur commissioner, Lenisa Prado, the CFM engaged in anti-competitive practices by establishing rules that forbid doctors to create bonds of any sort with companies that advertised or commercialised discount cards. Moreover, it also prohibited clinics from offering discounts related to such cards.

The other agency, Cremesp, acted to enforce these provisions. The agency would threaten doctors and clinics that participated in the programme, conducting investigations and disciplinary actions aimed at imposing sanctions.

"The evidence available in this Administrative Proceedings demonstrate the conduct practised by the CFM and Cremesp caused several professionals to change their practices regarding the Cartão de Todos, leading to a decrease in the offer to the consumers of this sector due to the resulting increase in fees charged", the rapporteur concluded.

This understanding was followed by Cade's Tribunal, which ordered the medical agencies to pay fines amounting to BRL 900,000 for their anti-competitive practices. Cade's decision also determines the CFM and Cremesp must refrain from developing rules, conducting official investigations, disciplinary administrative proceedings, boycotts or using any other means to punish, threaten, coerce, or retaliate doctors who intend to participate in discount cards.


Cade's investigation was launched in October 2018, reported by the Department of Consumer Protection and Defence of the Ministry of Justice and Public Security (DPDC/MJSP). The department presented documents that suggested the CFM and Cremesp were threatening doctors and clinics that participate in the discount card programme, conducting official investigations and disciplinary actions to impose sanctions.

In February 2019, Cade began the administrative proceedings and ordered a preventive measure against the CFM and Cremesp to suspend the effects of their practice while the case was under investigation. In view of the measure, Cremesp reported it suspended all investigations of professionals and disciplinary actions that were in progress at the time — a total of 275 procedures. Moreover, the CFM repealed resolutions and Article 72 of the Medical Code of Ethics, which limited the actions of discount card companies.

Despite suspending the investigations into health care practitioners and repealing the rules, the Tribunal condemned the defendants for anti-competitive practices. The evidence demonstrated the CFM and Cremesp carried out these practices for over seven years, causing losses to low-income consumers, delayed medical treatment, among other consequences.

Access the Administrative Proceedings 08700.005969/2018-29.