Reimbursement

In February 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, published Bulletins 0182 and 0079 with changes to be implemented no later than April 10, 2022. Three new procedure codes concerned robotic surgery in orthopaedic area, spinal procedures, and ophthalmology, and five new diagnostic codes were introduced.

At the end of February 2022, the Dental and Pharmaceutical Benefits Agency (TLV) has launched a theme survey on products for monitoring and diagnostics of sepsis to identify products that may be relevant for health economic assessments at TLV. The suggestions for the products of interest, ongoing clinical studies, or innovation projects could be received until 23 March 2022.

On February 08, 2022, the Reimbursement Commission of the Social Security Institution released an updated version of the Healthcare Implementation Communique. The main changes relate to the increase in reimbursement fees of services and medical devices by approximately 35-75%.

In February 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 total, thirty health apps are now available at the DiGA Directory.

A new temporary reimbursement framework for remote consultations is planned to be implemented in Belgium in spring 2022.

On February 15, 2022, the preliminary version of the DRG manual for 2022 was published in France. Introduced changes (new DRGs, change of DRG logic) concern surgical procedures on the breast, interventions for malignant skin tumors, interventions of excision and grafting on the skin and subcutaneous tissue, spondyloplasties.

On January 24, 2022, 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 no later than March 01, 2022. NLK system has been used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings since 2018. Thirty new codes were added medical biochemistry, medical microbiology, immunology and transfusiology, and clinical pharmacology areas.

On February 15, 2022, the French National Authority for Health (HAS) announced the start of the submission period for the applications for new procedure codes and IVD tests to be included in the 2023 HAS working program. Furthermore, a new platform for dossier submission is launched.

Since 2019, several low-cost and simple procedures in Belgium have been reimbursed not via individual INAMI fees but APR-DRG groups. This funding system is called “Low Variability Care”. On January 26, 2022, the list of APR-DRG groups and corresponding reimbursement amounts for 2022 was published.

On February 02, 2022, NHS England updated the 2021/22 National Genomic Test Directory for rare and inherited diseases, initially published in October 2021. No new codes were introduced. Amendments were made in 77 codes, including changing the test method, commissioning category, specialist group.

At the beginning of January 2022, the INAMI published a convention for 2022-2023 related to the financing of dialysis. The convention regulates the modalities of reimbursement for dialysis of patients with chronic renal failure.

On December 26, 2021, the new health app was 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, 28 health apps are now available at the DiGA Directory.