Practice clinic
The practice clinic is an institution for contract medical care. In the course of the Health Structure Act (GSG) in 1989, the term "practice clinic" found its way into the Social Security Code No. V with the following text:
"Section 115 Trilateral contracts and framework recommendations between health insurance companies, hospitals and contracted doctors
(1) The state associations of the health insurance companies and the substitute funds together and the associations of statutory health insurance physicians conclude contracts with the state hospital company or with the associations of hospital operators in the state with the aim of working closely between Contract doctors and approved hospitals ensure seamless outpatient and inpatient treatment for the insured.
(2) The contracts regulate in particular
1. the promotion of attending physicians and treatment in facilities in which the insured are cared for on an outpatient and inpatient basis through the cooperation of several contract doctors (practice clinics),
(3) if a contract according to paragraph 1 does not come into existence in whole or in part , its content will be determined at the request of a contracting party by the regional arbitration board in accordance with §114 ...
(4) If a regulation according to paragraphs 1 to 3 does not come into effect in whole or in part by December 31, 1990, its content will be determined by ordinance of the state government. .. "
To date, no contract has been concluded that includes the funding, the arbitration board has not been called by one of the parties, and a state government has not issued an ordinance.
While the outpatient part of care in practice clinics is clear from the regulation of the Association of Statutory Health Insurance Physicians , inpatient care remains unsolved. As a result, the development of the practice clinics lagged far behind the legislature's expectations. Practice clinics emerged exclusively as outpatient operation centers, although the legal text does not contain any restriction on specific specialists.
The reasons for the unsatisfactory development are analyzed in detail in the “Health Report for Germany, 1998, Outpatient Surgery, Chapter 7.13” and evaluated both medically and economically. In essence, remuneration incentives for the inpatient sector are described as the cause.
Definitions of the practice clinic are available from the State Medical Associations of Baden-Württemberg, Bavaria and North Rhine-Westphalia, mainly from the point of view of professional law, because the practice clinic, in contrast to the individual practice, may be active in advertising.
In 1995 the legislature made an attempt to regulate the inpatient part of the practice clinic. In the course of a law to reorganize the Hospital Financing-Hospital Reorganization Act 1997 (KHNG 1997) Drucksache 13/3062, practice clinics should be allowed to keep 4 beds in stock per contract doctor, in which short-term inpatient accommodation for a maximum of 4 days should be possible if necessary. The project failed in the Federal Council.
In 2006, the practice clinics founded their own umbrella association to promote the development of the facility, the Deutsche Praxisklinikgesellschaft e. V. (PKG) Your efforts led in 2009 in the course of the Hospital Financing Reform Act (KHRG) to the introduction of §122 in SGB V. This legitimizes the independent representation of these institutions and at the same time assigns them tasks that are assigned to them together with the Central Association of Health Insurance Funds solve what has not yet succeeded.
At the same time as the KHRG, Section 7 was added to Section 140b SGB V, which makes the conclusion of contracts for integrated care with health insurance companies legally secure for practice clinics.
literature
- Gerhard Schulte, Min. Director a. D. on the legal status of the practice clinic in SGB V.
Web links
- German Practice Clinic Society e. V.
- Leaflet of the State Medical Association of Baden-Württemberg (PDF file; 25 kB)