Draft 2022 High-End Medical Care reimbursement categories announced in Russia

30

Sep 2021

At the beginning of September 2021, the Government of the Russian Federation released the preliminary version of the Program of State Guarantees for the period of 2022-2024. The program determines the average level of financing of health care services, but most importantly, the two lists of procedures covered as part of the High-End Medical Care (HEMC). The following changes are expected to be introduced:

  • Major changes concerned the HEMC list I where two new procedures in the diagnostic imaging and cardiovascular field, as well as the neurovascular field, were added:
    • The FFR/IVUS/OCT for PCI with 1-3 stents in stable angina only is included in the HEMC List I category #76 with the tariff of 315,814 RUB;
    • The endovascular thrombectomy for acute ischemic stroke is included in the HEMC List I category #77 with the tariff of 741,288 RUB;
  • The HEMC list II was expanded with the procedures in the field of radiotherapy, neurology, and neurosurgery as well as surgical procedures as follows:
    • The installation of an intensive pump for continuous gel infusion after preliminary nasojejunal titration is included in the HEMC list II category #13 with the tariff of 431,771 RUB;
    • Total body irradiation, total lymphoid irradiation of the body, total bone marrow irradiation in children is included in the HEMC list II category #36 with the tariff of 584,382 RUB;
    • Proton beam therapy, including children, was expanded inside the HEMC list II; it entered the neurosurgery group as a category #20 with the tariff of 2,009,410 RUB;
    • Hybrid surgery for multilevel lesions of the main arteries and arteries of the lower extremities in patients with diabetes mellitus is included in the HEMC list II category #63 with the tariff of 655,545 RUB;
    • The treatment of acute leukemia using biotechnological methods in children is included in the HEMC list II category #35 with the tariff of 2,972,565 RUB.

The final version of the Program of State Guarantees is planned to be released in December of 2021.

In parallel, at the beginning of September 2021, the Ministry of Health of the Russian Federation released a preliminary Order with the updated list of organizations that provide services included in the HEMC list II; it excludes the Ministry of Defence clinical rehabilitation facility but includes three new facilities (Vernadsky Crimean Federal University, Rehabilitation Center of the Administrative Directorate of the President of the Russian Federation, Federal Research Center "Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences").

The preliminary version of the Program of State Guarantees can be found here.

The list of the organizations that provide High-End Medical Care can be found here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news).

Not ready for a subscription service? Subscribe to our free-of-charge newsletter delivered every second week to get updates about key reimbursement developments in Europe (10-12 news every two weeks). First EU issues of both newsletters are available for download free-of-charge.

The latest related news

27

Jan 2023

On January 09, 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published 2023 tariffs for the “low variability care” (APR-DRG) system. APR-DRG logic for 2023 is not published as of January 27, so no information about its changes or new DRGs is available.

Read more

26

Jan 2023

The updated German Uniform Evaluation Standard (EBM) catalog came into force on January 1, 2023. The EBM catalog (Einheitlicher Bewertungsmaßstab) regulates the reimbursement of services in the public outpatient sector in Germany and is updated once a quarter (four times a year). Among other changes, a new code for "zanadio" health app for follow-up and evaluation was introduced in the catalog.

Read more

25

Jan 2023

On December 31, 2022, the Decree defining the reimbursement of medical telemonitoring activities via the new framework was published in the Official Journal of the French Republic. The Decree determines the methods of evaluation of digital solutions, registration for reimbursement, modification of the registration conditions, removal and invoicing of medical telemonitoring activities, as well as the conditions for setting the reimbursement packages.

Read more

24

Jan 2023

In December 2022, NHS England launched a consultation on the preliminary 2023/25 NHS Payment Scheme, which is set for two years and will replace the National Tariff Payment System from April 2023. Two new cardiovascular categories (antibacterial envelope, mitral valve repair and replacement devices) are proposed for inclusion in the 2023/24 High Cost Device List (will be updated and reissued for 2024/25). The deadline for comments submission is January 27, 2023.

Read more

23

Jan 2023

On December 26, 2022, three more health apps were introduced in the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM) and thus became reimbursable. These apps can be prescribed by physicians and psychotherapists and will be reimbursed by sickness funds.

Read more