More Patients Will Now Have Access to Incontinence Aids
Since December of last year, new rules have been in effect for the prescription of medical aids prescribed through vouchers, including aids for urine collection and voiding. The new rules are governed by the current wording of Act No. 48/1997 Coll., on Public Health Insurance, which also includes a new categorization tree (Appendix No. 3 to the Act).
Extension of Interval to 24 Hours
One of the changes concerns the methodology for determining the degree of urinary incontinence. Instead of the previous 4 hours, leakage is now assessed over 24 hours, while the amount of urine remains unchanged. The degrees of incontinence are defined as follows:
- Incontinence grade I: involuntary urine leakage of between 50 and 100 ml over 24 hours
- Incontinence grade II: involuntary urine leakage of between 100 and 200 ml (+ fecal incontinence) over 24 hours
- Incontinence grade III: involuntary urine leakage of more than 200 ml or mixed incontinence over 24 hours
Due to the extended monitoring period, it is now possible to diagnose incontinence in patients with low but still bothersome volumes of urine leakage who would not have qualified for grade I incontinence under the previous rules.
Combine According to Patient Needs
Before the amendment to the law, patients could only be prescribed one type of incontinence aid, depending on the defined grade of incontinence. Another key change now allows doctors to freely combine aids according to the individual needs of the patient. For example, pull-up pants for nighttime and absorbent pads for daytime use. However, the statutory limits must be adhered to − both financial and quantity limits.
Other Changes and News
The amendment to the law also clearly defines the competent authority, which is the State Institute for Drug Control (SÚKL). SÚKL is responsible for the categorization and pricing of aids. SÚKL publishes a list of reimbursed medical devices on the electronic official board on the 20th of each month. The codes of individual aids have also been changed and now start with the number 5. These new codes must be included along with the incontinence grade on the voucher. The prescription restrictions, validity of the vouchers, and the possibility of prescribing a voucher for up to 3 months remain unchanged.
Summary and Conclusion
Thanks to the new rules, conditions for incontinent patients have significantly improved. Many more patients can now access aids paid for by public health insurance, and the possibility of combining aids according to individual needs is undoubtedly an advantage.
(mraf)
Sources:
1. Krhut J., Zachoval R. Informational material on the prescription of medical devices for urine collection and voiding. Czech Urological Society ČLS JEP, November 18, 2019. Available at: www.cus.cz/pro-odborniky/o-spolecnosti/dulezite-informace/informacni-material-k-preskripci-zdravotnickych-prostredku-pro-sber-a-vyprazdnovani-moci
2. New rules in the Public Health Insurance Act. Seni.cz. Available at: www.prolekare.cz/media/uhradova_regulace_zdravotnickych_prostredku_predepisovanych_lekari_na_poukaz.pdf
3. Methodology for reporting reimbursements of medical devices in selected reimbursement groups − updated version. SÚKL, November 25, 2019. Available at: www.sukl.cz/sukl/metodika-ohlasovani-uhrad-zdravotnickych-prostredku-u
4. Categorization and reimbursement regulation of medical devices reimbursed by voucher. National Health Information System. Available at: www.niszp.cz/kategorizace-uhradova-regulace-zdravotnickych-prostredku-hrazenych-na-poukaz
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