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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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Block contract payments until 31 July in NHS England

On 17 March 2020, NHS England announced that block contracts would be used to cover the period 1 April – 31 July, as the national tariff is suspended. Contractual arrangements for 2020/21 with NHS trusts/NHS foundation trusts and with non-NHS providers operating under the NHS Standard Contract were published.

Following the publication of the letter to NHS bodies on 17 March 2020, NHS outlined the following principles of the approach:

  • Provide certainty for all organizations providing NHS-funded services under the NHS Standard Contract that they will continue to be paid for the period April to July 2020; and
  • Minimize the burden of formal contract documents and contract management processes so that the COVID-19 response can be thoroughly handled by staff

The following contractual arrangements for 2020/21 with NHS trusts/NHS foundation trusts were provided:

  • At this time, there is no need to sign contracts between NHS commissioners and NHS Trusts / NHS Foundation Trusts between them for 2020/21. The NHS Standard Contract's nationally mandated terms for 2020/21 will apply for all relationships as of 1 April 2020. Commissioners and Trusts must not vary from the national terms
  • The national contract signing deadline set out in the NHS Operational Planning and Contracting Guidance 2020/21 of 27 March 2020 is no longer applicable
  • For each month from April to July 2020, payment will be made on a block basis as defined in the Stevens / Pritchard letter
  • NHS England and NHS Improvement will inform the specific amounts payable for each commissioner/trust relationship for which direct payment continues to be required through Sharepoint and the provider portal
  • Payment for all other CCG / Trust relationships will be handled nationally between April and July 2020, as set out in the separately published guidelines for block payments

More details are described in the document.

Contractual arrangements for 2020/21 with non-NHS providers operating under the NHS Standard Contract are also provided in the document.

In due course, more guidelines on payment and contracting will be given after 31 July 2020.

See the full details here.

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