Reimbursement

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.

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.