Healthcare: new charges for consultations and tests to come into effect in September

From 21 September, the new rates for the reimbursement of services provided by healthcare facilities on behalf of the National Health Service will come into effect: the update covers 448 specialist outpatient services (ranging from consultations to diagnostic tests) and 222 codes out of a total of 1,063 in the nomenclature for bespoke prosthetic care, specifically aids for people with disabilities. The decree – approved yesterday at the State-Regions Conference – had been long awaited and replaces the one dated 25 November 2024, which had been annulled by rulings of the Lazio Regional Administrative Court following a flood of appeals from accredited private healthcare facilities. At the time, the administrative judges had rejected the Ministry of Health’s calculations for reimbursement rates, deeming them outdated and insufficient – particularly, for example, regarding reimbursements for initial specialist consultations. These will now be subject to an average rate set at 26 euros, with higher rates for certain specialities, but the average increases – which stand at around 5.8 per cent – apply to many other specialist services such as colour Doppler ultrasound, vascular diagnostics, nuclear medicine, endoscopy and electromyography, as well as to devices such as spinal orthoses, limb prostheses and visual aids.

Once fully implemented, the tariff review will cost an additional 210.7 million per year – on top of the approximately 550 million that had already been earmarked to fund the 2024 decree – and they will be able to draw on the funds allocated in the latest budget, which set aside 100 million for this year and 183 million for 2027 specifically to enable the fee schedule to be revised upwards. However, the revision does not satisfy all private operators: in recent days, the UAP (National Union of Clinics, Medical Centres, Private Healthcare Organisations and Hospitals) had already spoken of a revision involving unsustainable tariffs, arguing that with these amounts ‘services are reduced, waiting times are lengthened and the entire National Health Service is weakened’.

Yesterday, at the State-Regions Conference, the decree allocating funds for the purchase of equipment to manage patients in the more than 1,200 new community care homes was also approved. The allocation of 235 million stems from a previous 2022 allocation intended for GPs and paediatricians to equip themselves with basic diagnostic tools (ECGs, spirometers, etc.), which can now be purchased using up to 50 per cent of the resources earmarked for the new local healthcare facilities funded with 2 billion from the National Recovery and Resilience Plan (PNRR). The regions must submit, within 90 days of the decree coming into force, a requirements plan for the use of the funds to be allocated to equipment; a portion of the funds must, in any case, be set aside to equip the practices of general practitioners and paediatricians, or group medical practices, located in inland areas, on small islands or in urban outskirts with diagnostic equipment: ‘The aim is to promote the widespread availability of primary diagnostic services and greater equity of access to care where the geographical and topographical features of the territory or demographic characteristics make this most necessary,’ states a note from the Regions.

Finally, also yesterday, an agreement was reached on the training requirements for medical staff for 2026/2027, which will enable the Ministry of Universities and Research to plan next year’s intake for degree courses based on regional guidelines. Specifically, to meet the needs of the National Health Service, 20,842 doctors and 25,479 nurses are required. The regions and autonomous provinces have identified the number of professionals required for each specialist category through a planning process carried out in collaboration with the Ministry of Health and the national federations of professional bodies. The planning also includes, amongst others, 1,599 dentists and 1,733 veterinary surgeons, 1,500 pharmacists, 2,673 biologists, 469 chemists and 287 physicists.

Meanwhile, Health Minister Orazio Schillaci has confirmed that, ahead of the Budget Bill – with a meeting due to take place in the coming days with his counterpart at the Ministry of the Economy, Giancarlo Giorgetti – “the first request will be to increase staffing levels and improve pay for those working in our National Health Service”.