Among other things, the NHF wants to introduce the possibility of billing breast MRI (Breast MRI) examinations within the scope of Comprehensive Oncology Care (KON-Breast), also for people without a known BRCA1/BRCA2 mutation.
Oncology
Draft Ordinance of the President of the National Health Fund on the terms and conditions of contracts for comprehensive oncology services available here
Among other things, the NHF wants to introduce the possibility of billing for tests magnetic resonance imaging of the breast (MRI) in terms of Comprehensive oncology care for breast cancer recipients (KON-Pierś), where there are medical indications for its performance. To date, the study has been able to be accounted for in a patient population with a BRCA1/BRCA2 mutation.
In addition, a new settlement product has been introduced in Annex 1on Diagnostic stay - code 5.60.01.0000015, cleared under Comprehensive oncology care on colorectal cancer patients (KON-JG) including cost-intensive diagnostic tests from the catalogue of products to be added up,
Technical changes have been made to Appendix No. 2 (catalogue of ranges of services - oncological comprehensive services) consisting in the removal of the items specified in column 6 - catalogue of separate products and in column 8 - catalogue of radiotherapy as billing products dedicated to individual ranges of services. These products - as stated by the NFZ in the justification - have been implemented into the catalogue of oncological comprehensive services.
Consultation, entry into force: The NFZ is waiting for feedback until 22 October 2021. Entry into force is planned for 1 November, with the exception of § 1(2)(b) and (3), which shall enter into force from 1 January 2022.
Cardiology
Draft Ordinance amending the Ordinance of the President of the National Health Fund on defining the conditions for the conclusion and performance of agreements on hospital treatment - comprehensive services available here
Changes have been made in relation to the published announcement of the President of the Agency for Health Technology Assessment and Tarification of 29 September 2021 on the tariff for guaranteed services in the area of cardiac surgery covering coronary artery bypass grafting. The published announcement concerns the tariff for guaranteed services in the area of cardiac surgery involving coronary artery bypass grafting:
- Coronary artery bypass grafting with plasty;
- Coronary artery bypass grafting with pw >=2;
- Coronary artery bypass grafting without pw
Accordingly, the order modifies the groups covering coronary artery bypass graft procedures by creating three groups instead of the four existing ones.
Consultation, entry into force: There is to be 14 days for consultation (but although the draft was published today, the time is counted from 6 October), and it is planned that the ordinance, as amended, will come into force on 1 November 2021.
Draft Ordinance amending the Ordinance of the President of the National Health Fund on defining the conditions for the conclusion and performance of contracts in the field of in-patient and out-patient hospital treatment - Highly specialised benefits - although with a different name this also applies to bridging changes. It is available here
And while in the first draft it was written that the changes in costs were previously taken into account, here the amount falls. The changes introduced result in financial consequences for guaranteed services in the area of cardiac surgery on the payer's side in the amount of 82 million PLN (the justification states a different amount, but probably erroneously are million PLN instead of PLN).
Consultation, entry into force: There is to be 14 days for consultation (but although the draft was published today, the time is counted from 6 October), and it is planned that the ordinance, as amended, will come into force on 1 November 2021.
Source: cowzdrowiu.pl