Professional association
A professional association (BAG) is a form of cooperation between doctors , psychotherapists or dentists , sometimes also other freelancers. In the German health this was formerly known as group practice called or is a medical center .
Basics
The group practices of doctors, psychotherapists or dentists that were common until 2007 are known as professional associations (BAGs). With the change in contract doctor law, the legislator has created new opportunities to practice the medical or psychotherapeutic profession. Since then, contract doctors have been able to employ more doctors, set up branch practices and set up BAGs. The most important cornerstones of the regulations are: In addition to local professional practice groups at a contract doctor or contract psychotherapist seat, supra- local professional practice groups (ÜBAGs) with partners at different contract doctor offices are also possible. BAG and ÜBAG must be approved in advance by the respective admissions committee.
The same applies to the establishment of dental practices.
Professional associations of contract doctors and contract psychotherapists are treated as an economic unit in the accounting relationship with the Association of Statutory Health Insurance Physicians . Interdisciplinary cooperation is also subject to approval, although the specialists and psychotherapists within a BAG have to confine themselves to their own area of expertise.
A BAG can also only be formed for part of the medical or psychotherapeutic services (partial professional community). However, these are not permitted with doctors who are only allowed to work on referral (e.g. radiologists , laboratory doctors , pathologists ).
BAGs appear as an economic unit (mostly BGB society ) when settling the accounts , while the members of the BAG are initially personally liable in the area of liability (e.g. for treatment errors ).
In contrast to this, there is the practice community , in which there are legally completely independent medical practices in shared rooms for both the patient and the Association of Statutory Health Insurance Physicians.
Supra-local professional community
The supra-local professional community (ÜBAG) represents a special professional community. Several independent doctors join forces for joint professional practice. The specialty is that the community does not practice their medical activities at a common practice, but at several physically separate offices. Until the change in the model professional code (MBO) for doctors in 2004, a professional association was generally only permitted at a single practice.
Legal basis and requirements
The professional legitimation of an ÜBAG is § 18 Para. 3 Clause 3 MBO. Joint professional practice with several practice offices is only permitted if at least one member of the professional practice group works full-time at each practice location. In addition, a uniform patient file must be kept. There are no restrictions at ÜBAG with regard to the number of practice seats and members. In principle, ÜBAGs can be set up with an indefinite number of seats. Both the regulations with regard to admission and billing to the Association of Statutory Health Insurance Physicians correspond to those of the “non-regional” professional community.
taxation
- Income tax
An ÜBAG is mostly run in the form of a civil law company, unless a partnership has been expressly concluded in accordance with the PartGG - § 1 Partnership Law (PartGG). The taxation of a üBAG does not differ from the taxation of previous group practices. From a tax point of view, ÜBAG is to be qualified as a co-entrepreneurship in most cases . Whether there is a co-entrepreneurship for tax purposes depends on whether the parties involved are to be regarded as shareholders of ÜBAG under civil law (in the majority of cases unproblematic), they develop co-entrepreneurial initiatives and bear co-entrepreneurial risk and they pursue a joint profit-making intention. If there is a co-entrepreneurship, ÜBAG receives its own tax number and its income is determined separately. The income is then distributed to the individual co-entrepreneurs. ÜBAG itself is not subject to income tax . Each co-entrepreneur pays taxes on the share of the income of ÜBAG that is attributable to him. For the co-entrepreneurs, this income represents income from self-employed work within the meaning of § 18 EStG and is therefore not subject to trade tax .
Under certain circumstances, however, the income of ÜBAG can in some cases also become commercial income within the meaning of Section 15 EStG and thus also be subject to trade tax. Such a case exists, for example, if a co-entrepreneur within the scope of the ÜBAG carries out a commercial secondary activity (e.g. sale of contact lenses by an ophthalmologist ) to a not only minor extent.
- value added tax
In terms of sales tax , ÜBAG is viewed as an entrepreneur and is therefore subject to sales tax as such. Here there is no distribution of sales to the individual members.
Just like the sales of a doctor who works alone, sales from medical services provided by an ÜBAG are generally also subject to § 4 No. 14 lit. a UStG exempt from sales tax. Services that are not medically necessary, such as cosmetic services, piercing and the like, are subject to sales tax.
Partial professional association
In the case of partial professional associations (TBAG), the collaboration is limited to a certain range of services, the practices involved remain fundamentally independent. As a rule, these are supra-local professional associations. In the area of statutory health insurance, TBAGs are only permitted for a limited period, which is why the regulation mainly applies to so-called individual health services . In the event of misuse, there is a particular risk of so-called kick-backs .
literature
- Rolf Michels , The supra-local professional community - design models and tax aspects, MedR (2011) 29; 411-418.
- BFH , judgment v. April 14, 2005, XI R 82/03, BSTBl II 2005, 752
Web links
- ÄrzteZeitung: Partial community practices
Individual evidence
- ↑ Information from the National Association of Statutory Health Insurance Physicians on the BAG
- ↑ Contract Doctor Law Amendment Act of December 22, 2006 ( Federal Law Gazette I p. 3439 )
- ↑ Sample professional regulations for doctors 2011 ( Memento from May 16, 2013 in the Internet Archive ) (PDF; 112 kB)
- ↑ Forms of dental practice ( memento of the original from March 19, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , Information brochure of the German Dental Association , 2011 (including a representation of the BAG) (PDF; 447 kB)
- ↑ KBV brochure on the law on amendments to the law on contract doctors
