CNAS Proposes New Rules: Wider Access to Healthcare Services, Less Bureaucracy

The National Health Insurance House (CNAS) has published draft normative acts for public consultation, proposing amendments to the Framework Contract and its implementing methodological norms. The stated aim is to improve insured persons' access to healthcare services, enhance the quality of medical care, and simplify administrative procedures, according to Agerpres.

General practice and prevention

General practitioners who temporarily take on patients from colleagues on leave will be able to claim reimbursement for consultations provided above the standard cap, ensuring patients retain access to services. The measure also supports doctors who take on additional workloads.

According to a CNAS press release cited by Agerpres, the draft legislation strengthens the role of general practice in prevention and chronic disease monitoring: HDL cholesterol testing for cardiovascular risk assessment will be included in preventive consultations, diagnostic criteria for chronic kidney disease will be updated in line with international guidelines, and procedures for monitoring HPV testing within cervical cancer screening programmes will be clarified.

Specialist outpatient clinics

The minimum operating hours for clinical specialist practices would be reduced from 35 to 17.5 hours per week, and from 5 to 3 working days — a measure aimed at keeping practices open in areas with a shortage of doctors and expanding the network of outpatient services.

Consultation times for paediatrics, internal medicine, geriatrics, and medical genetics will be extended to 20 minutes, allowing for more thorough assessments.

CNAS notes that the new rules will give practices greater organisational flexibility and allow doctors to exercise their right to annual leave without financial penalties.

Medicines and treatments

Patients with stabilised chronic conditions will be able to receive prescriptions for medicines under cost-volume contracts for periods of up to 90–92 days, dispensed in monthly instalments, thereby reducing the number of visits to the clinic.

The switch from a reference biological medicine to a biosimilar will take place within a maximum of 3 months of the biosimilar being added to the price list, down from the current 12 months, with the exception of patients who experience adverse effects.

It is clarified that access to treatment through national curative health programmes — covering oncological, cardiovascular, and other conditions included in these programmes — is free of charge in both public and private hospitals.

Diagnostics and digitalisation

Providers of paraclinical investigations will be required to interpret and communicate results within a maximum of 3 working days of the investigation being carried out. Results and medical images will be made available to patients via a secure electronic system with individual access, replacing CDs and paper-based reports. A framework for teleradiology will also be introduced to enable more efficient use of medical resources at national level.

The distribution of funds to medical analysis laboratories will be expedited as an interim measure pending the removal of spending caps.

Day hospitalisation and hospital funding

The day hospitalisation service package will be expanded to include services for monitoring pulmonary hypertension, administering certain biological therapies, and providing dental treatment for children under 7 years of age requiring procedural sedation.

The new contracting rules will seek a more predictable and equitable distribution of funds, based on hospitals' actual activity and capacity. Contracts will no longer be based on bed numbers but on resolved cases, with the number of contractable cases determined according to patient demand and the capacity of healthcare facilities. Hospitals will be required to publish activity data and managerial performance indicators on their own websites. A "risk fund" equivalent to 5% of allocated hospital service funds will also be introduced to cover justified circumstances arising during the course of contracts.

Medical devices

Replacement intervals will be reduced for certain devices, such as compression equipment for the treatment of lymphoedema and nebulisers. New devices for people with lymphoedema will be introduced, and the conditions for provision of custom orthoses and intraocular lenses will be updated.

Less paperwork

Healthcare providers will use electronic forms — referral letters, prescriptions, medical correspondence, medical rehabilitation procedure plans, and recommendations for medical devices and home care — replacing paper-based documents.

From 1 October 2026, an application for managing patient appointments will be introduced within the e-SanateaMea portal. Qualified electronic signatures will be used for contracts and addenda between providers and health insurance houses, which should shorten evaluation and contracting procedures.