The new Lea rewrite the appropriateness and look to the MEF – Il Sole 24 Ore

Appropriateness, and point at the head. The new Lea – that would finally ready for bollinatura, in hours, the MEF before moving to the opinions of the parliamentary committees, the regions and the Council of Ministers – bring back the calendar to a year ago and restore, in essence, the full freedom of prescribing doctors. The Dpcm presented today at a glance to the Ministry of Health by the owner Beatrice Lorenzin and the Dg Renato Botti along with the President Fnomceo Roberta Chersevani , with articles 16:21 writes the word “end” on a page at least stormy relations between white coats and institutions. Sanctioned the separation between the concepts of deliverability and prescriptive appropriateness, “the new text – explained the president Fnom – recalls both the autonomy and responsibility in pursuing medical appropriateness. Words well in our Code, but the whole affair of Dm appropriateness allowed us, if only to exploit. “
Now it comes to communicating, and well, in individual studies: a Manifesto will remind everyone ASSISTED him that the doctor can continue to prescribe anything deemed necessary for the protection of health, according to the scientific evidence and the rules provided for by the organization of the national health Service. “The request to prescribers to place suspected diagnosis in the request for an examination – continues Chersevani – always sticks in a perspective of communication to improve the dialogue between professionals, useful to promote sustainability and protection of the citizen.” And the “notes” that have so angered doctors? They will remain limited, guarantee by the Ministry, to very few situations, such as genomic tests. The rest have been identified, as stated in the new Illustrative Relations Lea, ‘indications of prescriptive appropriateness, for which there is no obligation on the part of the doctor to affix the note at the time of prescription. “

Completely closed also chapter sanctions, which in any case had been placed on standby already last autumn. “The prescribing behavior can be verified in time – precise Chersevani” – and “how EVALUATION will be defined by the State-Regions Agreement,” Botti added. As will be contracts and agreements to fix any disciplinary repercussions on medical practices.

So far, the appropriateness. But the Dpcm at what point is? “To await the hour MEF signature that has already communicated to us an informal green light – says the Minister of Health.” Presenting Dpcm as “the living core of the Pact for health. Live – adds Lorenzin – also because this opens a breakthrough in the method: the essential levels of care, repealing the current stops to 2001, from now on will be continuously updated, thanks to the work of the National Commission Lea that will allow us to update continuously the facilities and services that are guaranteed to citizens under the national health service. “

the most important new features . Updating the prosthetic assistance nomenclature (Still to 1999) and that of the specialist outpatient (subject to early 1996). In the first case, the ministry cited the examples of new computer aids and communication, digital technology hearing aids, mobility impairments principals as stretchers for the shower, baby carriages with vertical system and artificial limbs in advanced technology. The new nomenclature of specialist outpatient provides, among the novelties, all assisted reproduction performance – coming out of the hospital – the revision of the genetic performance, the introduction of genetic counseling and the provision of high-tech as the hadron therapy or the latest technology (such as enteroscopy with ingestible miniature camera).

Renewed the list of rare diseases: they enter over 110 new diseases, including sarcoidosis, progressive systemic sclerosis, and myasthenia gravis. Performance related to rare diseases are totally exempt. It lets out from the group of rare diseases to enter that of chronic diseases (in good company with Down syndrome, and connective tissue), celiac disease: it will be sufficient certification of a specialist to get the new exemption certificate concerning titte useful performance monitoring of the disease and preventing complications and exacerbations aventuali.

Six new chronic disease-free: thalidomide syndrome, chronic osteomyelitis, chronic kidney disease, autosomal dominant polycystic kidney disease, endometriosis in clinical stages “moderate” and “serious”, COPD from “moderate” to “very serious.” Debuts the introduction of neonatal screening for sorditcongenita and congenital cataract, and is extended to all new born extended newborn screening for inherited metabolic diseases.
“How to autism – would emphasize Lorenzin – the new Cabinet Decree It implements in full the law 134/2015 “.

The Vaccines Plan in Lea . “The vaccination plan – still warns the minister – is finally included in Lea. A turning point: until now the National Plans vaccines were funded as Plan Objectives. And the offer – he continues – is particularly rich: Lea area will be provided in the anti-HPV extended even to boys, the anti pneumococcal, meningococcal anti “. The sranno sufficient funds? The ministry believe so. “We did not start from a budget to decide what to put on the basis of that amount – would like to clarify the minister. We did a lot of performance and in depth evaluation work and “rejuvenation” or the way in which first were delivered and so we planned divestment of inappropriate performance or obsolete. If instead of 800 million had an estimated impact of 1.3 billion, we would have asked for it. ” To sum it Botti: “Overall the cost grid assigns 600 million to the district – of which 380 million and 153 million to the specialist prosthetics – and 220 million to prevention, that is, to vaccines. More are considered 20 million arising from the transfer of territory to the hospital. “