Amendment of the Reimbursement Law. What is changing this year?
Since last year, subsequent regulatory changes introduced by the Act Amending the Reimbursement of Medicines, Foodstuffs for Particular Nutritional Uses and Medical Products Act and certain other acts of August 17, 2023, have gradually come into force. With the new year, more new regulations came into force. Selected two changes are presented below.
Public pharmacies on duty
As of January 1, 2024, the rules on pharmacy duty have changed (this regulation does not apply to limited-service pharmacies). The previously unpaid duties were replaced by paid duties, which will be financed either from the poviat’s budget (applies to pharmacies run in cities being the seats of a poviat having more than 40,000 inhabitants) or by the National Health Fund (applies to pharmacies run in cities being the seats of a poviat and not having more than 40,000 inhabitants). The National Health Fund will pay only for the shifts scheduled under the definitions introduced into the Pharmaceutical Law Act of September 6, 2001, according to it:
- Duty on a holiday—is a duty performed by a public pharmacy on a Sunday or a holiday without a break for 4 consecutive hours between 10.00 AM. and 6.00 PM.
- Night duty—is a duty performed by a public pharmacy for 2 consecutive hours without a break between 7.00 PM. and 11 PM.
Duties performed at hours other than those specified in the Act, of course if adopted by the poviat’s board or the president of a city with poviat’s rights, shall be paid form the poviat’s budget.
How will the shifts be scheduled?
The schedules of pharmacies on duty will be prepared based on the working schedules of pharmacies reported to poviat’s authorities or a city’s president. According to them, the poviat shall identify the areas where patients’ access to medicines at special times is insufficient and will designate pharmacies on duty. To implement this assumption, pharmacy operators are obliged to present the schedules of working hours of their pharmacies for a given year by January 31, 2024, and in subsequent years this obligation will have to be fulfilled by the end of September. Changes to these schedules must also be notified at least 30 days in advance.
Hence, in a case when the work of retail pharmacies, in a poviat whose seat is a city with a population of no more than 40,000 inhabitants, according to their working hours, does not guarantee the satisfaction of the population’s needs in terms of access to medicines at night or o holidays, the poviat board will appoint, through a resolution (and the city president by an ordinance), a generally accessible pharmacy to be on duty. The resolution is issued for a period of one calendar year and specifies the days and hours of duty for a retail pharmacy run by a specific entrepreneur.
Poviat’s board (city’s president) shall inform entities running retail pharmacies at least 21 days before the day of the issuance of the resolution on the need to designate a generally accessible pharmacy to perform night duties on holidays, specifying the days and hours on which these duties are to be performed. In response, the pharmacy operator may report readiness to be on duty on the days and hours indicated by it, consistent with the days and hours specified in the information in question, within 7 days from the date of its receipt. To improve communication between the district and pharmacies, the legislator introduced an electronic form for correspondence.
The reasons for the change
The legislator explains the change as a need to encourage pharmacies to be on duty, especially in smaller towns, to improve the availability of pharmacy products at special times. The legislator wants to improve the profitability of providing on-duty services, especially in less populated areas, and thus encourage pharmacies to perform duties. It is unlikely that the change will tremendously increase the profitability, as per hour the pharmacy will receive 3.5% of the minimum wage, i.e. in the period from January 1, 2024, it will be 148.47 PLN and from July 1, 2024, 150.50 PLN. This remuneration will be paid within 15 days of the authority receiving from the pharmacy a summary of on-duty hours performed in each settlement period.
What will be to consequences for not fulfilling the agreed duty? If a pharmacy was not on duty or performed it for a period shorter than designated, the entity running the pharmacy is obliged to return the lump sum remuneration received so far, with statutory interests for dealt, within 14 days from the date of receipt of the payment request.
The system will calculate the amount of medicine used by the patient for more than 120 days
As of August 18, 2023, a provision has been in force stating that in the case of an electronic prescription, the patient from the date of filling the prescription, may receive the maximum amount of a medical product (foodstuff for particular nutritional purposes or medical product) necessary for the patient for 120 days of use calculated based on dosage method specified in the prescription. A regulation has been introduced that if the prescription specifies an amount greater than for 120 days of use, the patient may receive the next amount of the medicinal product (foodstuff for particular nutritional uses or a medical product) necessary for the next 120-day period of use after 3/4 of the period for which the prescription was filled.
Following the provisions above, from March 1, 2024, a provision will enter into force regulating the calculation of the amount of a medicinal product (foodstuff for particular nutritional uses or medical products) intended for distribution to a patient for a period longer than 120 days is performed by the IT system referred to in Article 7 section 1 of The Health Care information System Act of April 28, 2011, i.e. Electronic Platform for the Collection, Analysis and Sharing of Digital Resources about Medical Events (in Polish: Elektroniczna Platforma Gromadzenia, Analizy i Udostępnienia Zasobów Cyfrowych o Zdarzeniach Medycznych).