Reimbursement

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.

In early June 2022, NHS England and NHS Improvement updated information about the nationwide purchase and supply system for High Cost Tariff-Excluded Devices, which was introduced in 2016. The name of the program changed to the Specialised Service Devices program (SSDP). The program currently covers 15 categories of devices, and several new categories will be added during the 2022/23 financial year.

At the end of May 2022, the new intra-DRG list was published. No major changes were introduced in the list. No new devices were added to the list.

On June 01, 2022, the National Institute for Health and Disability Insurance (INAMI-RIZIV) updated tariffs for the APR-DRG system. No changes in DRG logic were made, and no new DRGs were implemented.

In late May 2022, the Norwegian Directorate of e-Health released an updated version of the National Laboratory code (NLK) system to be implemented no later than July 01, 2022, and associated tariffs for state and private laboratories to be implemented no later than June 01, 2022. NLK system is used for activity-based reimbursement by the Norwegian Health Economics Administration (Helfo) in outpatient settings.

In late May 2022, NHS England and NHS Improvement recalculated tariff prices to reflect higher inflation levels. They published an updated 2022/23 national tariff workbook and the non-mandatory prices workbook with increased prices.

On May 31, 2022, a decision of the National Union of Health Insurance Funds relating to the update of the Nomenclatures of procedures - Common classification of medical procedures (CCAM) and General nomenclature of professional acts (NGAP) - was published in the Official Journal of the French Republic. Various changes were introduced in the CCAM, such as the inclusion of new procedure codes, provisionally registered codes, and modification of the billing conditions. New CCAM codes were introduced in the field of ophthalmology, men’s health, and diagnostic imaging. These changes will be reflected in version 70 of the CCAM nomenclature, which will enter into force on June 30, 2022.

On June 3, 2022, the Swiss Federal Council rejected TARDOC outpatient tariff structure version 1.3, which was submitted in December 2021. According to the Federal Council, major progress has been made, but version 1.3 does still not meet the legal requirements, in particular cost neutrality.

On May 31, 2022, the French National Authority for Health (HAS) published the final positive opinion on the coverage of the endoscopic gastroplasty with the ENDOMINA triangulation platform under the Innovation package (Forfait innovation).

On May 25, 2022, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published an updated List of reimbursable devices that came into force on June 01, 2022. A total of 12 new codes with the corresponding conditions of reimbursement were added to the List, which concerned sacral neurostimulation in fecal incontinence treatment, soft tissue markers, and osteosynthesis devices.

On May 09, 2022, the updated List of Reimbursable Products and Services (LPPR) was published. It contains new devices included in the LPPR list in April 2022, as well as other modifications made during this period. New devices that were introduced in the LPPR list belong to the endocrine and gastrointestinal technology groups.

In mid-May 2022, the Swiss Federal Office for Statistics announced that they will be accepting applications for changes in procedure code (CHOP) nomenclature from June 1, 2022, until September 18, 2022. The applications made in 2022 will be reflected in the 2024 version of the CHOP nomenclature.