Almost nine years after the last update, the measures revising the Essential Levels of Care (Livelli essenziali di assistenza – LEAs) were published in the Official Gazette of 30 September 2026, having been adopted in August following a comprehensive review process. The new provisions will enter into force on 30 October 2026.

The LEAs identify the healthcare services and treatments that the Italian National Health Service (Servizio sanitario nazionale – SSN) is required to provide throughout Italy, either free of charge or subject to patient cost-sharing.

The update amends the Decree of the President of the Council of Ministers (D.P.C.M.) of 12 January 2017 and is set out in two separate measures: the Decree of the Minister of Health of 3 August 2026, issued jointly with the Minister of Economy and Finance, and the D.P.C.M. of 7 August 2026.

The use of two different types of measures reflects the procedure laid down by Law No. 208/2015. As a general rule, the LEAs are updated by D.P.C.M.; however, where amendments concern the lists of services provided by the SSN or measures aimed at improving their appropriateness and do not entail costs for public finances, the law allows the update to be adopted by decree of the Minister of Health, issued jointly with the Minister of Economy and Finance.

Overall, the update covers approximately 800 services, treatments and therapies, introducing new items as well as amending, replacing or revising existing ones.

The main changes include the nationwide introduction of newborn screening for spinal muscular atrophy (SMA) and the extension of newborn screening to additional metabolic and rare diseases. New services relating to pregnancy are also provided for, including non-invasive prenatal testing (NIPT), together with new measures in the field of oncology.

The update also covers rare, chronic and disabling diseases, adding new conditions and services eligible for exemption from patient cost-sharing and revising those already included. Specialist outpatient services and prosthetic care have also been updated, with new services being introduced and certain existing services being revised or removed.