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European CommissionThe Second Economic Adjustment Programme for Greece. Fourth ReviewΡar /ΡageMoU2.8.1.3.2.iMoU2.8.1.3.2.iiMoU2.8.1.3.3.iMoU2.8.1.3.3.iiMoU2.8.1.3.4MoU2.8.1.3.4Action Deadline Comments Statusvi. the interaction of the platform with the plannedsimplification of procurement legislation;vii. the means to facilitate access and use to the platformby users, including easy to use e-signature and e-IDsolutions.The execution of the plan and the respect of deadlines willbe closely monitored in cooperation with the Commission.The Government in the development of the e-procurementplatform, commits to run supplies and services contractsfor the Central Government through the e-procurementplatform.The Government in the development of the e-procurementplatform, commits to present the results of the pilot testingof the system software/architecture. The "fitness forpurpose" of the system will be subject to an independentassessment.The Government ensures the use of the platform asfollows:the Central Purchasing Bodies (General Directorate forpublic procurement for supplies and services of the GSCand EPY") manage the e-procurement platform for all theirtendering procedures.The Government ensures the use of the platform asfollows:the whole public sector in Greece uses the e-procurementplatform for commonly bought supplies and services.The Government submits to the Commission services thedata of the monitoring activities covering year 2013against the target user levels.In addition, the Government presents data on:i. the number of calls for tender published electronically(in absolute terms and as a percentage of total number ofpublished calls for tender);ii. the number of tenders with specifications publishedonline;iii. the number of contracts carried out electronicallyrelative to the total number of contracts.iv. the types of purchases carried out with the e-procurement platform.v. the number of contracting Authorities using e-procurement.2.9 Completing the pension reform to secure sustainabilityMoU2.9.1MoU2.9.2MoU2.9.3MoU2.9.3MoU2.10.1.1MoU2.10.1.2MEFP(12)The Government ensures that all social securitycontributions to ETEA will be recorded electronically.The Government ensures that the new single fund ETEAsets up, in a cost effective way, a computerised system ofindividual pension accounts to be finalisedThe Government produces a regular quarterly report of theactivities of the Health Committee, aimed at monitoringand revising the disability status and ensure that disabilitypensions correspond to not more than 10 percent of theoverall number of pensions.The Government produces a regular quarterly report of theactivities of the Health Committee, aimed at monitoringand revising the disability status and ensure that disabilitypensions correspond to not more than 10 percent of theoverall number of pensions.From January 2014, hospital services will start to bepurchased directly by EOPYY through prospectivebudgets based on KEN-DRGs costing procedure (andpayroll costs, should be at least reported).EOPYY ensures that the number of doctors is reduced inheadcount by a further 10% in 2013.We are launching a Health Voucher Program that willprovide 100.000 long-term uninsured citizens with accessto primary healthcare services and, with funding from theJuly 2013 The platform is operational. Observed.September2013June 2014December2015A team of experts is established, TASK FORCE isalso involved. The platform is evaluated.Observed.N/AN/AJanuary 2014 The obligation will be rephased. N/AJanuary 2014 The obligation will be rephased. N/ADecember2013December2013September2013December2013January 20142013July 2013The whole procedure is under process. It has beenlegislated by law 4225/2014 that auxiliary pensions'contributions will be reported by A.P.D. of IKAfrom December 2013. IDIKA has started developingthe project 'ATLAS' that will unify all social securitydata in Greece. IKA 's Information System has beenupgraded towards this direction. Electronic crosschecks have been already introduced.ETEA issues will be solved in the l. 4254/2014(IA2/3).The whole procedure is under process. It has beenlegislated by law 4225/2014 that auxiliary pensions'contributions will be reported by A.P.D. of IKAfrom December 2013. IDIKA has started developingthe project 'ATLAS' that will unify all social securitydata in Greece. IKA 's Information System has beenupgraded towards this direction. Electronic crosschecks have been already introduced.ETEA issues will be solved in the upcomingOmnibus (IA2/3)The technical report of Q3 2013 was delivered ontime and all targets have been met.The technical report of Q4 2013 is ready and sent tothe Ministry of Finance and EC/ECB/IMF with ref.no 2293/181 – 24/01/2014. The target of 10% ofdisability pensions has been reached (7,7%). Nextreview of Q1 2014 will be issued April 2014.MoHealth sent an updated DRG action plan and hasrequested to replace this action with another that isincluded in the updated plan.In 2013, the number of doctors-employees ofEOPYY was reduced by 19% and by 21% thenumber of contracted doctors. The relevant reportwas submitted to EC/ECB/IMF in January 2014.The Health Voucher Program is implemented since2-9-2013. (circular Y4a/81034/29-8-2013).NotObserved.NotObserved.Observed.Observed.NotObserved.Observed.Observed.96
ANNEXΡar /ΡageMoU2.10.2.1.1MoU2.10.2.1.1MoU2.10.2.1.1Action Deadline Comments StatusEuropean Social Fund, we plan to extend the program tomore beneficiaries while expanding the coverage ofhealthcare services.The government applies an automatic claw-backmechanism (every six months) to pharmaceuticalproducers which guarantees that the outpatientpharmaceutical expenditure (EOPYY budget) does notexceed the above targets.The government applies an automatic claw-backmechanism (every six months) to pharmaceuticalproducers which guarantees that the outpatientpharmaceutical expenditure (EOPYY budget) does notexceed the above targets.A note on the collection of claw back for 2013 for the firsthalf of 2013 is submitted.ContinuousContinuousSeptember2013MD for the claw-back was published (FEK 2045/22-8-2013). Letters about the amount of claw back weresent on 3/9/2013. The amounts were either offset orpaid.MD for 2014 claw-back target pending. Newdeadline: March 2014Progress report was submitted to EC/ECB/IMF on6/9/2013.Observed.Ongoing.NotObserved.Observed.MoU2.10.2.1.1A note on the collection of claw back for 2013 for the firsthalf of 2013 is submitted.December2013An updated progress report was submitted toEC/ECB/IMF on 3/2/2014.Observed.MoU2.10.2.1.2MoU2.10.2.1.3MoU2.10.2.2.1MoU2.10.2.2.1Activates contingency measures (including e.g. a crossthe-boardcut in prices or entry fee for the positive list), if,for any reason, the claw-back is not able to achieve thetarget. Such measures produce equivalent amount ofsavingsIn addition and if necessary, EOPYY introduces additionalincentives and mechanisms, including a prescription quotasystem for physicians, to ensure generic substitutionRevises downward the price of medicines, based on thethree EU countries with the lowest prices of price list inline with the provisions of Council Directive 89/105/EEC.Revises downward the price of medicines, based on thethree EU countries with the lowest prices of price list inline with the provisions of Council Directive 89/105/EEC.October 2013September2013Quarterly(Next lists tobe publishedby end June2013 andSeptember2013)QuarterlyThe pharmaceutical claw back process progressedsmoothly, so there is no need for contingencymeasures.The MD about incentives for insured citizens waspublished (FEK B 2219/9-9-2013). Measuresregarding incentives to pharmacies and doctors arein L. 4213 FEK A261/9-12-2013. Α MD regardingincentives for doctors was signed and published(113429/FEK Β3117/9-12-2013)The price list was published on 6/8/2013 (MD74725/6-8-2013). Corrective bulletin was publishedat 30/8/2013.The new price list was published at 12/2/2014 (MD14230/11-2-2014).Observed.Observed.Observed.Ongoing.Observed.MoU2.10.2.2.2MoU2.10.2.2.3MoU2.10.2.3.1MoU2.10.2.3.2On the basis of the report on the impact of the new profitmargins of pharmacies, reduce the profit margins down to15%.Ensures that EOPYY negotiates a 5% discount throughprice-volume or risk sharing agreements focusing on thetop spending medicines sold in EOPYY pharmacies.Update the positive list of reimbursed medicines and thelist of OTC medicines. These lists must be updated afterevery price bulletin or the corrective (deadlines shouldfollow 2.10.2.2.1 with some offset)Ensures full coverage of e-prescription to doctors,outpatient facilities and providers contracted by EOPYYand to all NHS facilities (health centres and hospitals).January 2014 New deadline was agreed (June 2014)Continuousfor 2013 and2014Quarterly(Next lists tobe publishedby end June2013 andSeptember2013)September2013Ongoing procedure. Relevant MD was published(FEK B2219/9-9-2013) that provides fornegotiations through price-volume or risk sharingagreements.The positive list was published (FEK 2467/2-10-2013 & 2477/3-10-2013). The list of OTC medicineswas published (FEK B 2840/7-11-2013).E-prescription coverage for medicines is 98% andfor the other medical acts (compulsory from April2013) is higher than 90%.NotObserved.Observed.Ongoing.Observed.Observed.MoU2.10.2.3.2MoU2.10.2.3.3MoU2.10.2.3.4E-prescribing is made compulsory and must include atleast 90 percent of all outpatient medical acts covered bypublic funds (medicines, referrals, diagnostics).Finalise the implementation of the system (API) wherebypharmacies electronically register any residual manualprescriptions from doctors into the e-prescriptionapplication established by IDIKA.Continue publishing prescription guidelines/protocols forphysicians, with priority for the most expensive and/ormostly used medicines, and makes them compulsoryContinuousSeptember2013ContinuousE-prescription coverage for medicines is 98% andfor the other medical acts (compulsory from April2013) is higher than 90%.Currently the coverage rate is 83% of prescriptions.Ongoing. Protocols are published on EOF websiteand continue to be developed.Observed.Observed.Observed.Ongoing.MoU2.10.2.3.5MoU2.10.2.3.6MoU2.10.2.3.7.iEnforce the application of prescription guidelines throughthe e-prescription system starting with at least 5therapeutic groupsFurther develop the e-prescription system by monitoringthe compulsory ICD-10 and enforcing SPC filters in the e-prescription system.(at a pace of 500 drugs per monthstarting October 2013).Enhance monitoring and assessment through:detailedmonthly auditing reports on the use of e-prescription inNHS facilities and by providers contracted by EOPYY.These reports are shared with the European Commission,ECB and IMF staff teams.September2013October 2013ContinuousOn 2 October, EOPYY announced the launch of theapplication of prescription guidelines through the e-prescription system for 5 therapeutic groups.The SPC filters are included in the e-prescriptionsystem by linking it with EOF database.December 2013 report was submitted in February.Observed.Ongoing.Observed.Observed.Ongoing.97
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OUTLINE OF THE REPORTEXECUTIVE SUMM
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LIST OF GRAPHSGraph 1. Economic cli
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ACKNOWLEDGEMENTSThe report was prep
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European CommissionThe Economic Adj
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1. INTRODUCTION1. INTRODUCTION1. Th
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2. MACROECONOMIC AND FINANCIAL DEVE
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2. Macroeconomic and financial deve
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European CommissionThe Second Econo
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