Reimbursement

On November 08, 2023, the Dutch Healthcare Authority (NZa) published 2024 update of the Digital Care Funding Guide, which describes the possibilities in the funding of digital care depending on the healthcare sector (primary care, medical specialist care, long-term care, etc.).

On November 7, 2023, the annual update of the Swedish NordDRG system was published to come into force on January 1, 2024. A total of 16 new DRGs will be implemented concerning ENT, radiology, and primary care.

On October 29, 2023, the Ministry of Health and Prevention published an Order in the Official Journal of the French Republic setting the tariffs for the medical telemonitoring activities covered within the early digital support scheme. The tariffs are set per patient based on the number of patients involved.

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 2023. Twelve recommendations were published in relation to the registration of medical devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, e-health, endocrine, gastrointestinal, neurology and neurosurgery, neuromodulation, and orthopedic devices, as well as medical aids.

In October 2023, the Dutch Healthcare Authority (NZa) published a policy rule that defines the amount for academic care contribution and the rules for its allocation in 2024. The policy rule aims to determine the reimbursement for costs that arise for certain healthcare providers because they permanently maintain facilities (staff and infrastructure) that enable them to provide highly specialized and innovative care linked to fundamental patient-centered research.

In October 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins with changes to be implemented no later than December 7, 2023. Eight new procedure codes (concerning endoscopy, gastrointestinal, interventional radiology, neurology and neurosurgery, orthopedics, and men's health) and three new diagnostic codes were introduced.

The updated German Uniform Evaluation Standard (EBM) catalog came into force on October 1, 2023. The EBM catalog (Einheitlicher Bewertungsmaßstab) regulates the reimbursement of services in the public outpatient sector in Germany and is updated once a quarter (four times a year). Among other changes, a new code for “Mawendo” and “Oviva Direkt für Adipositas” health apps were introduced in the catalog.

On September 27, 2023, the Italian Ministry of Health released a decree with which they adopted the launch of the new national screening program, which will be launched in January 2024. The screening program will screen children for type 1 diabetes and celiac disease.

In October 2023, the Norwegian Directorate of e-Health released the Norwegian Clinical Procedure Codes for 2024. The coding system consists of three parts: NCMP for medical procedures, NCSP for surgical, and NCRP for radiological procedures. A total of 28 new codes will be introduced from January 2024: 10 new surgical procedure codes, 14 new radiology procedure codes, and four new medical procedure codes.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on October 1, 2023. The most significant changes concern the introduction of the new EBM codes for several IVD tests, prostate-specific membrane antigen (PSMA) positron emission tomography, as well as for stereotactic radiosurgery (SRS) in vestibular schwannomas.

The so-called hybrid DRGs reimbursement mechanism will first cover services from the “starting catalog”, and it will be implemented at the beginning of 2024. The catalog itself is still not publicly available.

On September 28, 2023, the Dutch Healthcare Authority (NZa) published the second release of the DRG package for 2024 (RZ24b). One new procedure code, two new supplementary payments, and three new DRGs will be implemented across in-vitro diagnostics, urology, and cardiovascular technology groups.