e-card (chip card)

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e-card
e-card back side ( EKVK )

The Austrian “ e-card ” (SV chip card) is the personal chip card of the electronic administration system of the Austrian social insurance (health, accident, pension, unemployment insurance). This system has to support the administrative processes between insured persons, employers, contractual partners (doctors, hospitals, pharmacists, etc.) and persons of equal status as well as social security agencies. It must be designed in such a way that the laws to be enforced by the social insurance institutions can largely be enforced without paper-based documents. In addition to e-cards also o-cards are used for marking medical ordinations issued, other types of cards (a card-for pharmacies , etc.) are considered.

Introduction and use

A field test was carried out in 1993/1994 with three doctors and around 4000 chip cards for their patients. On the basis of this experience, the Minister of Social Affairs was asked in 1996 to set up a chip card system. The relevant law appeared in 1999 parallel to the implementation of the Signature Directive.

In the first stage of expansion, the e-card replaces proof of insurance on paper (health insurance certificate, health insurance check, medical assistance certificate, patient certificate, treatment certificate, dental certificate). The test phase ran in December 2004 in Burgenland , in 2005 all people with social insurance in Austria (regardless of nationality and employment) were issued with the card. Since May 2009, the e-card has also made it possible to report and cancel sick leave. This service has been tested since May 2008 in a pilot project with 35 doctors and over 42,000 online reports in Upper Austria.

The e-card is part of the Austrian e-government . It uses electronic signatures and is not a pure health insurance card (health card), but a generally usable chip card. It is also possible to use it for electronic authentication of cardholders outside of the social security system ; the card offers secure access to personal data that is stored at other locations. An annual fee of € 10 is charged for the e-card. This amount replaces the previous "health insurance fee".

Approx. 350,000 to 580,000 patient contacts are processed via e-cards every working day. The busiest day was January 26, 2009 with 623,552 patient contacts. Over 11,000 contractual partners (mainly doctors) are connected to the e-card system. In total there are around 8.4 million active e-cards. By the end of 2006, 9,425,551 e-cards had been issued. Every year several hundred thousand cards have to be reissued for newborns, after a name change, loss, etc. On the other hand, there is the elimination of around 40 million sickness certificates and foreign health insurance certificates (Form E 111 etc.) that were previously issued manually , the elimination of the logistics of these paper receipts and the prevention of misuse (by simply reprinting these receipts, etc.).

Since the beginning of December 2009, new e-cards with the letters "sv" in Braille have been issued to take a further step towards barrier-free use of the health system.

e-card system

The e-card system is an online system through which insurance claims can be verified immediately (including additional information such as prescription fee exemptions, etc.). In the event that no line connection to the centrally managed data center can be established, it is possible off-line to save insurance-relevant information (doctor visits) and to transfer them after the connection has been re-established.

The e-card is valid for all statutory health insurance companies , as well as for a number of special systems for civil servants and (from September 2010) for recipients of social assistance (called “needs-based minimum income”). Changes of insurance do not affect the usability. Facilities for updating the map information are not necessary. Information about insurance coverage ( insurance status with which health insurance company, fee exemptions, etc.) is not stored on the e-card , but is determined with the card . This procedure avoids insurance coverage being dependent on the information on a card (possibly defective, lost, etc.) and saves separate security systems for such cases. For such situations, there are agreements that can go as far as a billing guarantee in favor of the doctor. Those who are not insured keep the e-card and can continue to use it for other purposes (e.g. as a citizen card , to document personal data ), a new insurance is documented (with the doctor, etc.) with the same card.

The e-card is used like a key; no medical data is or is stored on its chip . This would be technically possible and could - if concerns about data protection law can be dispelled - take place in a further expansion stage on a voluntary basis. This applies in particular to the statutory storage of emergency data on the card chip. The necessary implementation ordinance of the responsible Federal Minister was not issued because a number of fundamental questions remained open. For example, it does not depend on whether a chip card - readable - is available; the currentness of the data stored on it must also be verifiable.

The chip of the e-card meets the requirements that have to be placed on a citizen card system in public authorities and in business life (legally binding signature option through electronic signature based on clear identification of the person to whom the card is issued). As a result, the query of personal data via the Internet (including telebanking, tax returns, etc.) is prepared or already possible in some areas (insurance account query, tax returns) without having to work with separate PINs , TANs , passwords, etc. for each query option . The possible elimination of user administration also brings significant relief to the providers of such services. The citizen card function of an e-card can be used from any Internet PC with a card reader capable of signing.

The following data is recorded on the chip and on the card itself:

  • Card sequence number (if several cards with the same data were issued for a person after loss)
  • First names
  • Family name (two variants on the chip: with and without diacritical marks )
  • Date of birth
  • Academic degree
  • Identification number of the social security institution
  • Identification number of the card
  • Expiry Date
  • Social security number

With a commercially available chip card reader and appropriate software, such as. B. the software of the citizen card or other tools, this data can be read from the chip.

In 2010, the cost of an e-card including shipping was given as € 1.96.

On the back of the e-card is the European Health Insurance Card EHIC , also known as the European Health Insurance Card (EHIC) , which replaces the foreign health insurance certificate and thus the following forms:

  • E 110 - for international transport
  • E 111 - for temporary stays (e.g. vacation trips) in EU member states, EEA states and Switzerland
  • E 119 - for job search
  • E 128 - for studies and for posting workers to another country

The simplifications through the coupling of this card to the e-card (no parallel card management, later use of the same chip also for electronic readability) led to cost reductions of several million euros. Private group health insurers participate in this system if they operate an insurance that replaces statutory health insurance (opting-out models for freelance persons such as doctors, lawyers, civil engineers).

In 2010, as the first generation of e-cards began to expire with the five-year period for the EHIC on the back, around 4.2 million cards were exchanged, including technical innovations.

Criticism of the e-card

  • The Austrian Court of Auditors criticized the high ancillary costs and errors in project management. After a communication from the responsible Federal Minister to the National Council, the Court of Auditors also found that the project would have " amortized within a few years ". The Court of Auditors confirmed this point of view in its report on the administrative reform 2007: There - with reference to earlier reports with a critical assessment of the project execution (which was not solely attributable to the operator) - under "Assessment (savings potential, efficiency increase, quality improvement)" between 6 million And 50.5 million euros annually as well as efficiency increases.
  • Doctors and the medical association criticized errors in the introductory phase of the e-card. Checks showed that the majority of the error messages were due to the accuracy of the new system, because the e-card system displayed the insurance claims on-line on a day-by-day basis, while the earlier claim documents had a validity period of one to three months and changes such as discontinuation of the insurance coverage within these periods could not be taken into account. The dangers that arose from short-term insurance gaps (e.g. due to delays in reporting when changing employers or unemployment) were taken into account by generous tolerance periods (protection periods) of up to six months, and sometimes even longer for students. Another part of the criticism from the medical profession was driven by economic motives (feared additional expenditure), which was supported by the legal situation (mandatory conclusion of a contract with the social insurance company). To this end, the Court of Auditors agreed with the main association's opinion that, in order to maintain a health system that functions over the long term for the general population, instead of economic considerations by doctors, it will be necessary to make economic considerations with regard to the general compatibility of relevant legal norms. In the opinion of the Court of Auditors, the contractual partner law should be limited with regard to the award of service contracts for contract physicians where it hinders health policy developments.
  • Social welfare recipients did not initially receive an e-card. This was due to the fact that for this group of people in Austria it is not the health insurance carriers (health insurance funds) but the states and municipalities that are responsible, and financial questions were still open. Since September 2010, recipients of social assistance (recipients of needs-based minimum income) have also been included in the e-card system. Whether claims can be asserted, however, depends on the registration of the respective social assistance provider and cannot be influenced by the health insurance.
  • In January 2006 a threat of legal action against the main association of Austrian social insurance institutions, the publisher of the e-cards, became known. This lawsuit was not brought. Criminal charges brought in by different sides also had no effect. In March 2007, the Vienna Public Prosecutor's Office ended the preliminary inquiries and no further procedural steps were initiated. A lawsuit that was actually brought was finally dismissed by the Vienna Commercial Court with judgment of September 30, 2009, reference number 43 Cg 102 / 07h-24.

Additional applications outside of the health sector

In addition to the applications in the health sector, the e-card can be upgraded to a citizen card . To this end, advertising campaigns are carried out as part of public events (trade fairs, etc.) (sometimes in cooperation with the providers of chip card readers).

Other private and public applications are also possible within the legal framework outside of social insurance. For the use of the e-card, payments have to be made to the main association of Austrian social insurance institutions in accordance with the legal requirements (compensation for additional expenses).

Card exchange

Since the cards also represent the European health insurance cards and these have a statutory expiry date, they must be exchanged by the social security agencies. The most common period of validity is five years and applies to employees and co-insured spouses. A ten-year validity is provided for retirees. For the first time, around 4 million cards were exchanged in 2010. Efforts to also save a photo on the card to prevent misuse were not taken into account in this version for reasons of cost, but the cards are prepared for the attachment of photos. It was stated that the cost of the card would increase by 23 cents if photos were placed, which would increase the cost of 6 million people (without children, etc.) by € 1.38 million (assuming that there are already photos without their procurement costs).

From January 1, 2019, a photo must be permanently affixed to all e-cards that are newly issued or exchanged to persons over the age of 14 from this point in time, which clearly shows the cardholder. All e-cards that do not have a photo must be exchanged by December 31, 2023 (Section 31a (8) ASVG).

literature

  • Walter M. Bugnar: The infrastructure project e-card system of the Austrian social insurance. In: SozSi 2004, pp. 488–492.
  • Heinz Otter: The e-card as a citizen card. In: SozSi 2004, pp. 499–501.
  • Reinhard Posch: Possible uses of the e-card and ideas of the federal government for the introduction of the citizen card. In: SozSi 2004, pp. 501–504.
  • Heinz Otter: The e-card in international comparison. In: SozSi 2005, pp. 69–71.
  • Martin Hochreiter: The e-card data center. In: SozSi 2005, pp. 72–73.

Web links

Individual evidence

  1. ↑ 56th Amendment to the General Social Insurance Act - ASVG, Austrian Federal Law Gazette I No. 172/1999, passed in the National Council on July 16, 1999. Since then, changed several times, for versions see www.sozdok.at
  2. ↑ Directive (PDF; 128 kB) 1999/93 / EC of the European Parliament and of the Council of December 13, 1999 on Community framework conditions for electronic signatures, Official Journal L 13 of the European Communities of January 19, 2000
  3. ↑ For figures on the e-card, see parliamentary response to questions (PDF; 2.0 MB) No. 268 of March 20, 2007
  4. ^ Josef Souhrada: Data protection and e-card. In: Austrian specialist journal Soziale Sicherheit 2005, p. 194 (also footnote 97)
  5. ↑ Parliamentary Answer No. 5322 / AB (PDF; 44 kB) of July 15, 2010.
  6. ↑ Parliamentary responses to queries No. 5322 / AB of July 15, 2010 and No. 152 / AB of January 15, 2009 (PDF; 242 kB).
  7. ↑ Report (p. 49; PDF; 790 kB) to the National Council
  8. ↑ In the parliamentary response to the inquiry (PDF; 1.2 MB) No. 3918 of April 13, 2006, which was also accompanied by a detailed description of the project in terms of its timing and framework
  9. ^ Court of Auditors: Positions on administrative reform. Proposals by the Court of Auditors for administrative reform and the reduction of bureaucracy. Series 2007/1. Published by the Court of Auditors in August 2007. No ISBN, freely accessible (PDF; 4.1 MB). Page 51.
  10. ↑ In his report on p. 74 of the original, p. 80 of the linked .pdf
  11. ↑ See the parliamentary response to questions (PDF; 2.0 MB) No. 268 from the Minister of Health from March 20, 2007, question 22
  12. ↑ Ordinance of the Federal Minister for Social Administration of November 28, 1969 on the implementation of health insurance for persons included in health insurance according to § 9 ASVG in the version of the amendment in Austrian Federal Law Gazette II No. 262/2010 , announced August 18, 2010. § 1 Z 20. In force from September 1, 2010. For financing see § 75a ASVG in the version of the Social Insurance Amendment Act 2010, Federal Law Gazette I No. 63/2010 , page 3.
  13. ↑ For their background, see parliamentary question answer no. 3917, also dated April 13, 2006, and the other parliamentary documents on the "program director" cited in the references
  14. ↑ Judgment text at www.sozdok.at / ExpertInnensuche / Decisions, parl. Inquiry / search with "43 Cg 102 / 07h -24".
  15. ↑ 800,000 e-cards are exchanged in Vienna on ORF 9 of May 18, 2010 and Parliamentary Inquiry Response No. 152 / AB of January 15, 2009 (PDF; 242 kB).
  16. ↑ Art. 1 Z 1a BGBl. I No. 125/2017 .