The “Nomenclatore Tariffario” is the basic document which outlines all aspects of national orthopaedic assistance, and today, after nearly twenty years of the reign of the Ministerial Decree 332/99, it has finally been updated by the Prime Minister’s Decree dated 12 January 2017, published in the Official Gazette on 18 March last year, and includes the whole decree concerning the LEA (Essential Levels of Care).

There are three different lists inside Annex 5: list 1, on prosthetics and orthotics that are made or arranged to measure by a qualified professional; list 2A that refers to standard aids that must be applied by licensed health professionals and list 2B, relating to off-the-shelf standard aids.
Anyone who has even the slightest interest in the new Nomenclatore Tariffario for prostheses must keep a precise date in their sights: 28 February 2018. In fact, this is the final deadline for the second LEA update and for moving some defined technical aids from one list to another.
It is not the only legislative pronouncement that is missing; the orthopaedic sector has also been waiting a long time for the decree that should redefine the rates for each of the custom-made devices, and therefore those not included in list 1 of Annex 5 of the LEA.

In practice, it would be reasonable to expect a decree updating the LEA that in addition to regarding the 12 Aids which: “.. because of their characteristics and the specific functional needs of users they are intended for, require a customised prescriptive process and an appropriate assessment process conducted by a multidisciplinary team as well as adequate training on use, in order to ensure maximum customisation and adherence to users’ needs, objectives that are hard to achieve through tender procedures” and then as required by the 12th Social Affairs Commission at the Italian Chamber of Deputies, to move to List 1, should also concern a review of the descriptions and specifications of the standard products which in some cases are difficult to understand.
For this reason Moretti SpA, through the manufacturers’ association – ADM Areha- of which Alessandro Berti is Vice President, in his capacity as Moretti’s Public Affairs Officer, has considered it appropriate to provide notice, through the most appropriate institutional channels, about the various inconsistencies that may occur in the event of calls for bids covering various products on Lists 2.

One example is the recent call for bids by the Region of Basilicata which issued a call for all products in lists 2A and 2B and was then forced to suspend the tender procedure while it prepared to “..make partial changes to the tender documents…”.
The hope is that an important decree at national level like the Prime Minister’s Decree on LEA, may achieve full implementation at national level in a short time, with the greatest possible uniformity while respecting regional independence, and the best possible compliance with the various comments from stakeholders in the sector, and mainly from patients.