DISCUSSION ABOUT THE COVERAGE OF ORTHOTIC TREATMENT BY BRAZILIAN HEALTH INSURANCE/PLAN OPERATORS IN CASES OF POSITIONAL BRACHYCEPHALY AND PLAGIOCEPHALY IN BABIES Roberto Luiz Pardini Ferreira de Almeida, Renato Braz Mehanna Khamis, Fernando Reverendo Vidal Akaoi

Abstract

Positional Brachycephaly and Plagiocephaly are types of cranial asymmetry in babies, whose main causative agent is the position that newborns are placed during rest, whether in the cradle, stroller or car seat (supine or in dorsal decubitus position). The incidence of these syndromes has increased dramatically since the advent of the campaign Back to Sleep, by the American Academy of Pediatrics (AAP), due to the high number of sudden deaths of infants during the 1980s, having as main factor the prone or decubitus ventral position during rest. As cranial asymmetry is the nature of these types of deformities, a clinical treatment is performed through the use of cranial molding orthosis for a certain period, depending on each specific case, accompanied by specialists. In order to have the best results, treatment should occur within the 18 (eighteen) initial months of the infant's life and, if this is not done, several physical and functional consequences will arise which often can only be solved through invasive surgical procedures, more costly than clinical treatment. Consequently, it is discussed whether Health Insurance Providers should or should not pay for orthotic treatment, taking into consideration Brazilian laws in conjunction with the jurisprudential understanding currently applied, especially in the São Paulo Court of Justice. The importance of this study is the fact the Health Insurance does not cover the treatment, wich is less invasive and less expensive, when compared to surgical treatment and avoids future functional and social problems. The methodology used was exploratory research in the jurisprudence of the São Paulo Court of Justice, analysis of judicial precedent, analysis of constitutional and infraconstitutional legislation, doctrines and scientific thesis.