The National Association of Clinical Laboratories (ANL) has recently issued a technical-legal opinion justifying the need to update the tables of acts and agreed values in the areas of clinical analysis, clinical pathology, anatomic pathology, and medical genetics.
The association stated that the current values are based on tables from the 1980s and have not been revised since 2013, with only slight maintenance or value reduction adjustments being made.
“This situation occurs in a context of accumulated inflation exceeding 20% over the last decade, with minimum remuneration increases of more than 79%, leading contracted providers to bear, in isolation, the impact of the degradation of the real value of administratively imposed prices,” the ANL warned in a statement today.
The association further argued that since the conventional prices are unilaterally fixed by the State through adhesion contracts, they must comply with mandatory legal criteria, such as equity in access, quality of service provision, financial sustainability of providers, and transparency and periodicity of value revision.
The Legal Regime of Conventions establishes that the agreed tables must be based on “a methodology for setting and updating reference prices, which must adapt to the demands and specificities imposed by the different health services covered and ensure the indispensable balance between incentives for efficiency and the guarantee of quality health care provided to citizens.”
However, the ANL stressed, “so far, such a methodology has not been established, in manifest omission, for more than twelve years, of the legal obligation.”
“Besides the obvious price update deficiency, the incongruence and mismatch between the SNS acts table and the contracted sector acts tables hinder the functional articulation between public and contracted providers, generating structural imbalances” and prevent the SNS from fully utilizing the installed capacity of the contracted sector.
The ANL’s general director, Nuno Castro Marques, warned that “the freezing of acts tables and agreed values for more than a decade not only represents a technical problem: it is a structural omission that compromises equitable access to health and directly violates the Constitution of the Portuguese Republic.”
“Without an urgent revision, the response capacity of the contracted network will continue to degrade,” he warned.
The technical-legal opinion developed by the ANL also warns of the impact of this non-compliance on users’ lives, especially in regions where contracted laboratories are the only point of access for subsidized exams.
“The underfunding of the network is limiting citizens’ freedom of choice and endangering a network with more than 3,300 access points that took over 40 years to build, contradicting the objective and obligatoriness of proximity and complementarity between the sectors,” emphasized Nuno Castro Marques.
Given the severity of the diagnosis presented, the ANL advocates for an urgent review of agreed tables, based on a transparent and periodic methodology that ensures the technical alignment of the nomenclatures and values of the contracted sector tables with those of the SNS.
