Raportul privind mobilitatea pacientului / HEALTHCARE SUBJECT TO PRIOR AUTHORISATION 2023.xlsx

Healthcare subject to PA L1 HEALTHCARE SUBJECT TO PRIOR AUTHORISATION L2 "The questions in this section relate to healthcare subject to prior authorisation. The questions are divided into two subsections: 3.1 Requests for prior authorisation 3.2 Requests for reimbursement If no distinction can be made between Directive 2011/24/EU and the Social Security Coordination Regulations (Regulation (EC) No 883/2004 and Regulation (EC) No 987/2009), please provide additional information in section 5 or in a separate note explaining exactly which elements are affected and why. Please pay specific attention in relation to the number of received, authorised, or refused requests for prior authorisation, as well as the amount reimbursed. " Please try to leave no empty cells L3 Use NA when the data is not available L4 Use 0 if the data equals to zero L9 Please indicate whether or not you have implemented a system of prior authorisation L14 If a system of prior authorisation is no longer in place, if the system was changed, or if a system of prior authorisation was introduced, please provide this information in section 5 or in a separate note. L17 3.1 Requests for prior authorisation L19 a) How can a request for prior authorisation be made (in person, post, e-mail, online, other means)? L20 • A vertical scroll bar will appear to enable you to scroll down if the text inserted is longer than the size of the textbox. L21 "=IF([1]Answers!D61,[1]Answers!E64,"""") [valoare memorată: ]" L23 L24 b) Number of requests for prior authorisation *Alt+Enter to new line … L25 Please provide the number of requests received (excluding withdrawn/inadmissible requests), authorised (regardless of the year of receipt) and refused (regardless of the year of receipt) in 2023. The number of withdrawn/inadmissible requests is not requested anymore due to low data quality in previous years. Be aware that the sum of the number of authorised and refused requests can but does not have to equal the number of received requests, as some requests are received later in the year and are not processed until the following year. The number of authorised and refused requests may also relate to requests received in the previous year. L28 Number of received requests 2 "=IF(OR(OR(AND(ISNUMBER(D28),D28>=0),D28=""NA""),ISBLANK(D28)),"""",[1]Answers!E64) [valoare memorată: ]" L29 Number of authorised requests 0 "=IF(OR(OR(AND(ISNUMBER(D29),D29>=0),D29=""NA""),ISBLANK(D29)),"""",[1]Answers!E65) [valoare memorată: ]" L30 Number of refused requests 2 "=IF(OR(OR(AND(ISNUMBER(D30),D30>=0),D30=""NA""),ISBLANK(D30)),"""",[1]Answers!E66) [valoare memorată: ]" L32 c) Processing times L33 Please respond to the questions below relating to your processing times (in working days) in 2023. Please specify if the amount reported below is not working days. In addition, please provide in section 5 or in a separate note information about events that have increased the processing times and/or steps taken to reduce the processing times, such as the introduction of electronic applications to speed up the processing procedures. L35 Average processing time L36 Please provide the average time (in working days) for processing requests for prior authorisation in 2023. L37 69.5 "=IF(OR(OR(AND(ISNUMBER(B37),B37>=0),B37=""NA""),ISBLANK(B37)),"""",[1]Answers!E67) [valoare memorată: ]" L39 Maximum time limit L40 Please provide the maximum time limit (in working days) allowed according to your national legislation (specifically related to cross-border healthcare or as part of the general administrative legislation) for processing requests for prior authorisation. Please specify if the unit specified in your legislation and reported below is not working days. In addition, please specify if the maximum time limit is related specifically to cross-border healthcare or if it is part of the general administrative legislation. L43 Time limit Legislation L44 5 L45 "=IF(OR(OR(AND(ISNUMBER(B44),B44>=0),B44=""NA""),ISBLANK(B44)),"""",[1]Answers!E68) [valoare memorată: ]" L46 d) Authorised requests for prior authorisation by type of healthcare L47 Please provide the number of authorised requests for prior authorisation by type of healthcare. The boxes for providing your reply are automatically marked red if the total number of authorisations does not correspond to the figure provided under section 3.1 b). Please mention in the text box to the right if more than one reason is indicated in relation to one authorised request, in which case you can ignore the boxes turning red. L49 Type of healthcare Number of requests L50 • Healthcare which is made subject to planning requirements relating to the object of ensuring sufficient and permanent access to a balanced range of high-quality treatment in the Member State concerned or to the wish to control costs and avoid, as far as possible, any waste of financial, technical and human resources and involves overnight hospital accommodation of the patient in question for at least one night (Article 8(2)(a)(i) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G50),G50>=0),G50=""NA""),ISBLANK(G50)),"""",[1]Answers!E71) [valoare memorată: ]" "=IF(SUM(G50:G54)<>D29,""The total sum does not equal the 'number of authorised requests' as inserted in Question 3.1b. Please doublecheck or provide reason in the text box"","""") [valoare memorată: ]" L51 • Healthcare which is made subject to planning requirements relating to the object of ensuring sufficient and permanent access to a balanced range of high-quality treatment in the Member State concerned or to the wish to control costs and avoid, as far as possible, any waste of financial, technical and human resources and requires use of highly specialised and cost-intensive medical infrastructure or medical equipment (Article 8(2)(a)(ii) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G51),G51>=0),G51=""NA""),ISBLANK(G51)),"""",[1]Answers!E72) [valoare memorată: ]" L52 "• Healthcare which involves treatments presenting a particular risk for the patient (Article 8(2)(b) of Directive 2011/24/EU). " 0 "=IF(OR(OR(AND(ISNUMBER(G52),G52>=0),G52=""NA""),ISBLANK(G52)),"""",[1]Answers!E73) [valoare memorată: ]" L53 • Healthcare which involves treatments presenting a particular risk for the population (Article 8(2)(b) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G53),G53>=0),G53=""NA""),ISBLANK(G53)),"""",[1]Answers!E74) [valoare memorată: ]" L54 • Healthcare which is provided by a healthcare provider that, on a case-by-case basis, could give rise to serious and specific concerns relating to the quality or safety of the care, with the exception of healthcare which is subject to Union legislation ensuring a minimum level of safety and quality throughout the Union (Article 8(2)(c) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G54),G54>=0),G54=""NA""),ISBLANK(G54)),"""",[1]Answers!E79) [valoare memorată: ]" * Additional comments only (Alt+Enter to new line ...) L56 e) Authorised requests for prior authorisation by country of treatment L57 Please provide the number of authorised requests for prior authorisation by country of treatment. The boxes for providing your reply are automatically marked red if the total number of authorisations does not correspond to the figure provided under section 3.1 b). If that is the case please provide an explanation in the text box to the right L59 Country of treatment Number of requests L60 Austria 0 "=IF(OR(OR(AND(ISNUMBER(C60),C60>=0),C60=""NA""),ISBLANK(C60)),"""",[1]Answers!E79) [valoare memorată: ]" L61 Belgium 0 "=IF(OR(OR(AND(ISNUMBER(C61),C61>=0),C61=""NA""),ISBLANK(C61)),"""",[1]Answers!E80) [valoare memorată: ]" "=IF(SUM(C60:C89)<>$D$29,""The total sum does not equal the 'number of authorised requests' as inserted in Question 3.1b. Please doublecheck or provide reason in the text box"","""") [valoare memorată: ]" L62 Bulgaria 0 "=IF(OR(OR(AND(ISNUMBER(C62),C62>=0),C62=""NA""),ISBLANK(C62)),"""",[1]Answers!E81) [valoare memorată: ]" L63 Croatia 0 "=IF(OR(OR(AND(ISNUMBER(C63),C63>=0),C63=""NA""),ISBLANK(C63)),"""",[1]Answers!E82) [valoare memorată: ]" L64 Cyprus 0 "=IF(OR(OR(AND(ISNUMBER(C64),C64>=0),C64=""NA""),ISBLANK(C64)),"""",[1]Answers!E83) [valoare memorată: ]" L65 Czechia 0 "=IF(OR(OR(AND(ISNUMBER(C65),C65>=0),C65=""NA""),ISBLANK(C65)),"""",[1]Answers!E84) [valoare memorată: ]" L66 Denmark 0 "=IF(OR(OR(AND(ISNUMBER(C66),C66>=0),C66=""NA""),ISBLANK(C66)),"""",[1]Answers!E85) [valoare memorată: ]" L67 Estonia 0 "=IF(OR(OR(AND(ISNUMBER(C67),C67>=0),C67=""NA""),ISBLANK(C67)),"""",[1]Answers!E86) [valoare memorată: ]" L68 Finland 0 "=IF(OR(OR(AND(ISNUMBER(C68),C68>=0),C68=""NA""),ISBLANK(C68)),"""",[1]Answers!E87) [valoare memorată: ]" L69 France 0 "=IF(OR(OR(AND(ISNUMBER(C69),C69>=0),C69=""NA""),ISBLANK(C69)),"""",[1]Answers!E88) [valoare memorată: ]" L70 Germany 0 "=IF(OR(OR(AND(ISNUMBER(C70),C70>=0),C70=""NA""),ISBLANK(C70)),"""",[1]Answers!E89) [valoare memorată: ]" L71 Greece 0 "=IF(OR(OR(AND(ISNUMBER(C71),C71>=0),C71=""NA""),ISBLANK(C71)),"""",[1]Answers!E90) [valoare memorată: ]" * Additional comments only (Alt+Enter to new line ...) L72 Hungary 0 "=IF(OR(OR(AND(ISNUMBER(C72),C72>=0),C72=""NA""),ISBLANK(C72)),"""",[1]Answers!E91) [valoare memorată: ]" L73 Iceland 0 "=IF(OR(OR(AND(ISNUMBER(C73),C73>=0),C73=""NA""),ISBLANK(C73)),"""",[1]Answers!E92) [valoare memorată: ]" L74 Ireland 0 "=IF(OR(OR(AND(ISNUMBER(C74),C74>=0),C74=""NA""),ISBLANK(C74)),"""",[1]Answers!E93) [valoare memorată: ]" L75 Italy 0 "=IF(OR(OR(AND(ISNUMBER(C75),C75>=0),C75=""NA""),ISBLANK(C75)),"""",[1]Answers!E94) [valoare memorată: ]" L76 Latvia 0 "=IF(OR(OR(AND(ISNUMBER(C76),C76>=0),C76=""NA""),ISBLANK(C76)),"""",[1]Answers!E95) [valoare memorată: ]" L77 Liechtenstein 0 "=IF(OR(OR(AND(ISNUMBER(C77),C77>=0),C77=""NA""),ISBLANK(C77)),"""",[1]Answers!E96) [valoare memorată: ]" L78 Lithuania 0 "=IF(OR(OR(AND(ISNUMBER(C78),C78>=0),C78=""NA""),ISBLANK(C78)),"""",[1]Answers!E97) [valoare memorată: ]" L79 Luxembourg 0 "=IF(OR(OR(AND(ISNUMBER(C79),C79>=0),C79=""NA""),ISBLANK(C79)),"""",[1]Answers!E98) [valoare memorată: ]" L80 Malta 0 "=IF(OR(OR(AND(ISNUMBER(C80),C80>=0),C80=""NA""),ISBLANK(C80)),"""",[1]Answers!E99) [valoare memorată: ]" L81 Netherlands 0 "=IF(OR(OR(AND(ISNUMBER(C81),C81>=0),C81=""NA""),ISBLANK(C81)),"""",[1]Answers!E100) [valoare memorată: ]" L82 Norway 0 "=IF(OR(OR(AND(ISNUMBER(C82),C82>=0),C82=""NA""),ISBLANK(C82)),"""",[1]Answers!E101) [valoare memorată: ]" L83 Poland 0 "=IF(OR(OR(AND(ISNUMBER(C83),C83>=0),C83=""NA""),ISBLANK(C83)),"""",[1]Answers!E102) [valoare memorată: ]" L84 Portugal 0 "=IF(OR(OR(AND(ISNUMBER(C84),C84>=0),C84=""NA""),ISBLANK(C84)),"""",[1]Answers!E103) [valoare memorată: ]" L85 Romania 0 "=IF(OR(OR(AND(ISNUMBER(C85),C85>=0),C85=""NA""),ISBLANK(C85)),"""",[1]Answers!E104) [valoare memorată: ]" L86 Slovakia 0 "=IF(OR(OR(AND(ISNUMBER(C86),C86>=0),C86=""NA""),ISBLANK(C86)),"""",[1]Answers!E105) [valoare memorată: ]" L87 Slovenia 0 "=IF(OR(OR(AND(ISNUMBER(C87),C87>=0),C87=""NA""),ISBLANK(C87)),"""",[1]Answers!E106) [valoare memorată: ]" L88 Spain 0 "=IF(OR(OR(AND(ISNUMBER(C88),C88>=0),C88=""NA""),ISBLANK(C88)),"""",[1]Answers!E107) [valoare memorată: ]" L89 Sweden 0 "=IF(OR(OR(AND(ISNUMBER(C89),C89>=0),C89=""NA""),ISBLANK(C89)),"""",[1]Answers!E107) [valoare memorată: ]" L91 f) Refused requests for prior authorisation by reason for refusal L92 Please provide the number of refused requests for prior authorisation by reason for refusal. The boxes for providing your reply are automatically marked red if the total number of refusals does not correspond to the figure provided under section 3.1 b). Please mention in the text box to the right if more than one reason is indicated in relation to one refused request, in which case you can ignore the boxes turning red. L94 Reason for refusal Number of requests L95 • This healthcare can be provided on its territory within a time limit which is medically justifiable, taking into account the current state of health and the probable course of the illness of each patient concerned (Article 8(6)(d) of Directive 2011/24/EU). 2 "=IF(OR(OR(AND(ISNUMBER(G95),G95>=0),G95=""NA""),ISBLANK(G95)),"""",[1]Answers!E116) [valoare memorată: ]" "=IF(SUM(G95:G99)<>$D$30,""The total sum does not equal the 'number of refused requests' as inserted in Question 3.1b. Please doublecheck or provide reason in the text box"","""") [valoare memorată: ]" L96 • The healthcare is not included among the national healthcare benefits of the Member State of affiliation (Article 7(1) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G96),G96>=0),G96=""NA""),ISBLANK(G96)),"""",[1]Answers!E117) [valoare memorată: ]" L97 "• The patient will, according to a clinical evaluation, be exposed with reasonable certainty to a patient-safety risk that cannot be regarded as acceptable, taking into account the potential benefit for the patient of the sought cross-border healthcare (Article 8(6)(a) of Directive 2011/24/EU). " 0 "=IF(OR(OR(AND(ISNUMBER(G97),G97>=0),G97=""NA""),ISBLANK(G97)),"""",[1]Answers!E118) [valoare memorată: ]" L98 • The general public will be exposed with reasonable certainty to a substantial safety hazard as a result of the cross-border healthcare in question (Article 8(6)(b) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G98),G98>=0),G98=""NA""),ISBLANK(G98)),"""",[1]Answers!E119) [valoare memorată: ]" L99 • This healthcare is to be provided by a healthcare provider that raises serious and specific concerns relating to the respect of standards and guidelines on quality of care and patient safety, including provisions on supervision, whether these standards and guidelines are laid down by laws and regulations or through accreditation systems established by the Member State of treatment (Article 8(6)(c) of Directive 2011/24/EU). 0 "=IF(OR(OR(AND(ISNUMBER(G99),G99>=0),G99=""NA""),ISBLANK(G99)),"""",[1]Answers!E120) [valoare memorată: ]" L100 * Additional comments only (Alt+Enter to new line ...) L101 3.2 Requests for reimbursement L102 If a distinction cannot be made between requests for reimbursement related to treatments with prior authorisation and requests for reimbursement related to treatments not requiring prior authorisation, please provide further information in section 5 or in a separate note. L104 a) How can a request for reimbursement be made (in person, post, e-mail, online, other means)? L105 • A vertical scroll bar will appear to enable you to scroll down if the text inserted is longer than the size of the textbox. L106 "=IF([1]Answers!D128,[1]Answers!E124,"""") [valoare memorată: ]" L109 b) Processing times *Alt+Enter to new line … L110 Please respond to the questions below relating to your processing times (in working days) in 2023. Please specify if the amount reported below is not working days. In addition, please provide in section 5 or in a separate note information about events that have increased the processing times and/or steps taken to reduce the processing times, such as the introduction of electronic applications to speed up the processing procedures. L112 Average processing time L113 Please provide the average time (in working days) for processing requests for reimbursement in 2023. L114 69.5 "=IF(OR(OR(AND(ISNUMBER(B114),B114>=0),B114=""NA""),ISBLANK(B114)),"""",[1]Answers!E131) [valoare memorată: ]" L116 Maximum time limit L117 Please provide the maximum time limit (in working days) allowed according to your national legislation (specifically related to cross-border healthcare or as part of the general administrative legislation) for processing requests for reimbursement. Please specify if the unit specified in your legislation and reported below is not working days. In addition, please specify if the maximum time limit is related specifically to cross-border healthcare or if it is part of the general administrative legislation. L120 Time limit Legislation L122 "=IF(OR(OR(AND(ISNUMBER(B121),B121>=0),B121=""NA""),ISBLANK(B121)),"""",[1]Answers!E132) [valoare memorată: ]" L123 c) Amount reimbursed L124 Please provide the aggregated amount reimbursed in 2023. L125 EUR L126 "=IF(OR(OR(AND(ISNUMBER(B125),B125>=0),B125=""NA""),ISBLANK(B125)),"""",[1]Answers!E134) [valoare memorată: ]"