Government planning to reintroduce co-payments for medical services through an emergency ordinance

Aurel Dragan 04/04/2019 | 16:15

The co-payment for medical services, “particularly for the segment of continuous hospitalization, specialized ambulatory and paraclinical ambulatory” is about to be reintroduced by the government, according to a draft Emergency Ordinance (OUG) that was released for public debate on the Health Ministry’s website.

The OUG project states that “failure to adopt immediate measures by emergency ordinance would lead to real difficulties in the optimal functioning of the entire medical activity with serious consequences in the effective use of public funds and the provision of quality care to patients,” as cited by Hotnews.

The draft OUG that would amend Law no. 95/2006 on healthcare reform says that “given that the state has, on one hand, the obligation to ensure public health by ensuring the population’s access to medical services, and, on the other hand, the obligation to ensure the efficient use of funds allocated for this purpose in order to reach the maximum potential of the public health system in Romania (…) especially for the segment of continuous hospitalization, specialized ambulatory and paraclinical ambulatory the failure to adopt immediate measures, by emergency ordinance, would lead to real difficulties in optimal operation of all medical activities, with serious consequences in terms of efficient use of public funds and provision of quality health care to patients.”

Among the changes that will be made to article 230 (2), letter e, is the following: “to receive reimbursement of all expenses incurred during hospitalization with medicinal products, sanitary materials and paraclinical investigations to which they would have been entitled without personal contribution under the terms and conditions imposed by the framework contract, except for the personal contribution they pay directly to the provider medical services.”

Also, article 237 (1) shall be amended and shall have the following content:

(1) Curative medical services whose costs are borne by the fund and which may attract the personal contribution of the patient are:

  1. Description of the current situation (according to draft normative act):

“Under Law 95/2006 on Health Reform, republished, as subsequently amended and supplemented, policyholders are entitled to reimbursement of all expenses incurred during hospitalization with medicinal products, sanitary materials and paraclinical investigations to which they would have been entitled without personal contribution under the terms of the framework contract.

At the same time, according to art. 237 of the Law no. 95/2006 are strictly listed curative medical services whose costs are borne by the Fund without expressly regulating these services, such as the personal contribution of the patient.”

  1. Expected changes (according to draft normative act):

“The amendments proposed by this project create the legal framework so as to ensure the personal contribution of the patients to cover the real costs of medical services, especially for the segment of continuous hospitalization, specialized ambulatory and paraclinical ambulatory. These changes are necessary because the failure to adopt immediate measures by this normative act would lead to real difficulties in the optimal functioning of the whole medical activity, with serious consequences in terms of the efficient use of public funds and the provision of quality medical care patients.”

The co-payment of medical services in hospitals was also introduced in 2013, in the term of Eugen Nicolaescu’s minister. The patients then paid between 5 and 10 lei once for hospital discharge, and certain categories of patients were exempted from the co-payment of medical services.

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