Romania adopts measure advancing telemedicine, long-distance care

In response to the current pandemic, the Romanian government has adopted measures aimed at facilitating long-distance care and telemedicine.

The latest measures have been taken on 8 May 2020, when the government adopted Decision no. 369/2020 (GD 369/2020) for the amendment of Government Decision no. 252/2020 on measures in the healthcare field during the state of emergency in Romania (GD 252/2020).

We remind that GD 252/2020 had introduced a new set of measures concerning telemedicine that are applicable during the state of emergency. There measures include:

• Family doctors and specialist doctors at outpatient clinics can grant medical consultations remotely for basic services and in the minimum package of medical services by any means of communication within a maximum of eight consultations an hour.
• Since patients with symptoms suggesting coronavirus infection can greatly benefit from remote consultations, this right of care is now granted to all persons living in the territory of Romania, even if they are not insured.
• Distance consultations will be granted and settled according to the legal regulations in force applicable to medical-office consultations as provided in the service packages of primary care, and from specialised outpatient care for clinical specialties. The distance consultations provided to patients with coronavirus symptoms will be included with consultations from the package of medical-office basic services for acute and subacute diseases and chronic diseases.
• Note that remote consultations can be granted in the outpatient areas of public and private hospitals for the issuance of a medical prescription. This will not always be required (e.g. for patients with chronic diseases who are on a stable therapeutic regimen, family doctors can issue prescriptions based on the medical documents already issued to them).
• A family doctor or specialist from an outpatient unit will record the remote medical consultations in the patient’s file and in the consultation register. The record must indicate the means of communication used and the length of time of the consultation. The physician will then issue any necessary documents to the patient by electronic means.
• An insured person may send documents by electronic means to the health insurance house, which can in turn use electronic means to transmit the issued documents necessary to the insured person.
• The obligation to use the national health card and its replacement documents is suspended during the state of emergency.

GD 353/2020 introduces further measures aimed at addressing the issue of reimbursement from public funds for the price of medical care, including remote care under GD 252/2020. The deadlines of the current framework contract regulating the provision of healthcare, medicines and medical devices within the social health-insurance system for the years 2018 and 2019 respectively has now been extended until 31 December 2020.

Furthermore, relevant stakeholders and industry players are now considering a potential extension of these measures beyond the end of the state of emergency (i.e. after 15 May 2020).

The National Health Insurance House (NHIH) announced that consultations will be conducted with healthcare specialists and a draft law will be proposed on the way forward to provide medical services in order to limit the spread of the coronavirus. The NHIH stated that it will continue to recommend that each patient contact his family doctor by telephone, and that this physician will decide whether this patient can be consulted remotely, or should be summoned to the medical office or referred to another healthcare specialist.

Healthcare providers have applauded the NHIH’s announcement. According to the Healthcare Private Providers Association (PALMED), more than half of the activity of private medical units is currently performed through telemedicine via phone or video applications. Furthermore, in case of individual offices, PALMED estimates that about 80% of its activities are now carried out through telemedicine.

Like the public sector, the National Federation of Family Physician Associations (FNPMF) supports the NHIH’s announcement since it made a similar request to the Romanian Ministry of Health. In addition, the FNPMF requested that the budget be supplemented for primary healthcare within the 2020 Single National Health Insurance Fund.

It is now clear that telemedicine can improve the health and quality of life of citizens and that it benefits both patients and healthcare practitioners. It is not yet certain how telemedicine will be transposed and defined legally after the pandemic and state of emergency has concluded.

It is hoped that the Romanian Ministry of Health and the NHIH will continue their efforts to establish a functioning framework for telemedicine in Romania into the future.

For more information on this e-Alert and telemedicine in Romania, contact your regular CMS advisor or local CMS experts Valentina Parvu and Anca Elena Ion.