In a significant development, the National Institute for Health and Disability Insurance (INAMI-RIZIV) has approved a new agreement (Convention) that allows for the reimbursement of percutaneous computed tomography-guided (CT) ablation of renal, hepatic, pulmonary, and bone tumors. This agreement, set to take effect on November 1, 2024, will be valid until October 31, 2029. Specialized centers meeting certain eligibility criteria can apply to join the Convention before September 14, 2024. The list of approved centers will be made available on the INAMI/RIZIV website, providing transparency and accessibility to all interested parties.
The reimbursement will be facilitated through new pseudonomenclature codes introduced by the Convention, such as 587134-587145 for “Percutaneous ablation of one or more renal tumors under CT guidance.” The types of ablation covered under this agreement include thermoablation (laser, radiofrequency, microwave, cryoablation) and electroporation, ensuring a comprehensive approach to tumor treatment. Additionally, other pseudonomenclature codes have been introduced for anesthesiology services and multidisciplinary consultations, reflecting the holistic nature of the treatment process. The Convention specifies specific reimbursement conditions that must be fulfilled, ensuring that the procedures are performed under stringent and standardized conditions.
Enhanced Eligibility and Application Process
Eligible specialized centers must demonstrate compliance with specific criteria to apply for inclusion in the Convention. These criteria ensure that the centers possess the necessary expertise, equipment, and infrastructure to perform the procedures safely and effectively. The application process includes a thorough review of the center’s capabilities and adherence to the established guidelines. By maintaining strict eligibility standards, the INAMI-RIZIV aims to uphold high-quality care and ensure patient safety throughout the treatment process.
The introduction of reimbursement for percutaneous CT-guided ablation represents a significant advancement in the treatment options available to patients with renal, hepatic, pulmonary, and bone tumors. This minimally invasive procedure offers several advantages over traditional surgical methods, including reduced recovery times and fewer complications, thereby enhancing patient outcomes. By enabling reimbursement for these procedures, the INAMI-RIZIV is making these advanced treatments more accessible to patients across Belgium. This move is expected to improve the quality of care for patients with tumors and provide a more cost-effective treatment option for the healthcare system.
Monitoring and Compliance
The new agreement underscores the importance of continuous improvement and innovation in the healthcare sector. Specialized centers that join the Convention will be monitored to ensure compliance with the specified conditions, maintaining high standards of care. The INAMI-RIZIV will periodically review the outcomes and effectiveness of the reimbursed procedures to ensure they meet the desired health outcomes and provide value for money. This monitoring process includes regular audits, performance evaluations, and feedback mechanisms to address any issues promptly.
This initiative is part of a broader effort to integrate advanced medical technologies into standard care practices, reflecting a commitment to adopting evidence-based treatments that can significantly benefit patients. The reimbursement framework established by the Convention sets a precedent for future agreements, encouraging the adoption of innovative treatments that can enhance patient care. As technology and medical practices continue to evolve, the INAMI-RIZIV remains dedicated to updating and refining the guidelines to ensure they reflect the latest advancements in the field.
Resource: Mtrconsult, July 23, 2024
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