National Association of Statutory Health Insurance Physicians

National Association of Statutory Health Insurance Physicians (KBV)
	;
organization	Medical self-administration
legal form	Public corporation
Supervisory authority	Federal Ministry of Health
Headquarters	Herbert-Lewin-Platz 2 ; 10623 Berlin
Board	Andreas Gassen , (since 2014 chairman, specialist medical care) ; Stephan Hofmeister (since 2017 deputy chairman, ; general practitioner care) Thomas Kriedel (since 2017 board member)
Members	17 National Association of Statutory Health Insurance Physicians
Website	KBV.de

The National Association of Statutory Health Insurance Physicians ( KBV ) is the umbrella organization of the 17 associations of statutory health insurance physicians and is organized as a corporation under public law . It is subject to the state supervision of the Federal Ministry of Health .

Emergence

The foundation of the Association of Statutory Health Insurance Physicians goes back to an emergency ordinance issued by the Reich President in 1931 , which was intended to mediate the labor disputes between doctors and health insurance companies . It resulted in the final replacement of the individual contract system , in which each doctor concluded individual billing contracts with the health insurance companies, and led to the establishment of a system of regional associations of statutory health insurance physicians. After the National Socialists seized power, the newly founded regional organizations were brought into line in the Association of Statutory Health Insurance Physicians in Germany (KVD). The National Association of Statutory Health Insurance Physicians (KBV) was founded in 1955 as the legal successor to the Association of Statutory Health Insurance Physicians in Germany.

Function and tasks

Building of the Federal Joint Committee (left), the National Association of Statutory Health Insurance Physicians (center) and the German Medical Association (right) on Herbert-Lewin- Platz in Berlin-Charlottenburg.

Advocacy

The KBV represents the rights of contract doctors and contract psychotherapists vis-à-vis the health insurance funds at the federal level (Section 75 Paragraph 2 Sentence 1 SGB V ). The case law deduces from this that the KBV has no general political mandate (e.g. the Federal Court of Justice (BGH) in its decision of May 13, 1985, Az. AnwZ (B) 49/84). It is recognized, however, that it is also committed to politics, the legislature, professional associations, industry and the public in professional policy matters (according to Nösser / Schröder, in Heidelberger Commentary, Mr. 2800, Rn. 27).

Backup order

KVen or KBV guarantee patients with statutory health insurance a qualified outpatient medical care (so-called security order in Section 75 (1) SGB V).

Self-management

In the Federal Joint Committee , representatives from the KBV, the National Association of Statutory Health Insurance Dentists (KZBV), the German Hospital Association and health insurance companies assess the benefits, the necessity and the economic viability of medical services. In addition, they determine the requirements planning and draw up guidelines to ensure economical, quality-assured statutory medical care.

Furthermore, the KBV concludes the federal shell contracts , among other things for the agreement of the uniform evaluation standard , the quality assurance of the medical activity and the details of the medical insurance billing. The KBV settles external health insurance payments among the statutory health insurance associations. From 2012 the KBV will publish a quarterly report on the results of the fee distribution.

The KBV keeps accounting statistics. With the introduction of EDP billing in 1988, the KBV was given the task of defining the data format for the transmission of billing data from medical practices and clinics to KV ( xDT ). The KBV controls the correctness of the medical billing by specifying the guidelines for the accounting software and exercising the software approval process.

Together with the KVen, the KBV maintains the Central Institute for Statutory Health Insurance in the Federal Republic of Germany , which collects the ZI Practice Panel , and conducts a business survey of resident doctors and psychotherapists.

In addition, the KBV organizes the forms for contract doctors. These forms are here as a pattern called. They have the numbers from 1 ( certificate of incapacity for work ) to 70A ("after-treatment for artificial insemination "). Some of these forms can also be found in private patients use.

Cooperations

The KBV maintains the Medical Center for Quality in Medicine as a joint institution with the German Medical Association . The central institute for the associations of statutory health insurance physicians is the independent research institute of the KBV and the associations of statutory health insurance physicians. Together with the statutory health insurance companies, she runs the mammography cooperation center.

Federal Medical Register

The KBV maintains the Federal Medical Register, in which all entries in the medical register of all KVs are stored.

Telephone number 116117

The National Association of Statutory Health Insurance Physicians was assigned the number 116117 for an “on-call service for medical help in non-life-threatening situations”. In urgent but not life-threatening cases outside normal practice hours , callers can use the nationwide number 116117 ("elf 6 elf 7", the elves who help ) to be referred to a general medical doctor in their area. The number can be reached free of charge from the landline network and all cellular networks. The activation took place on April 16, 2012.

criticism

Retirement affair

In 2016, the Federal Ministry of Health ultimately asked the KBV to reverse illegal pension payments and real estate transactions and threatened with forced administration. In May 2016, the meeting of representatives decided to reclaim high pension payments from the former board member Andreas Köhler, as well as retirement payments to other former employees. The Ministry of Health Minister Hermann Gröhe also objected to the illegal financing of KBV real estate in Berlin.