Medical service of the umbrella association of the health insurance funds

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Logo of the medical service of the umbrella organization Bund der Krankenkassen e. V.

The Medical Service of the Central Association of Health Insurance Funds ( MDS ) is a medical and nursing organization and was founded on October 18, 1989 as a working group "Medical Service of the Central Association of Health Insurance Funds" in accordance with Section 282 of the Social Code Book V, based in Essen. On July 1, 2008, the previous medical service of the central associations of the health insurance funds was transferred to the umbrella organization of the Federation of Health Insurance Funds (GKV-Spitzenverband). From now on it is called the Medical Service of the National Association of Health Insurance Funds with the legal form of a registered association .

tasks

The tasks of the MDS are defined in the Social Security Code 5 (SGB V, § 282). The MDS coordinates the technical work of the 15 Medical Services of the Health Insurance (MDK ) in the federal states and advises the National Association of Statutory Health Insurance Funds on medical and nursing care, performance, quality and structural issues.

A central part of the advice provided by the National Association of Statutory Health Insurance Funds are expert opinions on fundamental questions of medical and nursing care - for example, the use of new medical procedures or the safety of medical products . The National Association of Statutory Health Insurance Funds uses these for the fulfillment of its tasks and the deliberations in the Federal Joint Committee (G-BA) or in other bodies . In addition, the MDS supports the National Association of Statutory Health Insurance Funds directly as a consultant in committees or in negotiations.

As an expert organization, the MDS works according to the scientific standards of evidence-based medicine (EbM) . He bases his analyzes and advice on the latest medical and scientific findings. The basic idea of ​​evidence-based health care is to support decisions with the best possible scientific evidence from clinical studies. Evidence-based benefit assessments are created in a transparent process according to established methodological standards. They include a systematic search for clinical studies as well as analysis and summary of the evidence that is available on a question.

The MDS experts are professionally independent when performing their advisory tasks.

The MDS has been operating the IGeL monitor since 2012 . The internet portal offers insured persons a scientifically sound decision-making aid for or against the use of services that they have to pay for themselves at the doctor (individual health services - IGeL). The evaluations of the IGeL-Monitor are based on the methods of evidence-based medicine.

In addition, the MDS coordinates and promotes the implementation of the tasks and the cooperation of the medical services of the health insurance in medical, nursing and organizational questions. The aim is to ensure assessment and advice according to nationwide uniform criteria and current standards. This is ensured in particular by assessment guidelines that the MDS develops together with the National Association of Statutory Health Insurance Funds and with the participation of the MDK. At the federal level, the MDS represents the interests of the MDK community vis-à-vis politics, associations and the public in close cooperation with the National Association of Statutory Health Insurance Funds.

For social long-term care insurance, the MDS brings the experience of the MDK from the care appraisals and quality checks of care facilities into its consultations. He is also involved in the development of norms and standards. Every three years the MDS publishes a report on the quality of outpatient and inpatient care. In addition, it brings together the data from the MDK care report in nationwide statistics.

The MDS offers information databases for the MDK and the health insurance companies and a practice-oriented and target group-oriented nationwide training program for the MDK experts.

In addition, the MDS creates reports and statistics that represent the assessments of the MDK and especially the development in the quality of care and assessment of treatment error allegations.

Members

Is the sole decision-making member in accordance with Section 282 SGB V

The associations of health insurance companies at the federal level belong to the association as supporting members. You help shape the health policy direction of the MDS. This includes:

In addition, the medical services of the health insurance can join the MDS as sponsoring members.

organs

The organs of the MDS are the board of directors , the general assembly and the management .

The central self-governing body of the MDS is the Board of Directors. It consists of seven insured and seven employer representatives who are elected by the Board of Directors of the National Association of Statutory Health Insurance Funds from among its ranks. The full-time executive board of the National Association of Statutory Health Insurance Funds provides two further board members. These 16 members are entitled to vote. The Board of Directors adopts the statutes of the MDS and defines guidelines for the work of the MDS. The board of directors also elects the managing director and his deputy. It defines the guidelines for the work of the management and decides on the admission or exclusion of members.

The general assembly of the MDS consists of representatives of the National Association of Statutory Health Insurance Funds and the supporting members. She advises on guidelines and principles for promoting cooperation in the MDK community and with health insurance companies. It gives recommendations to the Board of Directors on this.

At the top of the MDS are the managing director, Peter Pick (as of 12/2018) and the deputy managing director and senior doctor, Stefan Gronemeyer (as of 12/2018). You are also a board member within the meaning of § 26 BGB. The managing directors draw up the budget and the annual accounts and represent the MDS in and out of court.

Web links

Individual evidence

  1. ↑ § 282 SGB 5 - single standard. Retrieved December 10, 2018 .
  2. ↑ § 282 SGB 5 - single standard. Retrieved December 10, 2018 .
  3. ↑ § 282 SGB 5 - single standard. Retrieved December 10, 2018 .
  4. ↑ § 26 BGB - single standard. Retrieved December 10, 2018 .