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03-02-2023

Changes did not disappoint: administrative burden has decreased three times

Iliustracija

A year has passed since the decision was made for all Lithuanian pharmacies to conclude a three-year contract with one Territorial Health Insurance Fund (THIF) regarding reimbursement of the costs for compensated medicines and medical aids. Both representatives of the National Health Insurance Funds (NHIF) and pharmacists agree that these changes helped to significantly decrease administrative work in the pharmacies.

“Previously, every THIF would annually conclude agreements with the pharmacies in their operation area. Therefore, if pharmacy companies operated in the operation areas of five NHIF, the same company had to make five agreements of the same content with all the five NHIF. Also, five workers from different NHIF had to accept prescription data provided by a pharmacy, therefore, different procedures for the inspection of prescriptions could have been applied and different practices of prescription acceptance could have developed. Such a pharmacy would provide five different invoices to the NHIF for the payment and later it would receive five money transfers into one company’s account,” Irma Medžiaušaitė, Adviser to the Pharmaceuticals Reimbursement Division of the NHIF under the Ministry of Health, told about the complicated practice that existed.

A year ago, seeking to improve the procedure for concluding agreements between the NHIF and pharmacies on the reimbursement of the costs of reimbursement of the purchase of medicines and medical aids from the Compulsory Health Insurance Fund, it was established that only one NHIF of Kaunas will conclude an agreement with all the pharmacies of the country. Also, it was decided to decrease administrative burden of the pharmacies 3 times, providing that pharmacies will sign an agreement with NHIF for three years and not for a year.
One year after the changes entered into force, representatives of pharmacies, interviewed by the NHIF, noticed that a new model for the conclusion of contracts is suitable and has significantly facilitated daily work of pharmacies.

“All the changes introduced in the contracts with the NHIF proved its worth and significantly decreased the amount of administrative work for pharmacies. We escape annual process of concluding identical contracts, also, while managing accounts and payment documents of pharmacies every month for prescriptions of compensated medicines and medical aids issued to the citizens, there is no need to send data of these prescription to five NHIF and wait for their payment. We expect subsequent cooperation with national health insurance funds continuing the processes of improving performance”, said Donata Pranaitienė, the head of Pharmaceutical activity of UAB “Nemuno vaistinė”, managing one of the biggest pharmacy networks “Camelia”.

Currently Kaunas NHIF has concluded 105 contracts with pharmacies, which will be valid for another two years. This year, pharmacies are operating in 1284 locations in Lithuania.  

(Freepik photo)

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Last updated: 09-05-2023

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