MUGEJU Creates Two Committees to Authorize Growth Hormone and Proton Therapy in 2026

Key data

Members of the judicial collective affiliated with insurance entities contracted with MUGEJU will need, as of 18 September 2026, prior authorization from two new internal committees to access growth hormone and proton therapy treatments. This is established by the Order PJC/972/2026, published in the BOE on the same day it entered into force.

The trigger for this regulation is twofold: the termination of the agreement that MUGEJU maintained with the Ministry of Health—which allowed the mutual collective to access the pre-existing ministerial committee to evaluate growth hormone treatments—and the need to formalize a body already constituted in fact to evaluate proton therapy requests in accordance with the criteria of the National Health System of 2020.

What does this regulation establish?

Order PJC/972/2026 regulates the creation, composition and functions of two collegiate bodies within MUGEJU:

Both committees operate exclusively for the collective of members affiliated with insurance entities contracted with MUGEJU. Their function is to ensure the rational use of high-cost medicines and techniques, ensuring equitable access and control of healthcare spending for the judicial collective.

Prior authorization from these committees is a necessary requirement for contracted insurers to cover these treatments. Without that approval, the treatment is not covered by the contracted coverage.

Economic and operational impact

Although the regulation does not establish direct economic amounts, its operational and spending impact is significant for two key actors:

• Contracted insurance entities: Must adapt their internal protocols for authorizing benefits to incorporate the validation step before MUGEJU's new committees. Any growth hormone or proton therapy treatment authorized without going through these committees will be outside the contracted coverage, with the risk of claims or non-payment.
• MUGEJU as an autonomous body: The creation of these committees means internally assuming a function that it previously delegated to the Ministry of Health (for growth hormone) or exercised informally (for proton therapy). This implies human resources, procedures and its own resolution timeframes.
• Members: Access to these high-cost treatments is conditioned on the favorable resolution of the corresponding committee. The prior authorization process may introduce additional timeframes compared to the previous circuit.

The stated objective of the regulation is the control of healthcare spending for the judicial collective and the guarantee of equitable access, which means that authorization criteria will be homogeneous and based on clinical evidence, aligned with NHS 2020 standards for proton therapy.

Who does it affect?

• MUGEJU members (personnel serving the Administration of Justice) who have coverage with a contracted insurance entity and need growth hormone or proton therapy treatment.
• Insurance entities contracted with MUGEJU that manage healthcare benefits for the judicial collective: must adapt their benefit authorization circuits.
• MUGEJU as an autonomous body: assumes the management and operation of the two new committees.
• Healthcare professionals who care for judicial mutual members and who must channel requests for these treatments through the new prior authorization procedure.

It does not affect MUGEJU members who have direct coverage through the National Health System, but exclusively those affiliated with contracted insurance entities.

Practical example

A civil servant of the Administration of Justice, a MUGEJU member, is affiliated with a contracted insurer. His doctor prescribes a growth hormone treatment.

Before 18 September 2026, the authorization request was channeled through the Ministry of Health committee, to which MUGEJU had access by agreement. That agreement no longer exists.

As of 18 September 2026, the process is as follows:

1. The doctor or member submits the request to MUGEJU.
2. The new Advisory Committee for the Evaluation of Growth Hormone Treatments and Related Substances evaluates the request according to established criteria.
3. If the committee issues favorable authorization, the contracted insurer can cover the treatment.
4. Without that authorization, the treatment is not covered by the contracted coverage.

The same scheme applies to proton therapy, with the Interdisciplinary Committee for the Evaluation of Proton Therapy Treatments, which is now formally regulated following NHS 2020 criteria.

What should companies do now?

1. Insurance entities contracted with MUGEJU: Immediately review internal protocols for authorizing growth hormone and proton therapy benefits, and incorporate the validation step before MUGEJU's new committees as a prerequisite for coverage.
2. Benefits management departments: Identify current or pending requests for these treatments and verify if they require going through the new authorization circuit.
3. Communication to policyholders: Inform affected members about the new prior authorization procedure, to avoid coverage expectations without validation from the corresponding committee.
4. MUGEJU: Operationally launch the two committees, define resolution timeframes and request channels, and communicate them to contracted insurers and members.
5. Healthcare professionals: Know the new circuit for requesting prior authorization for these treatments when treating MUGEJU member patients with contracted coverage.

Official source

Consult complete regulation in official source

Notice: This article is for informational purposes only and does not constitute legal advice. For specific decisions, consult a qualified professional. Source: https://www.boe.es/diario_boe/txt.php?id=BOE-A-2026-19421