The Supreme Medical Council adopted a resolution on Friday that from January 1, all doctors and dentists will only issue full-paid prescriptions, also for drugs reimbursed by the National Health Fund – said Maciej Hamankiewicz, President of the NRL.
A meeting on this matter was held on Friday at the headquarters of the NRL with the participation of, among others representatives of the Ministry of Health, the Ombudsman, the Patient Rights Ombudsman, the National Health Fund, the parliamentary health committee, trade unions, incl. OZZL.
Doctors will not define patients’ entitlements to reimbursed drugs and will not enter fees. On the prescription, however, they will annotate: Drug reimbursement to be decided by the National Health Fund – said Hamankiewicz after the meeting. He added that the revocation of this provision of the NRL may only result in a change in the provisions of the Reimbursement Act. It is about the provisions on punishing doctors for prescribing prescriptions for drugs financed by the National Health Fund to unauthorized persons.
We are guided by the idea that the doctor should treat people, give medical advice not burdened with administrative tasks. These steps must be taken by an official of the National Health Fund, who cannot mock himself by handing over his competences to a doctor who does not have the tools to do so. There is no certain insurance document in Poland, said Hamankiewicz.
According to him, representatives of state authorities present at the meeting admitted that the doctors’ comments were justified and announced that they would do anything to change this very bad law. MEPs from the health committee assured us that in this situation they would urgently try to amend this (reimbursement) act – he added.
Artur Fałek, the director of the Medicines Policy Department of the Ministry of Health, told journalists that the Ministry of Health was working on a regulation on prescriptions. drug reimbursement. When asked whether the Ministry of Health would delay the entry into force of the provisions of the Reimbursement Act, he replied that the ministry did not have such a possibility. He assured that after the new year the drugs would be reimbursed, but he did not want to present details of solutions that would take into account the doctors’ announcement that no reimbursement would be issued on prescriptions.
When asked about the agreement concluded by the NRL with the Ministry of Health in October, the President of the NRL emphasized that it concerned problems that could be solved beyond the statutory changes, including punish doctors for writing prescriptions for themselves and their families. This problem was solved because the president of the National Health Fund announced that he would be developing the rules for the control of doctors by the National Health Fund, and this is being implemented – explained the president of the NRL. We also agreed that the president of the National Health Fund would not define the model of the contract without the approval of the NRL. The draft of this contract has been sent to us, we have set up a team to work on it – he added. As he noted, the basic problem that the doctor has to perform administrative tasks remains.
At the end of October, during a meeting of doctors with the then Minister of Health, Ewa Kopacz, it was established, among others, that the National Health Fund together with the NRL would develop a model agreement to be signed by doctors issuing prescriptions for reimbursed drugs.
On the other hand, Krzysztof Bukiel from the Healthcare Center for Healthcare (HRD) argued after Friday’s meeting that from January a patient who receives a prescription for reimbursement to the decision of the National Health Fund, will be able to apply for a refund to the NHF department. According to him, also in the pharmacy, on the basis of an insurance document, the drug will be dispensed with the reimbursement due to the patient.
NFZ spokesman Andrzej Troszyński said in an interview with PAP that the National Health Fund does not determine which drugs are reimbursed, this is due to the reimbursement lists, and the refusal to write a prescription for a reimbursed drug is inconsistent with the medical ethics code. Patients are required to show proof of insurance at registration, if they fail to do so, the visit is payable – he added.
In the resolutions adopted on Friday, the NRL called on all doctors not to sign new contracts for the issuance of reimbursed prescriptions until the NRL accepts the model of such an agreement.
The NRL also recommended hospitals, clinics and medical practices to refrain from signing contracts for the provision of healthcare services with the National Health Fund for 2012 and the following years, if an integral part of these contracts is the obligation to issue reimbursed prescriptions under the terms of the new reimbursement act.
The NRL also asked the Ombudsman to submit a request to the Constitutional Tribunal to review the constitutionality of the Reimbursement Act. Such an application was submitted by OZZL to the Constitutional Tribunal on Thursday.
The Council demands that the regulations be changed in such a way that the patient’s entitlement to a reimbursed drug is checked by the National Health Fund, while doctors would only be concerned with indicating what drug the patient needs on the prescription. The NRL also wants to abolish the penalty for reimbursing an “undue” refund.
The outrage of the medical community is caused by the fact that issuing prescriptions to an unauthorized person is to result in the imposition of contractual penalties and the obligation to return the refund amount. Doctors are also opposed to the rules on new prescription formulas. According to the draft regulation of the Ministry of Health, they are to apply from January. The prescriptions will include, among others information on the amount of payment for drugs; so far there has been no such data on them.
The Ministry of Health emphasizes that prescribers are obliged to check whether the patient has a document confirming the right to reimbursement of drugs.
The right to issue reimbursed prescriptions is available to doctors who have concluded contracts directly with the National Health Fund or are employed in facilities that have signed such a contract. The Reimbursement Act lists the cases where the physician is obliged to return the amount of the undue reimbursement with interest. It is about issuing a prescription that is unjustified for medical reasons or inconsistent with the patient’s entitlements, inconsistent with the list of reimbursed drugs, or if the prescription is issued in a place not specified in the contract.