# Lombardy regional autonomy and healthcare reforms > Live situation record from CLSTR: https://clstr.news/situations/lombardy-regional-autonomy-and-healthcare-reforms > Updated: 2026-09-09T16:05:40.000Z. Sources: 28. Developments: 3. The Lombardy Region is advancing institutional and healthcare reforms through new agreements and autonomy initiatives. In the healthcare sector, the regional government, Federfarma Lombardia, and Assofarm/Confservizi Lombardia have adopted a three-year Regional Integrative Agreement (AIR) for pharmacies. Proposed by Councilor Guido Bertolaso, the agreement allocates 2,866,900 euros for 2026 to strengthen pharmacies as local healthcare hubs. Key provisions include a residency indemnity of 1,766,900 euros for owners and managers of rural pharmacies, distributed based on hardship indicators. A solidarity fund has also been established to support pharmacies with annual turnovers below 300,000 euros, with doubled contributions for those earning less than 150,000 euros. The plan emphasizes digitalization and the dematerialization of prescriptions. Regarding regional autonomy, the Institutional Affairs and Local Entities Commission and the Special Commission for Autonomy have begun reviewing proposed agreement schemes with the Italian government. These schemes target sectors such as civil protection, professional services, healthcare protection, and supplementary social security. Mauro Piazza, Undersecretary to the Presidency, noted the process aims to finalize autonomy by the end of the current national legislature, building on a 2017 consultative referendum. Lombardy's regional council has since approved resolutions granting greater control over civil protection, specific professions, supplementary social security, and healthcare financing. This includes the authority to issue emergency ordinances, manage local recruitment for civil protection, and set regional healthcare reimbursement rates. President Attilio Fontana described the approval as a “historic step toward reducing state centralism,” though opposition members have raised concerns regarding potential regional inequalities and impacts on national service standards. Most recently, the Lombardy Regional Council approved a resolution to advance differentiated autonomy by authorizing negotiations with the Italian government. ## Claims - The autonomy agreements cover civil protection, specific professions, supplementary social security, and health protection coordination. (disputed by 9 sources) - The autonomy plan excludes health professions and professional orders from the regional regulation of activities. (disputed by 9 sources) - The Lombardy Regional Council approved a resolution regarding the implementation of differentiated autonomy with 48 votes in favor and 21 against. (corroborated by 9 sources) - The resolution mandates the Regional Government to continue negotiations with the State regarding autonomy under Article 116 of the Constitution. (corroborated by 9 sources) - Under the new powers, the region could issue ordinances that deviate from state rules for local emergencies for up to two years. (corroborated by 9 sources) - The region may establish healthcare reimbursement rates different from national standards while respecting essential levels of assistance. (corroborated by 9 sources) - The Liguria Regional Council approved agreement schemes with the national government for differentiated autonomy. (corroborated by 2 sources) - Liguria's autonomy focuses on civil protection, professional regulation, and supplementary social security. (corroborated by 2 sources) ## Timeline ### 2026-09-09: Lombardy and Liguria advance differentiated autonomy through regional council votes Regional councils in Lombardy and Liguria have approved resolutions to implement differentiated autonomy, seeking greater control over civil protection, healthcare, and social security from the central state. 17 sources. https://clstr.news/cluster/liguria-simplifies-landscape-planning-for-small-municipalities ### 2026-08-26: Lombardy commissions begin review of regional autonomy agreements Lombardy regional commissions have begun reviewing agreements with the Italian government to grant the region increased autonomy in healthcare, civil protection, and social security. 8 sources. https://clstr.news/cluster/lombardy-commissions-begin-review-of-regional-autonomy-agreements ### 2026-08-26: Lombardy Region adopts new agreement for pharmacies Lombardy has implemented a new three-year agreement for pharmacies, allocating over 2.8 million euros for 2026 to support rural residency indemnities, solidarity funds, and digital services. 4 sources. https://clstr.news/cluster/lombardy-region-adopts-new-agreement-for-pharmacies --- Cite as: Lombardy regional autonomy and healthcare reforms. CLSTR, https://clstr.news/situations/lombardy-regional-autonomy-and-healthcare-reforms