Germany

The corresponding decision by the (the Federal Joint Committee) of January 16, 2020, was published in the Federal Gazette and came into force on April 9, 2020.

Since January 1, 2020, the nursing staff costs of the hospitals are excluded from the DRG case flat rates and financed in parallel to the DRG case flat rates using a hospital-specific care budget based on the principle of cost coverage.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on April 1, 2020. MTRC has compiled the selection of the most significant changes.

On behalf of the Federal Joint Committee (G-BA), the Institute for Quality and Efficiency in Health Care (IQWiG) investigated whether a test of newborns for spinal muscular atrophy (SMA) in Germany would make sense. The affected children benefit from early diagnosis as this enables an earlier start of therapy.

The revised EBM (German Uniform Evaluation Standard) comes into force on April 1, 2020. Among others, the amendments made concern the billing of the services within the framework of early detection of cervical cancer. Also, the new fee order item (GOP) for the human papillomaviruses (HPV) genotyping service was added.

Patients with a newly diagnosed glioblastoma will have an opportunity to benefit from the therapy with tumor-treating fields (TTF) at the expense of statutory health insurance. The Federal Joint Committee (G-BA) decided on March 20, 2020, the details concerning the indications and the quality assurance measures that will apply when prescribing this outpatient treatment method.

Balneophototherapy becomes covered by the National Association of Statutory Health Insurance Funds (GKV) for patients suffering from moderate to severe neurodermatitis. The Federal Joint Committee (G-BA) decided to include this treatment option to contract medical care on March 20, 2020.

On March 13, 2020, the Institute for Quality and Efficiency in Health Care (IQWiG) announced that the new HTA reports would concern cystitis, heart disease in children, social isolation, as well as vitamin B12 / vitamin D deficiency in the elderly, and the Feldenkrais Method in treatment of mobility disorders.

In severe cases of lipedema, the costs for liposuction will be covered by the statutory health insurance companies from January 2020. The National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV) have added several new fee order items to the EBM (German Uniform Evaluation Standard) and set the reimbursement.

On the 1st of February, 2020, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-SV) have made the agreement for laboratory diagnostic clarification about the novel coronavirus. Afterwards, the statutory health insurance companies will cover the costs of the test for the novel coronavirus (2019-nCoV) if there are justified suspected cases.

On the 17th of February 2020, the Innovation Committee at the Federal Joint Committee (G-BA) invited external stakeholders to suggest topics and criteria for future funding. Moreover, the submission of proposals for members of the new pool of experts was announced.

The patients diagnosed with osteoporosis requiring medication will be able to receive care within a structured treatment program (disease management program, DMP). The Federal Joint Committee (G-BA) decided in mid-January 2020 the details of participation and the various aspects of care.