What RN 507 says and how it affects health plans

Normative Resolution (RN) No. 507 of March 30, 2022, issued by Brazil’s National Supplementary Health Agency (ANS), establishes and regulates the Accreditation Program for Private Health Plan Operators.

Participation is voluntary, and the program aims to drive structural, care and governance improvements in health plans, aligning quality of care, risk management and economic and financial sustainability with the ANS regulatory model.

What does Normative Resolution No. 507 establish?

RN 507/2022 is a milestone in the pursuit of greater institutional maturity in Brazilian private healthcare. By creating a formal accreditation program, the rule establishes a regulatory mechanism to encourage excellence that goes beyond minimum compliance with legal requirements.

Unlike one-off audits or reactive inspections, accreditation is meant to induce and structure change. Its focus is on consolidating good management practices, improving the care model and continuously improving the plan member’s experience.

For health plans, accreditation is more than an institutional seal. It works as a regulatory indicator of operational efficiency, technical quality and organizational soundness, with direct effects on the relationship with the ANS and on the business’s economic performance.

The accreditation process is carried out by accrediting bodies recognized by the ANS, which are responsible for assessing how well the health plan meets the criteria set out in the rule.

The program applies to medical-hospital health plans and dental-only health plans, with the latter subject to specific criteria. Benefit administrators are not eligible for accreditation.

The four dimensions of the assessment

RN 507 structures the assessment of health plans into four strategic dimensions, considered essential for raising the standard of the industry. To obtain accreditation, the health plan must achieve a minimum score of 70 points in each dimension, ensuring a balance between governance, care and the plan member’s experience:

Organizational Management

Assesses corporate governance, decision-making structure, risk management, regulatory compliance and economic and financial sustainability.

Provider Network Management

Analyzes the quality of the care network, the criteria for contracting providers, performance monitoring and the mechanisms for regulating access.

Health Management

Examines care management, care coordination, the use of quality indicators and continuous improvement processes.

Plan Member Experience

Measures the plan member’s perception of access, problem resolution, communication and how their needs are met throughout the care journey.

Accreditation levels and validity period

Based on the arithmetic mean of the scores obtained in the four dimensions, the health plan is classified into three accreditation levels:

• Level I: final score of 90 or higher, compliance with at least 80% of the excellence items and a Supplementary Health Performance Index (IDSS) above 0.8.
  Validity: 3 years.

• Level II: final score of 80 or higher and below 90.
  Validity: 2 years.

• Level III: final score of 70 or higher and below 80.
  Validity: 2 years.

Prerequisites for joining the program

RN 507 sets objective eligibility criteria that work as regulatory filters. Only health plans that meet all of the requirements below at the same time can apply for accreditation:

• Have an active registration with the ANS and not be under special regimes (technical administration, fiscal administration or liquidation).

• Have an IDSS of 0.6 or higher.

• Not have received an adverse opinion or a disclaimer of opinion in the independent audit of the financial statements for the last fiscal year.

Regulatory incentives: a direct impact on the business

Beyond institutional recognition, accreditation brings concrete regulatory benefits, which makes the program strategically relevant to the sustainability of health plans:

IDSS bonus

Accreditation has a positive impact on the score in the Health Plan Qualification Program (PQO).

Lower regulatory capital

Accredited health plans can apply reduction factors to their capital requirements, freeing up resources for investments in care and technology.

Solvency margin

Possibility of a reduction in the monthly solvency margin requirement, according to criteria defined by the Directorate of Standards and Authorization of Operators (DIOPE).

The 2025 regulatory update: dental segment and suspension of the seal

RN No. 630/2025, which amended provisions of RN 507, introduced significant adjustments to the accreditation program.

The main change was the creation of a separate Accreditation Manual for dental health plans, with specific criteria and shorter implementation periods. For this segment, the minimum time for processes to mature was reduced to 180 days, compared with the 12 months required of medical-hospital health plans.

In addition, the minimum IDSS requirement for dental health plans to join the program was lowered to 0.5, broadening access to certification in this niche.

Another significant step forward was the introduction of the mechanism of accreditation suspension. Since the regulatory update, temporary failures in specific prerequisites — such as a one-time drop in the IDSS or problems with care indicators — may result only in the suspension of the seal, rather than its permanent loss.

This change makes the program more rational from a regulatory standpoint, allowing the health plan to correct the nonconformity and return to accredited status, as long as the certificate is still within its validity period.