The Federal Council of Medicine (“CFM”) issued, on June 2, 2026, Resolution CFM No. 2,462/2026, establishing administrative measures applicable to legal entities that fail to pay physicians for services rendered.
The regulation deserves attention because it creates a new supervisory mechanism for the Medical Councils and increases the regulatory exposure of legal entities involved in hiring, organizing, or intermediating medical services. In addition, the Resolution addresses a recurring issue in the healthcare sector—delays in payments to physicians—and adopts a stricter approach to its investigation and handling.
Who is affected?
The Resolution applies to all legal entities that provide, organize, hire, intermediate, or manage medical services, including, among others:
- Social Organizations (OSs);
- Associations and foundations;
- Philanthropic entities;
- Medical cooperatives;
- Hospitals and clinics;
- Companies that intermediate on-call shifts and medical schedules;
- Business entities engaged in the provision or organization of medical services.
The wording of the regulation is broad and may extend to health plan operators to the extent that they hire, organize, or intermediate the provision of medical services, although the scope of this application may still give rise to interpretative debates.
All covered entities must maintain active registration with the competent Regional Council of Medicine (“CRM”), including the designation of a duly registered medical technical director.
What constitutes payment default?
Payment default is defined as the total or partial failure to pay wages, fees, on-call shifts, standby compensation, or any other remuneration due to physicians after the contractual due date.
Proceedings may be initiated through:
- a complaint by a physician;
- a representation from a medical entity;
- a report from third parties; or
- ex officio action by the CRM.
The existence of minimum evidence of service provision, a contractual or factual relationship, and payment delay is sufficient to trigger an investigation.
Sanctions
Sanctions will be imposed according to the severity of the conduct, the extent of the damage, recurrence, voluntary remediation, and the risk of disruption of medical assistance.
| Sanction | When it applies | Effect |
|---|---|---|
| Warning | Default without recurrence, with demonstrated good faith. | Requirement to regularize within a specified deadline. |
| Fine | Applicable individually or cumulatively. | Between 1 and 50 annual fees; in case of recurrence, up to 100 annual fees. |
| Suspension of registration | Recurrence, severity, or failure to regularize. | Suspension for up to 1 year and blocking of national registration. |
| Cancellation of registration | Severe cases or use of the legal entity to precarize medical work. | Requirement for new registration and nationwide blocking. |
The fine may be imposed either individually or in conjunction with other sanctions.
In cases of suspension or cancellation, the CRM must immediately notify the CFM to block the national registration system of the legal entity and its partners.
Public disclosure of the irregular situation may only occur after the administrative decision becomes final and unappealable.
Regularization and reinstatement
Full settlement of outstanding debts prior to judgment may lead to dismissal of the case—except in cases of recurrence, fraud, withholding, or document falsification. Court-approved judicial or extrajudicial agreements are also recognized for purposes of administrative reinstatement, provided compliance is demonstrated.
Controversial points
Expansion of the sanctioning powers of the Medical Councils: The Resolution represents a significant expansion of the supervisory authority of the Medical Councils over legal entities. Although the CFM based the regulation on its authority over professional oversight and its duty to ensure adequate conditions for the practice of medicine, the extent of sanctioning powers of Professional Councils over legal entities remains subject to legal debate and may be challenged in future litigation.
To date, there is no record of lawsuits specifically challenging CFM Resolution No. 2,462/2026.
Liability regardless of financial transfer (Art. 2, §2): Paragraph 2 of Article 2 is the most controversial provision of the regulation: delays or failure in financial transfers by a public or private contracting party do not, by themselves, exempt the intermediary legal entity from administrative liability. In practice, hospitals, social organizations, cooperatives, and intermediary companies may be held liable even when the default results from delayed payments by municipalities, states, health plan operators, or other contracting parties. This provision increases the regulatory exposure of these entities and shifts a significant portion of the risks arising from the contractual chain onto them.
Trend toward stricter oversight: CREMERJ (Resolution 364/2026), CREMERN (Resolution 11/2026), and CRM-PR (Resolution 256/2026) had already adopted similar rules—some with as little as a 5-day deadline to initiate proceedings. The federal regulation standardizes the framework. Its publication indicates a broader trend toward harmonization and intensified oversight of delayed payments to physicians nationwide.
Practical recommendations
Considering that the regulation will come into force on July 2, 2026, it is recommended that potentially affected entities prioritize: (i) reviewing the regularity of their registration with the CRM and the status of their technical director; (ii) reviewing contracts with physicians and contracting parties, establishing clear due dates and safeguards in case of default within the contractual chain; (iii) implementing internal protocols to respond to potential complaints or proceedings before the CRM; and (iv) for larger entities, assessing the feasibility of a preventive judicial challenge to the regulation, in light of recent precedents regarding the CFM’s authority.
