Reimbursement
11
May 2021
In late April and early May 2021, 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 health insurers. In total, fifteen health apps are now available at the DiGA Directory.
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05
May 2021
Transcatheter aortic valve implantation (TAVI/TAVR) in severe aortic stenosis treatment across all surgical risk groups was being evaluated within the "New Methods" framework since 2019. On April 26, 2021, the Decision Forum for "New Methods" made a positive coverage decision for TAVI/TAVR to treat patients with severe aortic stenosis across all surgical risk groups.
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04
May 2021
In April 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0176 and 0073 with changes to be implemented not later than August 01, 2021. Four new procedure codes related to men's health and breast surgery and one new companion diagnostic code were introduced.
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03
May 2021
On April 22, 2021, the List of reimbursable implants and invasive medical devices, maintained by the National Institute for Health and Disability Insurance (INAMI), was updated with the corresponding Nominative lists of brand-specific devices. Two new Nominative lists with reimbursable devices used for peripheral vascular interventions were introduced.
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22
Apr 2021
The revised EBM (German Uniform Evaluation Standard) catalog came into force on April 1, 2021. Two new EBM codes for IVD tests were introduced, and reimbursement conditions for two IVD tests were amended.
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13
Apr 2021
On March 23, 2021, the Norwegian Directorate of e-Health released an updated version of the National Laboratory code (NLK) system and associated tariffs for state and private laboratories to be implemented not later than May 01, 2021. NLK system is used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings since 2018.Thirty-four new codes were added in medical biochemistry and medical microbiology areas.
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12
Apr 2021
On March 17, 2021, NHS Digital released HRG4+ 2021/22 Local Payment Grouper. In general, there were no significant changes in the HRG logic for 2021/22, and no new HRGs were introduced. Two new ICD-10 codes for COVID-19 were incorporated into the grouping logic in addition to three codes already included in the consultation grouper. Furthermore, three new Main Speciality Codes (MSC) and 25 new Treatment Function Codes (TFC), which were introduced in April 2020, became mandatory to use in Grouper from April 2021. These codes concern a wide specter of areas of care.
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08
Apr 2021
On March 22, 2021, NHS England and NHS Improvement released 2021/22 National Tariff Payment System consultation documents and launched an online feedback survey that closes on April 30, 2021. The main proposed change is introducing an "Aligned Payment and Incentive" (API) approach, comprising fixed and variable elements, for almost all services in the scope of the tariff and limiting national prices to unbundled diagnostic imaging services.
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07
Apr 2021
On March 31, 2021, the Order of the Ministry of Solidarity and Health on the 2021 DRG system was published in the Official Journal of the French Republic. The Order includes information on the 2021 updates of the DRG system, DRG tariffs, supplements for private and public hospitals, as well as the tariffs for specific packages (emergency treatment package, ATU; small equipment package, FFM; safety and hospital environment package, SE; administration package for pharmaceutical products, services, and specialties in a hospital environment, APE) applicable to the procedures performed in a hospital environment but without hospitalization, etc.
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06
Apr 2021
On March 22, 2021, NHS England published the final version of the 2021/22 NHS Standard Contract and associated documents, which took effect from April 01, 2021. NHS England mandates the NHS Standard Contract for use by commissioners for all healthcare services contracts other than primary care. Changes mainly concerned introducing new "Aligned Payment and Incentive" (API) rules proposed by the 2021/22 National Tariff Payment System.
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02
Apr 2021
According to the available financial results, published by the German Federal Ministry of Health, the German statutory health insurance companies reported a total deficit of around 2.65 billion euros in 2020. The health fund reported a deficit of 3.49 billion euros in 2020. As of January 15, 2021, the health fund's liquidity reserve was around 5.9 billion euros.
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30
Mar 2021
On March 17, 2021, the Evaluation Committee (Bewertungsausschuss) has decided to introduce two new EBM (German Uniform Evaluation Standard) codes related to prescription of health apps with retrospective effect from January 1, 2021.
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