Reimbursement

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.

On January 14, 2022, the Government of the Russian Federation released a Decree which approved the inclusion of three devices (implantable pulse generator for urinary/fecal incontinence, bioprosthetic aortic valve/xenoprosthesis, and vessels embolization material) in the List of Essential Implantable Medical Devices.

In December 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0181 and 0078 with changes to be implemented no later than February 01, 2022. Seven new procedure codes and four new diagnostic codes were introduced.

In spring 2022, a new reimbursement system for remote consultations will be launched with new reimbursement codes and conditions.

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 December 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, orthopedic, ENT devices, as well as medical aids. Except for this, CNEDiMTS published an opinion about transitional coverage (a newly established pathway for reimbursement) for a cardiovascular device.

Dutch Healthcare Authority (NZa) has issued a draft release of the DRG package for 2023, including a new procedure code for intermittent pneumatic compression therapy, a new diagnosis code for guidance in early pregnancy after a fertility program, and several new DRGs for pediatric palliative care, lymphovenous anastomosis surgery and light therapy in inflammatory dermatoses.

On December 20, 2021, the tariff partners of the novel TARDOC reimbursement system for outpatient care (association of health insurers curafutura and association of physicians, FMH) re-submitted the substantially revised version 1.3 of TARDOC to the Federal Council. The tariff partners hope that the Federal Council will assess the new reimbursement system in the first quarter of 2022 and that it could be implemented from January 2023.

In early December 2021, the Danish Health Authority (Sundhedsdatastyrelsen) has published DRG tariffs, as well as psychiatric and rehabilitation rates for 2022. Later on, in mid-December 2021, the DRG tariff system (Takstsystem) guide for 2022 was also published. Among other changes, seven new DRGs, specifically in ENT, endoscopy, obstetrics, and gynecology fields, were introduced.

In December 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, 27 health apps are now available at the DiGA Directory.

On December 17, 2021, NHS Digital released HRG4+ Consultation Grouper for 2022/23. This release is used to support the NHS England and Improvement consultation process for the 2022/23 National Tariff Payment System. In general, there are significant changes in base HRG design. A total of 120 new HRGs were created, multiple HRGs were removed, and the grouping logic was updated significantly. This Consultation Grouper will be superseded by the 2022/23 Local Payment Grouper in March 2022, for use from April 01, 2022.

On December 06, 2021, the President of the Russian Federation signed the Federal Law on a budget of mandatory Health Insurance for 2022 and the planning period of 2023 and 2024. In accordance with the approved budget, the amount of High-end Medical Care outside the basic compulsory medical insurance program for federal clinics will be 109.9 billion RUB which is an increase of 2.7 billion RUB.