Renal replacement therapy in new legislative conditions

Abstract

New normative documents of Government, Health care Ministry and Federal Fund for compulsory health insurance issued in December 2015 substantially change the conditions for the medical aid administering - particularly - in the field of renal replacement therapy. The potential consequences and necessary actions are discussed. New lists of Diagnosis-Related Groups were set up separately for in-patient and day hospital condition of medical care render. New section of established recommendation describes the payment for outpatient medical care. Dialysis sessions can be reimbursed as the unit of healthcare in condition of hospital (day hospital) admittance or in outpatient condition. The necessary medicinal therapy of CKD G5D syndromes can be reimbursed within the framework of DRG 40 (DRG 41) which provides one month patient management or be provided by budgetary funded system of Supplementary Drug Providing, accordingly. The different recommended tariffs for hemodiafiltration, automated peritoneal dialysis, prolonged renal replacement therapy and others were established; the prices sould not depend on condition of healthcare render. The DRG 112 (for inpatient condition) and DRG 42 were established for dialysis access placement. The coefficients of relative expenditure capacity were changed substantially for all DRG.