HPI

Act on minimum wage claims of nurses and midwives is on the Constitutional Court. The initiative to review its constitutionality was on Monday filed by the General Prosecutor's Office. Office also wants the Court to temporarily stop the force of law. Prosecution attacks its conception, which is, according to it, not in accordance with the Constitution. Prosecution argues that in order to ensure the constitutionality protection it is necessary to take into account the fact, whether there are real conditions for enforcement of the law or not.

From October 2012 there should be 5 209 pharmaceuticals available on Slovak market. The reimbursement list will be enlarged by 107 new pharmaceuticals. Ministry of Health estimates €60 million savings in pharmaceutical policy from October 1st, 2012 to October 1st, 2013. Ministry encourages the doctors to consistently follow the rational prescription, prescribe pharmaceuticals without co-payment or with minimum co-payment.

President Ivan Gašparovič signed the amendment to the Act on Health Insurance, which introduces the new mechanism of risk-adjusted premium redistribution. This step should bring additional almost €30 million annualy to state Všeobecná zdravotná poisťovňa (General Health Insurance Company). This will be paid by the private insurance companies Dôvera (almost €22 million) and Union (€8.7 million). New re-distribution scheme will enter into force in July. 

Patients may have to pay out of pocket for the treatment in the outpatient clinics. Všeobecná zdravotná poisťovňa (VšZP, General Health Insurance Company) and insurance company Union were not able to make an agreement with doctors on new contracts from July 1st. VšZP offers 6.5% increase of monthly payments to general practitioners and 5% to specialists, while doctors are asking for 20%. Insurance companies claim that requirements of doctors do not meet their resources.

Health insurance companies will refund to policyholders more co-payments for pharmaceuticals than before. This is the result of the extension of so called "protection limit on co-payments for pharmaceuticals". For first quarter the health insurance companies will refund the co-payments in amount of € 1.4 million to 64 043 policyholders. About two thirds of them are retired, the rest are handicapped. In last quarter of 2011 the amount of €87 592 was refunded to 5 834 people. 

According to the common statement of private physicians the prices, which were offered by the health insurance companies, are not acceptable for health care providers. Costs of private outpatient clinics, which arose also by increasing of salaries of nurses and doctors, are not included in the proposals of new contracts with Všeobecná zdravotná poisťovňa (General Health Insurance Company) and private insurance company Union. The representatives of Slovak Medical Chamber and civic association of private physicians Zdravita will meet on Monday June 25th and will agree on further proceeding. 

The intention of Všeobecná zdravotná poisťovňa (VšZP, General Health Insurance Company) to reduce the costs of hospitals on pharmaceuticals and medical devices has failed. Hospitals are spending even more. This results from the analysis of the costs of hospitals made by VšZP. During February and March hospitals should have reduced their average monthly costs on pharmaceuticals, dietary supplements and medical devices by 7%. Based on this VšZP increased from February the amount of finances for discharges, specially paid health services and outpatient care. Hospitals, however, failed to meet their commitment.

Health insurance companies will make an annual accounting also for policyholders, who are expected to have overpayment. Act, withal, does not require this from insurance companies. Všeobecná zdravotná poisťovňa (General Health Insurance Company) despite the fact that the act on health insurance does not consider these groups, will make an annual accounting also in the cases, when health insurance company does not have to, but may make an annual accounting because it will result in overpayment. Insurance companies Dôvera and Union will proceed similarly.  

Concept of terminal network of hospitals will be renewed from October. Amendment to the Act on Health Insurance was approved by the Parliament. Terminal network of hospitals will contains those institutions that are of strategic importance for state. Health insurance companies will be required to conclude the contracts with them. This concept was cancelled by former Government because such approach arguably led to the market deformations by favoring of selected (state-owned) health care institutions.

Ministry of Health is planning the changes in operation of night emergency services and allegedly considers also the time limit. Primary care doctors are asking for reduction of their night duty to 10 pm. According to the spokeswoman of the Ministry of Health Zuzana Čižmáriková the Ministry is aware of the problems with night emergencies. Doctors require also the establishment of basic rules for first aid medical services. According to them there is an absence of arrangements of relationships between providers and physicians.