The Minister of Health signed a new important order to regulate the conditions for the provision of medical assistance, medicines and medical devices within the social health insurance system for the years 2021-2022, implementing a series of changes aimed at improving the system for all Romanians.
The Minister of Health decided that the articles below should be modified by this order that he signed, and we are talking about a series of measures that will be applied throughout the country starting from this moment, and this is because the application of the provisions of the order is already mandatory from when it was published in the Official Gazette.
"Prove that for at least one norm per day - 7 hours - the schedule of the treatment base/workplace is covered by a doctor/physicians specializing in physical medicine and rehabilitation who carry out their profession in a legal form at the treatment base /point of work, with the exception of localities/areas lacking in the specialty of physical medicine and rehabilitation, for which the program of the provider/point of work may be less than 7 hours/day, respectively less than 35 hours per week, and less 5 days a week, program covered by doctor/doctors specializing in physical medicine and rehabilitation.
In annex no. 12 article 8, letter e) is amended and will have the following content:
e) to comply with the work schedule and to communicate it to the health insurance companies, based on a form whose model is provided in the rules, schedule assumed by the contract concluded with the health insurance company, with the obligation that for at least one rule per day – 7 hours – the schedule of the provider/workplace must be covered by a doctor/physicians with the specialty of physical medicine and rehabilitation who carry out their profession in a legal form at the respective provider/workplace.
With the exception of localities/areas lacking in the field of physical medicine and rehabilitation, for which the schedule of the respective provider/point of work may be less than 7 hours/day, respectively less than 35 hours per week, and less than 5 days per week , program covered by doctor/physicians specializing in physical medicine and rehabilitation; the working schedule can be changed by means of an addendum to the contract concluded with the health insurance company.
In annex no. 37 article 7, letter g) is amended and will have the following content: g) to draw up and present/transmit to the health insurance companies the necessary documents, in order to settle the medicines with and without personal contribution in outpatient treatment, according to and under the established conditions by Order of the Minister of Health and the President of the National Health Insurance House no. 1.068/627/2021 regarding the approval of the Methodological Norms for the application in 2021 of Government Decision no. 696/2021 for the approval of the service packages and the framework contract that regulates the conditions for the provision of medical assistance, medicines and medical devices within the social health insurance system for the years 2021-2022, with subsequent amendments and additions.
The data in the necessary documents presented/transmitted to the health insurance companies for the purpose of settlement must be correct and complete and correspond to the data related to the consumption of drugs with and without personal contribution in the ambulatory reported in the SIUI; with regard to medicines for which cost-volume-result contracts are concluded, the data in the necessary documents presented/transmitted to the health insurance companies for settlement must be correct and complete and correspond to the data related to the consumption of medicines reported in the IT platform from social health insurance."
