(i) Ordinance 19/2026/1 of 20 January
Ordinance 19/2026/1 has been published, introducing the second amendment to Ordinance 302/2024/1 of 25 November, which regulates the procedure applicable to the establishment of Model C Family Health Units (“USF”), i.e. primary healthcare units whose management is entrusted to private, social or cooperative entities, under contracts entered into with the National Health Service (“SNS”), preceded by specific pre-contractual procedures.
In particular, the amendment concerns paragraph 1 of Article 6, which now expressly provides that the submission of applications to the tender procedure is carried out directly on the electronic platform used by the contracting authority, through a specific form.
Likewise, paragraph 4 of the same Article 6 is repealed, eliminating the requirement that applications be submitted to the awarding Local Health Unit through the BASE portal, a requirement which had proven excessively restrictive considering the diversity of electronic platforms adopted by SNS entities.
These amendments aim to introduce greater procedural flexibility, allowing the accommodation of the various technological solutions adopted by contracting authorities, without modifying the substantive framework governing the contracting of Model C USFs.
The Ordinance produces effects on the day following its publication, namely on 21 January 2026.
Ordinance 19/2026/1 can be consulted here: Ordinance 19/2026/1 of 20 January | DR
(ii) Ordinance 20/2026/1 of 20 January
Ordinance 20/2026/1 has been published, introducing the second amendment to Ordinance 38-A/2023 of 2 February, which establishes an exceptional regime of inter-institutional coordination intended to frame the referral, temporary and transitional accommodation, and monitoring of persons who, after clinical discharge, remain hospitalised in National Health Service hospitals for reasons of a social nature, without meeting the criteria for referral to a continuing care unit.
In summary, this instrument represents a significant change in the response model to situations of delayed discharge for social reasons, strengthening centralised governance, restricting exceptional solutions and formally integrating intermediate units into the SNS.
Specifically, Article 1 is amended now providing that referral should prioritise return to the home, with adequate social support, or, where this is not possible, placement in an appropriate permanent social solution, and that intermediate units and intermediate beds constitute subsidiary and transitional accommodation solutions.
In turn, the referral of people in these circumstances is now the result of a joint assessment carried out by the Social Security Institute, I.P. (“ISS”), the Executive Directorate of the SNS and the social services of the hospital in question. In the absence of a permanent vacancy, referral to an intermediate unit or intermediate bed is admissible on a transitional basis, with priority given to the transition to home care.
Following the amendment to Article 5, vacancies in social solutions are to be made available through cooperation instruments. It is further clarified that recourse to vacancies in the private sector is only admissible where vacancies contracted with the social sector have been exhausted and no vacancy is available in an intermediate unit.
Articles 6 and 7 are also amended, now providing that the financial contribution of the ISS is based on the actual average cost of Residential Structures for Elderly Persons (“ERPI”) and that the financing of intermediate units or intermediate beds is to be tripartite, involving Social Security, the family contribution of the beneficiary of the vacancy and, as regards any additional healthcare that may be required, the SNS, with the respective financial responsibilities of each funding source being expressly distinguished.
It is now provided that the stay in an intermediate unit or intermediate bed may not exceed a maximum of six (6) months, exceptionally renewable for a further six (6) months, subject to mandatory reassessment with a view to integration into a more appropriate permanent social solution.
Finally, the following provisions are added:
- Article 5-A, which establishes a prohibition on the conclusion or renewal of direct contracts between hospitals, Local Health Units and entities from the private or social entities for the provision of care, with only exceptional authorisation being permitted;
- Article 5-B and the respective Annex, which specify the concept of intermediate units and intermediate beds, establishing structural, functional and organisational requirements, imposing prior authorisation by the ISS for their operation and regulating the form of their contracting;
- Article 7-A, which applies the SNS Partner Point Regime (Ordinance 322-B/2024 of 10 December) to intermediate units and intermediate beds.
The Ordinance enters into force on the day following its publication, namely 21 January 2026.
Ordinance 20/2026/1 can be consulted here: Ordinance 20/2026/1 of 20 January | DR
