After two years of advocacy by the NNC and over 20 organisations in the country, the National Health Insurance Fund has adopted two new codes through which medical foods for home treatment will be reimbursed
A huge step forward in our fight for the National Health Insurance Fund (NHIF) to provide medical foods for all children and adults in need. At a meeting of its Supervisory Board on 17 October, the NHIF agreed to add two ICD 10 codes – E43 for “Severe protein-calorie malnutrition, unspecified” and E44.0 for “Moderate protein-calorie malnutrition” – to the list of diseases for home treatment of which the NHIF pays in full or in part for medicines, medical devices and medical foods.
This means that more than 550 Bulgarian children, as well as adults, who need enteral nutrition, will receive it as care from the state instead of waiting for donation campaigns. After months of advocacy, the NHIF accepted that malnutrition is sufficient justification to reimburse medical food for patients who need it.
Behind this first step stand two years of voluntary work and the will for change of experts from the National Network for Children, the “Community Bridges” association, doctors, parents and representatives of 24 civil society organizations in the country, who wrote letters, made analyses instead of the institutions, knocked on the doors of many departments to explain the seriousness of the problem and to insist that the state take over the care of the patients with malnutrition and mal-digestion as it happens in other European countries.
The decision of the NHIF Supervisory Board is published on the NHIF website here, the document is also available on our website here. A few more steps are to be taken. At a subsequent meeting at the NHIF, a committee is to draw up the specifications for the foods to be purchased by the NHIF in 2024. These are to be approved by the Supervisory Board, after which the tendering process is to proceed. We expect medical foods to be available for children and adult patients with reimbursement from the beginning of next year. We will keep an eye on the process.