Reimbursement

Earlier this year, the CZ-DRG v5 was released in the Czech Republic by the Central Institute of Health Information and Statistics (ÚZIS). Currently, further changes are being implemented, and the CZ-DRG v5, revision 1, will be ready for implementation on January 1, 2023.

The Dental and Pharmaceutical Benefits Agency (TLV) has planned a theme survey on products for the diagnosis or treatment of lung cancer and colorectal cancer to identify products that may be relevant for health economic assessments at TLV. The survey is planned to be carried out in September – October 2022. No further information has been provided yet.

On September 1, 2022, the updated “List of state-paid services and their payment conditions” was published in Latvia. All six newly introduced codes concern the provision of services related to COVID-19 and flu vaccination.

In September 2022, Ordering Forum for New Methods has invited interested parties regarding electric field therapy (Optune, Tumor Treating Fields) alone or in combination with drugs for certain groups of glioblastoma patients, based on genome sequencing and biomarkers (indication II). Information should be submitted before November 8, 2022. Ordering Forum will be held on November 21, 2022, to decide whether the method will undergo evaluation at the national level.

In late August 2022, the updated version of the DRG tariff system guide (Takstsystem) was released by the Danish Health Data Agency (Sundhedsdatastyrelsen). No new DRGs were introduced in the updated version of the DRG tariff system guide. However, two new groups were added to the List of special services, for which supplementary payment may be charged.

On September 1, 2022, the Institute for Hospital Remuneration Systems (INeK) announced the start of the application process according to §6 (2) KHEntgG (New Examination and Treatment Methods, NUB) for 2023. The deadline for the submission of applications is October 31, 2022.

The French National Authority for Health (HAS) released new recommendations about transitional coverage of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in August 2022. One opinion was published regarding the cardiac resynchronization system WISE CRT-SYSTEM by EBR System.

The French National Authority for Health released new recommendations about add-on reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies in August 2022. One recommendation was published in relation to the registration for devices in the List of reimbursable products and services (LPPR List). The opinion concerns men’s health area.

On August 11, 2022, NHS England and NHS Improvement released an updated National Genomic Test Directory for rare and inherited diseases (version 3.1), which lists genomic tests commissioned by NHS England via Genomic Laboratory Hubs. No new codes (test-indication combinations) were introduced.

On August 01, 2022, Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) launched a new reimbursement framework for remote medical consultations. The Nomenclature was changed accordingly: a new article 37, “Remote care,” was introduced with four new codes and fees for video and telephone consultations by physicians.

On August 01, 2022, a new version of the Nomenclature of Medical Biology Acts (NABM080) was released. One new code for the detection of the monkeypox virus genome was introduced.

In August 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 0185 and 0082 with changes to be implemented no later than October 11, 2022. Seven new procedure codes (for photodynamic therapy to skin lesions, patch continuous ECG recording, shoulder stabilization procedure, and ear reconstruction) and no new diagnostic codes.