Reimbursement

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 February 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, neurovascular, ophthalmological, spine, and orthopedic devices, surgical procedures, as well as medical aids.

In February 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the completion of a pilot project for gene expression profiling (GEP) tests in early-stage breast cancer, which ran from 2019. The pilot showed significant benefits, and INAMI-RIZIV launched a reimbursement for certain tests under the specific agreement (GEP convention) with healthcare providers.

On February 7, 2023, the entity working on the new out-patient flat-rates, Solutions Tarifaires Suisses AG, announced the beginning of the consultation process for the work on version 0.3 of the new out-patient flat-rate reimbursement system. The comments can only be submitted by the tariff partners that established this body (associations of health insurers curafutura and santésuisse, as well as the association of hospitals H+, an association of physicians FMH, and medical tariff commission MTK/CTM). The consultations can be submitted until March 31, 2023.

In January and February 2023, five more health apps were 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 sickness funds.

In February 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 188 and 084 with changes to be implemented no later than March 23, 2023. Five new procedure codes (concerning interventional radiology, robotic surgery, and radiotherapy) and one new diagnostic code were introduced.

On January 27, 2023, the Swiss Federal Office for Public Health announced the update of Annex 3 of the Health Care Benefit Ordinance (KLV/OPre), which contains the list of reimbursed IVD tests (List of Analyses). Two new tests on Monkeypox virus check will be introduced in March 2023.

On January 31, 2023, the Order approving Addendum 11 to the National Convention for Laboratory Directors was published in the Official Journal of the French Republic. The Addendum implements financial measures provided for by the Social Security Financing Act – reduces the reimbursement tariffs for the tests registered in the main reimbursement catalog for IVD tests in France Nomenclature of Medical Biology Acts (NABM).

On January 23, 2023, 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 1, 2023. Twenty-four new codes were added, 179 codes were changed, and 23 codes were terminated.

The French National Authority for Health (HAS) released new recommendations about transitional coverage of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in January 2023. Two opinions were published regarding devices from two technology groups.

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 January 2023. Twenty-four 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, neurovascular, and orthopedic devices, in-vitro diagnostics, as well as medical aids.

On January 3, 2023, the Federal Joint Committee (G-BA) initiated the evaluation procedure concerning the method of renal denervation using ultrasound ablation in treatment-resistant hypertension (Paradise-System™ by ReCor Medical) within the framework of the early benefit assessment (in line with § 137h SGB V).

On January 09, 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published 2023 tariffs for the “low variability care” (APR-DRG) system. APR-DRG logic for 2023 is not published as of January 27, so no information about its changes or new DRGs is available.