Reimbursement

On March 30, 2020, the French High Authority for Health, has published the opinion of the National Commission for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS) regarding the Impella 5.0 device. The clinical added value was graded with level II (important) for the post-cardiotomy cardiogenic shock indication. After the negotiation with CEPS, Impella might be the first short-term VAD to enter add-on reimbursement list LPPR.

In March 2020, the entity managing the Swiss DRG system, SwissDRG, released several announcements about the changes related to the COVID19. The announcements concern diagnosis coding of COVID19, and the reimbursement changes required to adequately cover the care for the new disease.

Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) has introduced two new service codes for physicians’ teleconsultation regarding COVID-19. INAMI Insurance Committee established a reimbursement fee of €20.

On 22 January 2020, the consultation on proposals for a national tariff for 2020/21 closed. However, the release of the 2020/21 tariff has been postponed due to the NHS response to COVID-19. NHS will report publishing details at the earliest opportunity.

On March 4, 2020, the List of Analyses (AL/EA) and the Services Ordinance (KLV/OPre) were updated in Switzerland. On April 1, 2020, the KLV/OPre, the AL/EA, and the List of Medical Aids (MiGel/EMAp) will be updated in Switzerland.

Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) has issued an agreement document on March 17, 2020, providing principles for billing and funding the Coronavirus (COVID-19) Detection Tests. Previously in Protocol for Hospitals on March 10, 2020, it was outlined that COVID-19 tests performed outside the National Reference Center for Respiratory Pathogens at UZ Leuven have no specific nomenclature codes, and no reimbursement was provided, therefore, was paid by patients. The new agreement clarifies principles for reimbursement, but the invoicing for the tests still on hold.

On February 12, 2020, it was announced that the Swiss Federal Council is planning to modify the Health Insurance Ordinance (OAMal / KVV) with the goal of enhancing hospital planning, and unification of the inpatient tariffs throughout the country.

On March 3, 2020, the Reimbursement Commission made major updates to the SUT. The main changes relate to the increase in reimbursement fees of procedures (reimbursement fees increased depending on the type from 10% to 30%).

In severe cases of lipedema, the costs for liposuction will be covered by the statutory health insurance companies from January 2020. The National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV) have added several new fee order items to the EBM (German Uniform Evaluation Standard) and set the reimbursement.

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, etc. A total of 6 decisions were made.

On January 1, 2020, as a part of healthcare reform in Austria, the Austrian health insurance fund (Die Österreichische Gesundheitskasse (ÖGK)) was created by merging the nine former regional health insurance funds. The ÖGK is based in Vienna.

The “Subsidy for promising care” scheme makes it possible to obtain temporary financing for care that looks promising but is not yet reimbursed from the basic health insurance package. The deadline to apply for funding via this scheme is April 7, 2020.