«Today in the Regional Council the sense of duty won. Three very important regulations have been approved for a state-of-the-art Puglia and the first in Italy. This is the rule to give effect to 406 health services envisaged in the 2017 LEAs and unfortunately always postponed by the various national governments, including the last one, despite the fact that since 2017 the Regions have regularly received the money to provide them; of the norm on screening for hip dysplasia, so as to intervene early and avoid early arthrosis and serious walking problems; of the law for the start of the procedure for the construction of 6 new public centers for the care and treatment of those affected by autism spectrum disorder. These rules were approved with the approval and favorable opinion of President Emiliano, and the unanimous vote of all the majority and opposition colleagues. And for this I am truly grateful to everyone”, declared the President of the Regional Budget and Planning Commission Fabiano Amati.
«With reference to the new LEAs, i.e. the most complex provision, the new nomenclator activated today by the Regional Council provides for the necessary and long-awaited update of the nomenclator governed by the ministerial decree of 22 July 1996, including technologically advanced services and eliminating those that are now obsolete. Numerous diagnostic and therapeutic procedures are being introduced which in 1996 had an almost “experimental” nature or could only be performed safely in hospital, but which today have entered current clinical practice and can be provided in an outpatient setting” added Amati.
HERE IS THE DETAIL OF THE FREE THERAPIES YOU CAN ACCESS
In detail, the proposed law:
– clearly identifies all medically assisted procreation services (PMA) which will be paid by the National Health Service (until now only provided on an inpatient basis);
– deeply reviews the list of genetics services and, for each individual service, refers to a specific list of pathologies for which investigation of a specific number of genes is necessary;
– introduces genetic counseling, which makes it possible to explain to the patient the importance and meaning of the test at the time of its execution, the implications connected to the result at the time of delivery of the report and, possibly, to provide the patient with the necessary support to deal with often emotionally difficult situations;
– introduces services of very high technological content (hadrontherapy) or recent technology (enteroscopy with ingestible microcamera, stereotactic radiotherapy).
With reference, however, to the new nomenclature of prosthetic assistance, are guaranteed:
– IT and communication aids (including eye communicators and keyboards adapted for people with very serious disabilities);
– digital technology hearing aids, home automation equipment and command and control sensors for environments
(alarm and remote assistance);
– cutlery and furnishings adapted for motor disabilities, stretchers adapted for the shower, four-wheeled scooters, wheelchairs with verticalisation system, wheelchairs for large and complex disabilities, fixed and bathtub lifts, support systems in the bathroom ( handles and armrests), indoor stairlift trolleys;
– advanced technology artificial limbs and voice recognition and eye pointing systems.
Add to all this the revision of the list of rare diseases. In fact, the provision provides for a significant expansion of the list of rare diseases, achieved through the inclusion of more than 110 new entities between individual rare diseases and groups of diseases. For example, the following are included in the list: sarcoidiosis; progressive systemic sclerosis; myasthenia gravis. It should be noted that the services relating to rare diseases are provided under the exemption regime.
With reference to the review of chronic diseases, other important news:
– six new exempt pathologies are introduced: thalidomide syndrome, chronic osteomyelitis, chronic kidney disease, autosomal dominant polycystic kidney disease, endometriosis in the “moderate” and “severe” clinical stages, chronic obstructive pulmonary disease in the “moderate”, “severe” and “severe” clinical stages “very serious”;
– some pathologies already exempt as rare diseases are moved to chronic diseases, such as: celiac disease, Down syndrome, s. Klinefelter, undifferentiated connective tissue.
For most of the diseases included in the list, a series of services that can be used exempt are identified. For some particular diseases they are identified promptly, as the patients’ care needs are extensive and variable. In this case, to ensure greater care flexibility, the doctor will identify them from time to time.
Vaccines
With the new law there is the introduction of new vaccines (such as: anti-Papillomavirus, anti-Pneumococcal, anti-Meningococcal) and the extension to new recipients (for example, for the Papillomavirus the vaccine is also given to male adolescents) .
Screening neonatale
Introduction of newborn screening for congenital deafness and congenital cataracts, and the extension of newborn screening to all newborns.
Endometriosis
The inclusion of endometriosis in the list of chronic and disabling pathologies is envisaged, in the “moderate” and “severe” clinical stages. Consequently, patients are recognized as having the right to benefit from certain specialist control services exemptly. approximately 300,000 exemptions.
Celiac disease
Celiac disease becomes a chronic disease from a rare disease. This is because the diagnostic process for this pathology is not, to date, tortuous, long and burdensome as is the case for rare disease patients.
All specialist outpatient services included in the LEAs, useful for monitoring the pathology and preventing complications and any worsening, are kept exempt.
As with all chronic diseases, a disease certificate drawn up by a specialist from the National Health Service is sufficient to obtain the new exemption certificate.
The regulation of granting food to celiacs is maintained
Autism
The new draft decree implements law no. 134 of 2015, which provides for the updating of the essential levels of assistance for the early diagnosis, care and individualized treatment of autism spectrum disorders.
Medically assisted procreation
Until now, medically assisted procreation services were provided only on an inpatient basis.
For the future:
– the inclusion in the nomenclature of the outpatient specialist of all the services necessary in the various phases concerning medically assisted, homologous and heterologous procreation is envisaged. All the services of collection, conservation and distribution of reproductive cells aimed at heterologous medically assisted procreation are borne by the National Health Service.
