Reimbursement

Since January 1, 2020, the nursing staff costs of the hospitals are excluded from the DRG case flat rates and financed in parallel to the DRG case flat rates using a hospital-specific care budget based on the principle of cost coverage.

MTRC has summarized the most important DRG changes in Norway, which came in force in 2020. This includes five new DRGs, one deleted DRG, changes in the titles of four DRGs and other changes.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on April 1, 2020. MTRC has compiled the selection of the most significant changes.

Sixty-three new procedure codes and other changes were introduced into the service catalog of the LKF model 2020 for the inpatient and outpatient area in Austria.

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern pediatric cataract involving lensectomy with or without lens implant, pediatric cataract involving lens aspiration and implant, delivery of a fraction MR Linac adaptive planned radiotherapy, low-level laser therapy for inflammation/pain relief and others. The codes are introduced with a recommended adoption date being the 1st of May 2020. The documents also contain a list of textual changes in codes and unacceptable combinations.

On 17 March 2020, NHS England announced that block contracts would be used to cover the period 1 April – 31 July, as the national tariff is suspended. Contractual arrangements for 2020/21 with NHS trusts/NHS foundation trusts and with non-NHS providers operating under the NHS Standard Contract were published.

New material codes for a locking stylus for extraction of endovenous electrodes and system with recovery lasso for the extraction of endovenous electrodes by femoral approach were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in April 2020. Some reimbursement conditions were updated as well.

Patients with a newly diagnosed glioblastoma will have an opportunity to benefit from the therapy with tumor-treating fields (TTF) at the expense of statutory health insurance. The Federal Joint Committee (G-BA) decided on March 20, 2020, the details concerning the indications and the quality assurance measures that will apply when prescribing this outpatient treatment method.

On March 27, 2020, the BMSGPK release the notes with the rules on diagnosis coding and administrative documentation for COVID-19 in hospitals as part of the project "Performance-based hospital financing (LKF)."

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in February 2020 concern various types of devices, for example, cardiovascular and orthopaedic devices, diabetes management systems, and other types of devices. A total of 27 decisions were made.

Balneophototherapy becomes covered by the National Association of Statutory Health Insurance Funds (GKV) for patients suffering from moderate to severe neurodermatitis. The Federal Joint Committee (G-BA) decided to include this treatment option to contract medical care on March 20, 2020.

In March 2020, the Nomenclature was updated. The update brought changes regarding the creation of new codes, deletion of codes, modification of existing codes, and reimbursement conditions.