From heterologous fertilization to new vaccines, from rare diseases to endometriosis, from new prosthetic aids to autism. The new Essential Levels of Assistance have been in force since last Saturday, with the publication in the Official Gazette, which profoundly renew the Italian public health (16 years after the last update).
A "historic passage", as defined by the Minister of Health Beatrice Lorenzin. These are the activities, services and benefits that the National Health Service is required to provide to all citizens, free of charge or upon payment of a participation fee, with the resources collected through general taxation. The Leas will be updated annually. Here are the main novelties of the decree: – Innovates the nomenclature of outpatient specialist services, which dated back to 1996, excluding obsolete services and introducing technologically advanced services.
For example: hadrontherapy, enteroscopy with ingestible microcamera, retinal tomography (OTC); – Innovates the nomenclature of prosthetic assistance, after 18 years, introducing technologically advanced prosthetic aids and excluding obsolete ones. For example: alternative and augmentative communication tools and software, keyboards adapted for people with very serious disabilities, innovative technology prostheses and orthoses;
– Update the lists of rare, chronic and disabling diseases that qualify for exemption from the ticket. It inserts more than 110 entities, including single rare diseases and groups, and 6 new chronic diseases; – Offers new vaccines and identifies new recipients in accordance with the new National Vaccine Prevention Plan.
– Update the list of services that the NHS offers free (without a ticket) to couples and women in the preconceptional period, and in pregnancy and in the postpartum period in full accordance with the guidelines on pregnancy;
Introduces newborn screening for congenital deafness and congenital cataract. And expanded newborn screening for many inherited metabolic diseases to all newborns; – Inserts endometriosis in the list of chronic and disabling pathologies, in the moderate and severe clinical stages. Consequently, patients are recognized as having the right to benefit from certain specialist check-up services without exemption; – Transfers celiac disease from the list of rare diseases to the list of chronic diseases.
An illness certificate drawn up by a NHS specialist will be sufficient to obtain the new exemption certificate; – It implements the law n. 134 of 2015 on autism spectrum disorders, which provides for the updating of the essential levels of assistance for early diagnosis, care and individualized treatment of autism spectrum disorders; – It includes all the necessary services for medically assisted, homologous and heterologous procreation in the specialist outpatient clinic, until now provided only in hospitalization.
The new provision represents the result of a work shared between the State, the Regions and scientific societies. The 2016 Stability Law tied up 800 million euros for updating the LEAs. To guarantee continuous, systematic updating on clear rules and scientifically valid criteria of the essential levels of assistance, the National Commission for the updating of the LEAs and the promotion of appropriateness in the National Health Service was established, chaired by the Minister of health, with the participation of the Regions and the involvement of subjects with technical-scientific skills available at central and regional level.
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