Reimbursement

The French National Authority for Health released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies in July 2022. Twenty recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services. Opinions concern cardiovascular and peripheral vascular, neurovascular and neuromodulation, orthopedic, endocrine, and ENT devices, as well as breast implants and medical aids. Except for this, CNEDiMTS published two positive and two negative opinions concerning transitional coverage of devices.

In May-July 2022, two 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 July 2022, Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the extension of temporary reimbursement for gene expression profile (GEP) testing for early-stage breast cancer detection until December 31, 2022, and for molecular biology tests by next-generation sequencing (NGS) until June 30, 2023.

The French National Authority for Health released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies in June 2022. Nineteen recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services. Opinions concern cardiovascular, interventional radiology, orthopedic, neurovascular and neuromodulation, ophthalmology, as well as medical aids.

On June 23, 2022, the National Association of Statutory Health Insurance Physicians (KBV) announced the first steps aimed to expand the utilization of surgical procedures within day case/outpatient settings (reimbursed via the German Uniform Evaluation Standard (EBM) catalog).

The revised EBM (German Uniform Evaluation Standard) catalog came into force on July 1, 2022. The most significant changes concern introducing and updating multiple EBM codes for IVD tests and adjusting tariffs and content of radiotherapy services.

On June 28, 2022, the Dutch Organization for Health Research and Development (ZonMw) launched a call for subsidy “Implementation of Knowledge and Innovations in Appropriate Care” to improve Dutch healthcare in line with Appropriate Care principles. Subsidy applications will be submitted until September 13, 2022.

On June 17, 2022, INAMI announced the launch of a new reimbursement framework for remote medical consultations from August 01, 2022. The reimbursement for remote consultations was first introduced during the COVID-19 crisis via "teleconsultation" codes, which will now be terminated and replaced by other Nomenclature codes for telephone and video consultations. Physicians will receive a higher fee for video consultations.

In June 2022, NHS England and NHS Improvement (NHSEI) defined timelines for the evaluation of applications to update the National Genomic Test Directory in 2022/23. Applications can be submitted at any time throughout the year. Applications submitted before August 31, 2022, will be reviewed and considered for inclusion in the April 2023 update to the Test Directory

On June 06, 2022, the Reimbursement Commission of the Social Security Institution (SSI) released an updated version of the Healthcare Implementation Communique (SUT). The main changes relate to the increase in reimbursement fees of genetic tests by approximately 10%. Also, 138 new IVD tests have been added to the SUT.

In June 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0184 and 0081 with changes to be implemented no later than August 09, 2022. Two new procedure codes for robotic surgery and two new diagnostic codes were introduced.

In mid-June, the Swiss Federal Office for Public Health announced the update of the Annexes of the Services Ordinance (KLV/OPre). Annexes 1, 2, and 3 were updated. The updates related to the endocrine, IVD, and interventional radiology technology groups.