Ragioneria Generale dello Stato - Ministero dell'Economia e delle Finanze

The decree extending the Healthcare Card experimental project to the Umbria, Emilia Romagna, Veneto and Lazio regions published in the Official Gazette.

Rome - November 4, 2004 - The decree, signed by the Minister of Economy and Finance and by the Minister of Health, extending to Umbria, Emilia Romagna, Veneto and Lazio the implementation of the Healthcare Card system, has been published today in the Official Gazette.

The programme that has already been tested in the Abruzzo region since last July, involving the distribution of the healthcare card enabling citizens to have access to the national health system services and the adoption of a new medical prescription model, will start this month in Umbria, on January 2005 in Emilia Romagna, on February in Veneto and on March in the Lazio region.

The Healthcare Card (Tessera Sanitaria - TS) project objective - this card will be gradually extended to all other Italian regions - is to improve the national health system services, to favour the use of the resources allocated to this sector and to enforce an efficient service and expenditure monitoring system.

The Card will be sent by the Ministry of Economy and Finance to all citizens provided with a fiscal code and holders of the healthcare right, gradually and in compliance with the individual regions' Healthcare Card Project implementation plan, established by the decrees implementing sub paragraph 6 of the aforementioned art. 50.

Within the healthcare card framework, it is provided that as of January 1, 2005 the new standard fiber optic reader healthcare prescription model shall come into force. Consequently, as of that date, physicians shall exclusively prescribe pharmaceutical or specialistic services to be charged to the National Health Service, to the Ministry of Health and foreign institutions, through the use of said new model.

Until January 1, 2005 the books of prescription currently in use will remain valid. By that date, when receiving the new books of prescription, prescribing physicians shall hand in the still unused or partially used books of prescription. As far as the Abruzzo region is concerned, these obligations have been in force since September 1, 2004.

Please be informed that the decrees implementing the Healthcare Card Project had already been published in the Official Gazette No. 159 of October 25, 2004 - they can be seen in the aforementioned internet sites - concerning the definition of the Healthcare Card technical characteristics, the new medical prescription model, the technical modalities for the transmission of data containing the prescription - prescribing physician connection and the definition of data that the Ministries and the other bodies involved shall send to the Ministry of the Economy and Finance.

The project, in line with the wider medical prescription monitoring model envisaged within the framework of the "Cabina di regia del Nuovo Sistema Informativo Sanitario - NSIS" of the Ministry of Health, stems from the implementation of the provisions laid down under art. 50 of law decree No.269 of September 30, 2003, turned, with amendments, into law No. 326 of November 24, 2003, indicating provisions for monitoring health expenditure and ensuring medical prescription suitability. To develop such system, the State General Accounting Department will be in charge of the project, the Revenue Agency will handle the operating aspects of the project, Sogei SpA will be the technological partner and they will all be working in close collaboration with the Ministry of Health.

Healthcare Card

It contains:

1	the citizen's personal data and fiscal code;
2	expiry date only applicable for healthcare purposes (for example, in the case of foreigners with a stay permit);
3	a free space for possible regional health data;
4	three Braille characters for the blind;
5	the citizen's bar code and magnetic band fiscal code and the European health insurance card (E111). This could be used, as of November 2004, to have access to healthcare services in European Union Countries and in Countries having bilateral agreements with Italy.

New standard fiber optic reader medical prescription model

It introduces some important changes, such as the following:

1	standardization of some existing types of prescriptions (basic prescription, prescription for crews, modular book for tourists);
2	it complies with provisions on privacy, by introducing a cover the patient's personal data area;
3	each medical prescription is identified by a national unique code, structured by region, to guarantee its traceability;
4	it makes it possible to identify the prescribing physician thanks to the connection between physician and prescription;
5	it provides a national unique connection with the patient, through his/her unique identification code (fiscal code, STP code, European health insurance card identifier);
6	it introduces a specific space for the CUF notes on drugs;
7	it favours the use of a standard medical (pharmaceutical, specialistic, outpatient, etc.) service coding system that will make it possible to collect information on the provided medical service types and volumes;
8	it introduces a new standard exemption coding system that will make it possible to collect information on the provided medical service types and volumes to which exemptions were applied;