Reimbursement

The French National Authority for Health (HAS) 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 (CNEDiMTS) in November 2021. More than 15 recommendations were published in relation to the registration, modification of registration conditions, renewal of registration of devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, peripheral vascular, neurovascular, dermatological, and endocrine devices, as well as medical aids.

On November 23, 2021, 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 January 01, 2021. 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 in medical biochemistry, immunology and transfusiology, and clinical pharmacology areas.

In late November 2021, the INeK (Institute for the Hospital Remuneration System) has published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and add-on reimbursement categories (ZEs) for 2022. Seven new DRGs and seventeen ZE categories were added to the catalog in 2022.

In November 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0180 and 0077 with changes to be implemented no later than February 01, 2022. Four new procedure codes related to neurology, spinal procedures, cancer pharmacotherapy, and ophthalmology, and three new diagnostic codes were introduced.

The French National Authority for Health (HAS) 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 (CNEDiMTS) in October 2021. More than 20 recommendations were published in relation to the registration, modification of registration conditions, renewal of registration of devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, peripheral vascular, neurovascular and neuromodulation, and other groups of devices, as well as medical aids.

Since October 2021, it is necessary to have the unique device identifier (UDI) of the various models and commercial references of the devices currently on the "intra-DRG" list in order to make it possible to collect and transmit the information relating to the use of these devices in health care establishments.

In late October 2021, the BfArM (Federal Institute for Drugs and Medical Devices) has published the final version of the 2022 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care.

On October 15, 2021, the Government of the Russian Federation released the decree on the plan for implementation of the ICD-11 classification of disease during the period of 2021-2024. In order to perform the transition, the working committees under the supervision of the Ministries of the Russian Federation will be created. The final changes should enter into force before 2025.

In early October 2021, three 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, 23 health apps are now available at the DiGA Directory.

In late September 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0179 and 0076 with changes to be implemented no later than January 01, 2022. Four new procedure codes related to gynecology, robotic surgery in the pulmonology area, and orthopedics, and four new diagnostic codes were introduced.

On September 16, 2021, the Federal Joint Committee (G-BA) has decided that it would not evaluate the proton therapy in a number of indications, including esophageal cancer and inoperable hepatocellular carcinoma (HCC).