Die neue Heilmittelrichtlinie, die ab dem Jahr 2021 in Kraft tritt, bringt eine Reihe von VerĂ€nderungen mit sich. So werden beispielsweise die Anforderungen an die Verordnung von Heilmitteln angepasst und die Dokumentationspflichten fĂŒr Therapeuten verschĂ€rft. Auch die Regelungen zur Zulassung von neuen Heilmitteln werden ĂŒberarbeitet. Doch was genau Ă€ndert sich mit der neuen Heilmittelrichtlinie im Detail?
Die neue Heilmittelrichtlinie - welche Ănderungen gibt es 2021?
Hi and welcome to our “Ask the Expert” interview series, where we speak with experts about current topics in the healthcare industry. My name is Joyce from Praxis-Profi and I’m in charge of the social media department. We’ve noticed through your comments that there are still many uncertainties and questions about the “New Heilmittelverordnung” (new healthcare ordinance) that came into effect on January 1st of this year. Therefore, we wanted to revisit the topic and provide a free information brochure for you, which I will link at the end. But we’ve also decided to conduct an interview with an expert to clarify the most important questions. So, I’ve invited Natali Kewitz to join us, please introduce yourself.
Natali: Hi, I’m Natali Kewitz and I’m a customer advisor in the healthcare sector at opta data. Besides my duties as a customer advisor, I also handle support for the electronic prescription check tool, thevea. This free tool allows the user to check the prescription’s accuracy within seconds. I also have a professional background in the healthcare industry; I’m a qualified occupational therapist and have a Bachelor’s degree in healthcare and social management.
Joyce: Great, thank you, Natali. To start, could you summarize the new changes to the “Heilmittelrichtlinie” (healthcare ordinance) for us, please?
Natali: Sure, the most visible change is the unification of various forms into one new prescription form - the Muster 13 prescription form. There are other changes as well, such as the extension of the treatment start period from 14 to 28 days. Therefore, therapists and patients have more time to schedule the treatment. The elimination of the “Regelfallsystematik” system is also a significant point. That means, there are no longer initial or follow-up prescriptions, or prescriptions outside of regular cases. Instead, there is only one prescription.
Further changes include the consolidation of diagnosis groups from 22 to 13, and more leeway for therapists, such as not every amendment needing a physician’s stamp. The new changes provide several advantages for therapists and physicians.
Joyce: That sounds great. As a healthcare provider, I know that insurance companies will only reimburse the cost of treatment if prescriptions and forms are correctly filled and submitted. What should I look out for as a healthcare professional?
Natali: Yes, that’s an essential point. Each therapist has an obligation to check the accuracy of each prescription before starting the treatment. Mainly, it’s crucial to ensure that the diagnosis group matches the therapeutic group, and the treatment amount is adequate. The date of issuance is also critical because that’s the date used for determining when the latest treatment can start. Wherever there might be uncertainty over a prescription, we provide a useful tool called the eVO-Check, which can be used to validate the prescription’s accuracy. The app checks whether the prescription has been correctly issued and notifies appropriately.
ICD-10 codes’ assessment is especially essential in the event of long-term healthcare needs and special medical prescription requirements, where the most significant errors often occur. There is a lot of confusion and doubt among therapists, patients, and physicians. Therefore, opta data includes a helpful link to our brochure for more convenience.
Joyce: That’s really helpful. Could you clarify the terms “Verordnungsfall” (healthcare contract), “Ausstellungsdatum” (date of issuance), and “orientierte Behandlungsmenge” (recommended treatment frequency)?
Natali: Sure, the Verordnungsfall replaces the previous “Regelfallsystematik” system. The new form factor must relate to the illness and prescribing physician. In the past, the condition alone was only relevant.
The Ausstellungsdatum is used to assess the prescription’s time limit to begin the treatment. A patient has 28 days from the date of issuance to start treatment. The physician can indicate an imperative need for treatment with a checkmark on the prescription; in that case, the treatment must begin within 14 days.
The orientative Behandlungsmenge describes the suggested treatment frequency for each prescription. However, it is common to exceed this amount for chronic long-term medical care through additional documentation included in the patient’s file.
Joyce: Okay, thank you. As a former occupational therapist, what advantages do you see in these new regulations?
Natali: As an occupational therapist and opta data customer advisor, I believe that unifying the application forms into one format will benefit healthcare professionals, standardizing the procedure. Additionally, the longer treatment start period (28 days) provides more flexibility for scheduling treatment. Nonetheless, perhaps the most significant advantage is that doctors are no longer stuck with prescribing just one health service. Instead, in the fields of occupational therapy and physiotherapy, for example, physicians may prescribe up to three priority health services. This makes the treatment more effective by having more available treatment options to evaluate. Furthermore, prescriptions may now be adjusted more quickly, with not every amendment requiring a physician’s signature. The complete scrapping of the “Regelfallsystematik” system removes a layer of bureaucracy, reducing professional burdens, and facilitating accurate treatment.
Joyce: Thanks, Natali. Although the benefits are clear, we’ve learned that many members of the healthcare community have indicated concerns or open questions regarding these changes. Can you say more about this?
Natali: That’s true. A healthcare ordinance overhaul presents a range of challenges for all stakeholders involved. Various elements of the bundeseinheitlichen (federal regulation) for professional groups are still under review or unfinished, putting administrators in the wait-and-see position. For instance, who will sign in the performance provider field and clarify the podiatry and speech therapy national framework agreements? Also, as always when new laws and regulations are implemented, a learning curve unfolds. As a consequence, problems, uncertainties, and challenges arise that require human ingenuity to cope with.
Joyce: Great, finally, could you share your three main tips to help professionals stay on top of the new “Heilmittelverordnung”?
Natali: Well, as an experienced occupational therapist and healthcare consultant, I recommend to professionals:
âą Take sufficient care while completing the new Muster 13 prescription form, with an eye for accuracy in diagnosis groups and treatment volume.
âą Use the free eVO-check app for any doubts or uncertainties concerning prescriptions.
âą Participate in relevant webinars and educational events, such as those offered by opta data for occupational therapists, physiotherapists, speech pathologists, and podiatrists, to gain greater knowledge about the updated healthcare ordinance.
Joyce: That’s wonderful advice, thank you very much for sharing your knowledge and experience, Natali.
Natali:
source.