Admissions committee

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In the contract doctor law of SGB ​​V , the admissions committee has to make decisions about the admission of contract physicians or contract psychotherapists or the authorization of (hospital) doctors or institutions, as well as decisions about the withdrawal of the license or the revocation of the authorization. Dentists have their own admissions committee for licensing as a contract dentist .

The Appeals Committee can appeal against decisions made by the admissions committee . The method involved in the doctor or dentist, which are contradictory entitled ASHIP and national associations of health insurance . Subsequently, legal recourse to the social courts is open.

According to Section 96 SGB ​​V, the doctors' admissions committee is made up of three representatives each from the doctors and the health insurance funds, and the chairmanship changes.

In matters relating to psychological psychotherapists and the predominantly psychotherapeutic doctors, the admissions committee meets with an expanded number of three doctors, two psychological psychotherapists, a child and adolescent therapist and six representatives from the health insurance companies.

In the dental field, there is a separate admissions committee with three dentists and three health insurance representatives.

In making its decisions, the admissions committee is bound by the requirements of the admissions ordinance for doctors (ZV doctors) and the admissions ordinance for dentists (ZV dentists). For example, he has to observe the requirements planning and the regulations for undersupplied and oversupplied regions. According to this, the planning areas are the districts and the independent cities. Depending on the population density, the licensing ordinance specifies how high the need for doctors in a specific specialist group is in relation to the number of resident population. With a supply rate of 110%, a planning area is blocked so that new branches of doctors of this specialist group are no longer possible there. Several planning areas are combined in one approval district. Each Association of Statutory Health Insurance Physicians consists of one or more approval districts.

In the dental sector, the restriction on admissions was abolished on April 1, 2007 when the GKV Competition Strengthening Act (GKV-WSG) came into force.

Legal status

Admission and appointment committees, as bodies of joint self-administration by doctors and health insurance companies, are legally and organizationally independent, i.e. not assigned to the KVs as legal entities. They are authorities within the meaning of § 1 SGB ​​X and “able to participate” in the administrative procedure according to § 10 No. 3 SGB X. According to § 77, paragraph 5 SGB V, medical associations are public corporations (Kdö.R. ).

Individual evidence

  1. ↑ Admissions Committee , KVB
  2. ↑ | Section 103 (8) SGB V
  3. ↑ BSG, judgment of 6 May 2009 - B 6 KA 7/08 R - see there under II 3a .

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