They increase the procedures that the NHIF will pay for

Draft amendments to Ordinance No. 9 of 2019, which determines the package of health activities paid by the NHIF, has been submitted for public discussion. Among the main arguments for the need for it, the Acting Minister of Health, Dr. Stoicho Katsarov, points out that the package must meet the new classification system of medical procedures, which also introduces systems for coding diseases, health problems and medical procedures, as well as with the need to start actions aimed at increasing the number of organ donors.

Proposals for new activities in outpatient care

Additional study (tumor marker Human Epididymal Protein 4 – HE4). This makes it possible to make a more precise assessment of the risk of early metastases and for the early detection of malignant ovarian tumors.

A D-dimer study that gives a chance to assess the risk of thrombotic complications in various diseases, including cases of deep vein thrombosis, pulmonary embolism and complications in people with COVID-19. The examination is also important for the timely detection of blood coagulation disorders. It is able to prevent fatal complications.

Test for antibodies of the IgG class against the S-protein of the SARS-CoV-2 virus. Especially at the present moment, this allows the immune response of those who have been sick or vaccinated against COVID-19 to be followed.

A test that will detect at least 14 high-risk carcinogenic types of human papillomavirus (HPV). It must necessarily cover HPV 16 and HPV 18. There are more than a hundred types of human papillomavirus. The highest risk are precisely these 14, which can be the cause of cervical cancer. HPV 16 is at the root of nearly 60% of cervical cancers, and HPV 18 at 12%. At the same time, the disease is curable when detected in time. Changes are urgent because this type of cancer is the second most common after breast cancer.

What dental procedures am I entitled to annually?

Computed tomography and nuclear magnetic resonance also for young people under 18 years of age. It is specified here that since these highly specialized examinations are applied to the smallest after anesthesia, this is also included in the proposed package.

Diabetes

It is of great importance for one of the most common diseases in our country to be treated and its consequences to be avoided completely or delayed. This is completely achievable with the application of a suitable diet, physical activity, screening, therapy. To provide effective modern treatment means to limit diabetes, but also to reduce its complications, especially disability and death. For all this, the exceptional commitment of people with diabetes to daily control is of great importance. And since this is also achieved through training, the suggestions include:

• A new outpatient procedure related to the education and consultation of people with diabetes. They will receive additional information about their illness and treatment, they will be advised to carry out self-monitoring and control.

• A procedure is also being created for the diagnosis and treatment of people with insulin-dependent diabetes who use insulin pumps or sensors for long-term monitoring of glucose levels.

Through the new procedure classification system, medical activities are reflected in more detail and are much more precise in terms of their complexity and severity. All the activities that take place in hospitals are also specified in terms of their implementation by the different levels of the health system.

We are talking about procedures in the field of traumatology, orthopedics and surgery, which can be done both in the hospital and in the outpatient care.

Thanks to the new proposals, many of the activities can now also be carried out in outpatient care, and not, as until now, only in hospitals.

Are physiotherapy procedures regulated?

Medical criteria are being introduced for the follow-up of people with severe brain damage, where the donation coordinators in the country will be notified. In this way, the monitoring and security of patients will be standardized and improved on the one hand, and on the other, optimal conditions will be created for carrying out transplants in the country. The latter is particularly important, since the number of Bulgarians in need of a transplant is not small, but unfortunately, it is increasing, according to the data of the Ministry of Health.

The proposals related to intensive care in cases of brain damage are a real chance for the better quality of medical care, but above all for improving the conditions of transplantation in the country.

Last but not least, the inclusion of new types of research that the Fund will undertake opens up the possibility of timely diagnosis of a number of socially significant diseases.

Proposals for change rely on improvement and efficiency in all its dimensions when it comes to public health.

First of all, to define clearly the medical procedures in hospital and outpatient care.

Activities should be reported much more precisely, which is a guarantee of transparency and more effective control of hospital financing.

Presenting the project, the Ministry of Health emphasizes that its introduction does not require additional financial resources, as the costs for all new activities are actually within the budget of the NHIF.

Public consultation continues until December 19, 2021.

Milena Vasileva

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