title: [Expert assessment of unconventional treatment methods within the scope of legal health insurance--problems based on current court decisions].
abstract: Court decisions of the Federal Court for Problems of Social Welfare (Bundessozialgericht) make health insurance pay for unconventional methods under certain circumstances. Physicians of the Health Insurance Medical Service (MDK) have to examine whether these conditions are fulfilled in a special case. The specific problems they encounter there are being described in this paper. Hermeneutic differences can be noticed. To guarantee the quality of medical care, which is the duty of the statutory health insurances, seems to be difficult in the case of "unconventional" medical methods.
mesh_terms: D000529:Complementary Therapies / Q000331:legislation & jurisprudence*; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D005858:Germany; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence*
vernacular_title: Die Begutachtung unkonventioneller Heilmethoden im Rahmen der gesetzlichen Krankenversicherung--Probleme vor dem Hintergrund der derzeitigen Rechtsprechung.