Andorra Approves CASS Coverage for Dietetics and Nutrition Services

The Andorran Council of Ministers approved the inclusion of dietetics and nutrition services in the Caixa Andorrana de Seguretat Social (CASS) portfolio on Wednesday, with coverage effective from 1 September. Health Minister Helena Mas detailed the policy at a subsequent press conference, pointing to scientific evidence on nutrition's essential role in preventing, treating and monitoring various conditions.

The approval involves three decrees: one updating the CASS services catalogue; a second setting procedures, terminology and public funding rules for outpatient dietetics and nutrition; and a third specifying accreditation standards for professionals able to enter CASS agreements. Mas highlighted ongoing collaboration with the Official College of Dietitians and Nutritionists in shaping the measures.

Support targets pathologies where dietary intervention significantly affects health outcomes and prognosis. Morbid obesity (BMI over 30) offers the broadest access, with six initial sessions and two more the next year. Growth delays, overweight (BMI over 25) and eating disorders provide four sessions, renewable twice annually. Type 2 diabetes covers three non-renewable sessions. Coeliac disease, gastritis, certain food allergies and active oncological disease each allow two non-renewable sessions. Additional coverage applies to cardiovascular diseases, digestive issues, renal failure and select paediatric conditions, with session limits varying by case.

Sessions are priced at €28, with CASS covering 75% and patients paying 25%. Referrals from primary care doctors or specialists are mandatory, and services must take place at accredited professionals' premises under CASS contracts. Mas stressed exclusions for sports performance goals or slimming diets without linked pathology, limiting aid to cases where nutrition notably influences disease course.

On session caps, Mas said they stem from evidence-based evaluations, where initial advice suffices for some issues but renewals suit others, such as eating disorders. Dietitians-nutritionists must first secure ministry accreditation, then arrange CASS deals, following models used for psychology and similar fields.

This step advances the National Health Pact's goal to broaden CASS services this legislative term, building on additions like outpatient psychology, expanded aids for hearing devices, glasses and contact lenses, podiatry for diabetes, neuropsychology, gender identity care and 100% funding for more high-complexity drugs.