Reimbursement

On July 17, 2022, the Austrian Institute for HTA (AIHTA) published four decision support documents, which provide recommendations regarding the inclusion of new medical interventions in the catalog of individual medical services of the performance-oriented hospital financing (Leistungsorientierten Krankenanstaltenfinanzierung, LKF) model, as well as three updates to previous decision support documents.

On July 07, 2023, the Ministry of Health and Prevention announced the implementation of the transitional period for innovative technologies following the experiment under Article 51 of the Social Security Financing Act.

In July 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) significantly updated the process to obtain reimbursement for health apps. More stakeholders, including the industry, can now submit an application to INAMI-RIZIV for temporary or permanent reimbursement. The new process will come into force on October 1, 2023.

At the end of June 2023, the French National Authority for Health (HAS) published a new document with the goal of improving professional practices: Digital medical devices for professional use – Guide on choosing digital medical devices for professional use.

In late June 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) decided to extend reimbursement for molecular biology tests by next-generation sequencing (NGS) for one year until June 30, 2024. NGS in oncology and hemato-oncology are temporarily reimbursed as a pilot under a specific agreement (Convention) with INAMI-RIZIV from 2019.

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 June 2023. Twenty-eight recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular and peripheral vascular, endocrine, ENT, orthopedic, spinal, and surgical devices, as well as medical aids.

On July 3, 2023, the document "Changes and innovations in the 2024 LKF model" (Änderungen und Neuerungen in den LKF-Modellen 2024) was published. The document summarizes the most significant changes and innovations in the LKF model for inpatient and outpatient care. The newly added procedure codes mainly concern endoscopic procedures, orthopedics, peripheral vascular, and pulmonary and airways fields.

On July 1, 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) updated the conditions of reimbursement for continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM, commonly called flash glucose monitoring, FGM). Full coverage by health insurance became available to more patient categories.

On July 05, 2023, the new version of the List of reimbursable products and services (LPPR) was released. Five new reimbursement codes for reimbursement of digital medical devices for medical telemonitoring activities were introduced.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on July 1, 2023. The most significant changes concern introducing the new EBM codes for several IVD tests, as well as for the cryopreservation of the ovarian tissue.

On June 19, 2023, the Swiss Federal Office of Public Health (FOPH) published the changes that will occur to the Healthcare Benefit Ordinance (KLV/OPre) and its Annexes, which determines coverage of medical services in Switzerland. Key changes relate to introduction of two codes for genetic tests, several extensions of Coverage with Evidence Development, and updates in reimbursement conditions for transcatheter aortic valve implantation. The changes entered into force on July 1, 2023.

On June 11, 2023, the Ministry of Health and Prevention published an Order in the Official Journal of the French Republic on the transitional coverage for the Insides System from Insides Company for the treatment of intestinal failure associated with temporary double enterostomy or enterocutaneous fistula by actively reinfusing chyme into the distal intestine.