Guvernul a prelungit până la sfârşitul anului măsurile privind sistemul de asigurări sociale de sănătate în contextul COVID-19

Guvernul a prelungit până la sfârşitul anului o serie de măsuri care vizează sistemul de asigurări sociale de sănătate, cu impact „pozitiv” în limitarea răspândirii noului coronavirus, precum şi acordarea tuturor persoanelor aflate pe teritoriul României şi suportarea din bugetul FNUASS a serviciilor medicale şi medicamentelor pentru tratarea cazurilor COVID-19 şi a complicaţiilor acestora.

Potrivit unui comunicat de presă al Ministerului Sănătăţii, s-a aprobat prelungirea până la data de 31 decembrie 2020 a următoarelor măsuri:

Acordarea tuturor persoanelor aflate pe teritoriul României şi suportarea din bugetul FNUASS a serviciilor medicale şi medicamentelor pentru tratarea cazurilor COVID-19 şi complicaţiilor acestora;

* contractarea de către casele de asigurări de sănătate a întregii sume alocate de Casa Naţională de Asigurări de Sănătate cu destinaţie servicii medicale spitaliceşti;

* menţinerea modalităţii de decontare lunară pentru unităţile sanitare cu paturi care furnizează servicii medicale spitaliceşti, în regim de spitalizare continuă, fără a mai fi necesară o regularizare a trimestrelor II, III şi IV;

* decontarea serviciilor medicale acordate în unităţile sanitare din asistenţa medicală primară şi ambulatoriul de specialitate clinic la nivelul activităţii efectiv realizate, dar nu mai mult de 8 consultaţii/oră/medic;

* consultaţiile medicale acordate în asistenţa medicală primară şi ambulatoriul de specialitate, inclusiv pentru unele servicii conexe necesare actului medical, pot fi acordate şi la distanţă, utilizând orice mijloace de comunicare;

* posibilitatea ca medicii de familie să prescrie pentru pacienţii cronici medicamente restricţionate din Lista cuprinzând denumirile comune internaţionale corespunzătoare medicamentelor de care beneficiază asiguraţii, cu sau fără contribuţie personală, pe bază de prescripţie medicală în sistemul de asigurări sociale de sănătate, precum şi denumirile comune internaţionale corespunzătoare medicamentelor care se acordă în cadrul programelor naţionale de sănătate, aprobată prin Hotărârea Guvernului nr. 720/2008, cu modificările şi completările ulterioare;

* decontarea la nivelul realizat a serviciilor acordate de unităţile specializate, care furnizează consultaţii de urgenţă la domiciliu şi transport sanitar neasistat, aflate în relaţie contractuală cu casele de asigurări de sănătate, în condiţiile în care acestea depăşesc nivelul contractat;

* posibilitatea suplimentării sumelor contractate cu casele de asigurări de sănătate cu furnizorii de servicii medicale paraclinice, pentru investigaţiile paraclinice efectuate în regim ambulatoriu, necesare monitorizării pacienţilor diagnosticaţi cu COVID-19 după externarea din spital;

* decontarea la nivelul realizat a serviciilor de îngrijiri medicale la domiciliu şi serviciile de îngrijiri paliative la domiciliu, în condiţiile în care acestea depăşesc nivelul contractat;

* decontarea serviciilor medicale acordate de sanatoriile/secţiile sanatoriale din spitale, care desfăşoară activitate, la nivelul indicatorilor realizaţi în limita valorii de contract, dacă se acoperă cheltuielile efectiv realizate sau, după caz, la nivelul cheltuielilor efectiv realizate, în limita valorii de contract, în situaţia în care valoarea indicatorilor realizaţi este mai mică sau egală cu nivelul cheltuielilor efectiv realizate, fără a mai fi necesară o regularizare a trimestrelor II, III şi IV;

* menţinerea valabilităţii biletelor de trimitere pentru specialităţi clinice, inclusiv cele pentru specialitatea medicină fizică şi de reabilitare, biletelor de trimitere pentru specialităţi paraclinice, recomandărilor medicale pentru dispozitive medicale, tehnologii şi dispozitive asistive, precum şi a deciziilor de aprobare pentru procurarea dispozitivelor medicale, tehnologiilor şi dispozitivelor asistive, al căror termen de valabilitate expiră până la data de 31 decembrie 2020

În ceea ce priveşte acordarea certificatelor şi indemnizaţiilor de concedii medicale în cadrul sistemului de asigurări sociale de sănătate, prin actul normativ s-a aprobat menţinerea alocării în bugetul Fondului naţional unic de asigurări sociale de sănătate a sumelor suplimentare pentru decontarea cu prioritate a concediilor medicale acordate persoanelor pentru care s-a instituit măsura de carantină sau izolare, potrivit dispoziţiilor Legii nr. 136/2020 privind instituirea unor măsuri în domeniul sănătăţii publice în situaţii de risc epidemiologic şi biologic.

„Totodată, se impune şi menţinerea aplicabilităţii măsurilor instituite de către puterea legislativă prin Legea nr. 179/2020, respectiv: obligaţia caselor de asigurări de sănătate de a deconta serviciile medicale acordate de unităţile sanitare care derulează programe naţionale de sănătate curative la nivelul realizat, prin acte adiţionale de suplimentare a sumelor contractate, după încheierea lunii în care serviciile au fost acordate, inclusiv dacă a fost depăşit nivelul contractat; posibilitatea suplimentării sumelor contractate cu casele de asigurări de sănătate pentru investigaţiile paraclinice şi de imagistică medicală efectuate în regim ambulatoriu, necesare monitorizării pacienţilor diagnosticaţi cu COVID-19 după externarea din spital şi pentru care furnizorii de servicii medicale paraclinice au evidenţe distincte, precum şi a pacienţilor diagnosticaţi cu boli oncologice, diabet, afecţiuni rare, boli cardiovasculare, boli cerebrovasculare, boli neurologice, după încheierea lunii în care au fost acordate investigaţiile paraclinice, prin acte adiţionale”, se arată în comunicat.

Alte prevederi se referă la: alocarea de sume suplimentare în bugetul Fondului naţional unic de asigurări sociale de sănătate pentru decontarea programelor de sănătate curative, precum şi a investigaţiilor paraclinice, inclusiv de imagistică medicală menţionate mai sus, la nivelul realizat; decontarea serviciilor de dializă precum şi regularizarea trimestrială a acestora, din sumele suplimentare alocate în bugetul Fondului naţional unic de asigurări sociale de sănătate cu această destinaţie, se vor efectua ţinând cont de prevederile art. 6 alin. (1) din Legea nr. 500/2002 privind finanţele publice, cu modificările şi completările ulterioare”, se mai arată în comunicat. 

Sursa: Realitatea de Realitatea Medicala

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