Germany Proposes Major Change in Billing for Compounded Medicines
The German Federal Ministry of Health (BMG) has proposed a shift in the billing process for compounded medications. Currently, pharmacies invoice for entire packages, but the ministry aims to transition to billing only for the exact amounts used. The BMG's proposal seeks to simplify billing by utilizing readily available package prices. However, the current Arzneimittelpreisverordnung (AMPreisV) permits pharmacies to invoice for full packages, leading to some ambiguity. Recently, Germany's Federal Social Court ruled that health insurers cannot override their own agreements when attempting to reduce costs for compounded medications. This decision underscores the importance of clear communication and negotiation between pharmacies and insurers. If insurers wish to deviate from the proposed change, they must engage in contractual negotiations or advocate for amended regulatory provisions. The BMG's proposal aims to simplify billing for compounded medications, but the current regulation allows for full package billing. The court's recent ruling emphasizes the need for clear agreements between pharmacies and insurers. The future of billing for compounded medications remains uncertain and will likely depend on further negotiations and potential regulatory changes.
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