Reimbursement

On July 15, 2024, the Austrian Institute for HTA (AIHTA) published three decision support documents that provide recommendations regarding the inclusion of new medical interventions in the catalog of individual medical services (MEL) for reimbursement, as well as two updates to previous decision support documents. The decisions relate to cardiovascular, peripheral vascular, interventional radiology, neuromodulation, and endocrine technology groups.

On June 19, 2024, the Swiss Federal Council granted partial approval to the new outpatient reimbursement system, consisting of the TARDOC catalog of individual service tariffs and the flat-rate system, which were developed independently. Adjustments were requested to ensure better coordination and adherence to cost neutrality. The full implementation of the new system is now postponed until 2026.

The application window for changes in the Swiss classification of surgical procedures (CHOP) will open on June 3, 2024. The eligible applicants can submit applications until September 15, 2024.

On April 25, 2024, the Ministry of Labor, Health, and Solidarity published an Order in the Official Journal of the French Republic setting the tariffs for digital medical devices with therapeutic functions covered within the early digital support (PECAN) scheme. The tariff for the manufacturer will include an initial lump sum of €435 per patient billable for up to 3 months and a subsequent monthly package of €38.30. The maximum amount of financial compensation is €780 per year per patient.

On May 07, 2024, the Dutch Healthcare Institute (ZIN) published the updated list of medical procedures reimbursed under basic health insurance with restrictions or limitations. The additional indications for autologous fat transplantation after a total breast removal were newly introduced to the list.

On April 18, 2024, the French National Authority for Health (HAS) announced the submission of requests for registration in the 2025 HAS Good Practice Recommendations Work program – for professional organizations and in the 2025 HAS Work program – for patient associations.

On May 1, 2024, the Swiss Federal Council adopted a message to amend the Federal Health Insurance Act (KVG) following a parliamentary mandate, which requires a change in how tariffs for laboratory analyses are determined. Instead of being set by the Federal Department of Home Affairs (FDHA), the tariffs of tests in the List of Analyses will be determined through negotiations between collective bargaining partners, streamlining the inclusion of innovative analyses and slowing down the increase in healthcare costs.

On April 18, 2024, the Ministry of Labor, Health, and Solidarity published the Order in the Official Journal of the French Republic, setting DRG tariffs and tariffs for other packages and supplements for 2024. New tariffs are applicable from March 1, 2024.

On March 31, 2024, the Ministry of Labor, Health, and Solidarity published a Decree in the Official Journal of the French Republic relating to the conditions of coverage of innovative IVD tests within the RIHN framework, which should facilitate the transition from the RIHN framework to regular reimbursement via the NABM Nomenclature.

On April 8, 2024, the updated version of the intra-DRG list of April 6, 2024, was published. One new device was registered, and other changes concerned modifying the registration conditions and renewing registration or extending the registration.

The Essential Levels of Care (LEA) defines outpatient specialist and prosthetic care guaranteed to the Italian population. Although the LEA document was brought in 2017, the national tariffs for outpatient specialist and prosthetic care were launched in April last year after seven years of development. They were supposed to come into effect on January 1, 2024 (later postponed to April 1, 2024). However, on March 27, 2024, the need for tariff revision and the new Decree postponing the tariffs until January 2025 was announced by the Italian Ministry of Health

On March 1, 2024, the updated Benefit Order was published in the Official Journal of the French Republic. Notable updates encompass modifications to existing emergency care supplements and the addition of new ones for non-hospitalized emergency care services, such as laboratory tests, imaging, specialist consultations, out-of-hours care, and specific provisions based on patient condition and age.