Changes to drug, treatment, and reimbursement system from the SSI

The changes made by the Social Security Institution (SSI) Health Services Pricing Commission to the Health Implementation Communiqué (SUT) have been published in the Official Gazette. With the regulation, updates were made in many areas ranging from drug prices to reimbursement conditions, and from SMA treatment criteria to home healthcare services.

COMPREHENSIVE UPDATE TO DRUG LISTS

Within the scope of the new regulation, the prices of numerous drugs included in the SUT's EK-4/C drug list were revised. While the barcode and name information of some drugs were changed, new drugs were added to replace products removed from the list due to cost reasons.

NEW REIMBURSEMENT CONDITIONS FOR SMA TREATMENTS

A change was also made to the article titled "Principles for the use of nusinersen sodium and risdiplam in Spinal Muscular Atrophy disease" in the SUT. Thus, the usage and reimbursement criteria to be applied for SMA patients' access to these treatments were reorganized.

NEW MEDICAL PROCEDURES INCLUDED IN REIMBURSEMENT SCOPE

With the decision, various new procedures were added to the Fee-for-Service Procedure Point List and the Diagnosis-Related Procedure Point List. These include vaginal birth after cesarean section, polysomnography and multiple sleep latency test, diagnostic cholangioscopy, biopsy, stone removal and laser lithotripsy, Actinium-225 PSMA therapy, bone mineral density measurement, bronchoscopic cryobiopsy, endobronchial ultrasound-guided transbronchial cryobiopsy, bronchial thermoplasty, cardiopulmonary exercise test, exhaled nitric oxide test, pulsed field ablation, and residual cystic duct excision.

CHANGES IN HOME HEALTHCARE SERVICES

With the regulation, home healthcare services, physical therapy and rehabilitation practices, session durations, health board report requirements, and reimbursement rules were also redefined.

In addition, reimbursement prices for numerous medical materials used in cardiology, cardiovascular surgery, interventional radiology, and spinal surgery were updated. While some provisions of the decision entered into force on the date they were published in the Official Gazette, some regulations will begin to be applied on the dates specified in the communiqué.

News Source: 12punto