Obligation to notify secondary illnesses of medically unnecessary treatments
The participants in the panel doctors participating care physicians and facilities and the approved contract hospitals in Germany are subject to since July 1, 2008 obligation of sequelae not medically necessary treatments . This obligation exists towards the health insurance companies if a patient has contracted an illness resulting from a medically unnecessary cosmetic operation , a tattoo or a piercing . The health insurance companies can appropriately share the patient's treatment costs for a complication that has arisen as a result. In addition, the health insurance company can cancel or reduce sick pay .
Legal bases
According to Section 52 (2) SGB V introduced by the law to strengthen competition in statutory health insurance on January 1, 2008 , the health insurance company has insured persons who have undergone a medically non-indicated measure such as cosmetic surgery, a tattoo or a piercing to share appropriately in the costs of a resulting complication. The list is final.
In order for the responsible health insurance company to be able to share the costs with the patient in the case of the complications mentioned, according to Section 294a of the Social Code Book V, the doctors and institutions participating in the contract medical care and the hospitals according to Section 108 of the SGB V must provide the health insurance companies with the necessary data. The insured must be informed of the reason for the report and the reported data.
criticism
The regulation is referred to by the doctors' representatives and the media as the Petzparagraph . Doctors and associations such as the German Medical Association or the NAV-Virchow-Bund have criticized the provision as an attack on medical confidentiality . In addition, the relationship of trust between doctor and patient would be damaged and the obligation to report would prevent the patient from seeking medical help if necessary. The proportionality of the measure has been questioned. Prior to the introduction of the paragraph in November 2007, the Techniker Krankenkasse estimated cost savings for the health insurance fund of a maximum of 200,000 euros per year.
literature
- Albrecht Wienke, Wolfram Eberbach, Hans-Jürgen Kramer, Kathrin Janke: The Improvement of Humans: Actual and Legal Aspects of Wish-Fulfilling Medicine. MedR series of publications on medical law, Springer 2009, ISBN 3-642-00882-8 .
- Petra Kolip, Julia Lademann: Women's Views on the Health System: Women's Health Care Between Marketing and Ignorance. Beltz Juventa 2010, ISBN 3-779-92236-3 .
- Daniel Strech, Irene Hirschberg, Georg Marckmann: Ethics in Public Health and Health Policy: Concepts, Methods, Case Studies. Springer 2013, ISBN 9-400-76374-3 .
Web links
- bundesaerztekammer.de: Doctors are not responsible for rationing. Retrieved December 12, 2013 .
- aerztezeitung.de: botch with piercing & Co .: Who pays? Retrieved December 12, 2013 .
- LINKE calls for the "Petz paragraph" to be deleted. Retrieved December 13, 2013 .
- MDR – Jumpradio: Self-inflicted accidents. Retrieved December 13, 2013 .
Individual evidence
- ↑ a b Consequences of piercing and Co: The cash registers ask for cash , through health January-March 2009
- ↑ Law to Strengthen Competition in Statutory Health Insurance (GKV Competition Strengthening Act - GKV-WSG) of March 26, 2007, Federal Law Gazette IS 378, 386
- ↑ stern.de of April 22, 2008: Doctors should blacken patients. Retrieved December 12, 2013 .
- ↑ Generation Botox , Süddeutsche from May 17, 2010
- ↑ Changes from July 2008 (Part 1): Reform of long-term care insurance
