Romania operates using the Social Health Insurance (SHI) model. The Framework Contract defines the SHI benefits package, the conditions for providing services and payments. It is developed jointly by the National Health Insurance House (CNAS) and the Ministry of Health. Typically, it is updated every two years; however, the 2020 update was postponed until July 2021.
The "Application Norms of Framework Contract" and its annexes provide a detailed picture of the covered services. Furthermore, the annexes of the "Application Norms of Framework Contract" list the DRG cost weights, as well as the tariffs for outpatient specialist services. It also contains the list of requirements the providers need to meet in order to get the contract with the CNAS.
The changes in the updated Framework Contract cover primary care services (remote consultations, home consultations, remote monitoring), outpatient specialist care (remote specialist consultations and medical prescription, rehabilitation services after COVID-19 infection), hospital care, palliative home care, medical aid prescription. The summary of changes in the updated version of the Framework Contract can be found here.
The updated Framework Contract will be valid for the years 2021-2022. The full details in Romanian can be found here.
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