[The growing endangerment of specialists in private practice--opening up access to hospital outpatient clinics from a legal point of view].
There are two new rules of the German Health System Modernisation Act (GMG) affecting the activity of specialists in private practice: the authorization of a hospital according to Sect. 116 a (SGB V; Title Five of the Social Code) subsidiary to the registration of a SHI physicians and the authorization of a hospital-based physician. Negative effects on office-based physician in private practice will only occur if, for example, an ambulatory healthcare centre (MVZ) is being established by the hospital owner. Currently, Sect. 116 b SGB V also does not have any negative impact on office-based specialists. The benefits catalogue according to Sect. 116 b Para 3 SGB V has so far been narrowly defined. And, in the face of the diverging interests within the Joint Federal Committee Health Insurances/NationalAssociation of Statutory Health Insurance Physicians and Health Reform Consensus Act (GKG)--a noticeable broadening of this catalogue is not to be expected. Also, such a broadening of the scope of this catalogue will be counteracted by the fact that no legal right exists to the conclusion of a contract with the health insurance companies and that the health insurers will actually have to additionally reimburse for medical services according to the catalogue of Sect. 116b Para 3 SGB V beyond the total reimbursement budget.
Luxenburger
Bernd
B
Rechtsanwalt Heimes & Müller, Saarbrücken. dr.luxenburger@heimes-mueller.de
D005858:Germany; D006801:Humans; D007883:Legislation, Medical; D008505:Medical Staff, Hospital / Q000331:legislation & jurisprudence / Q000592:standards; D008511:Medicine / Q000592:standards*; D010044:Outpatient Clinics, Hospital / Q000331:legislation & jurisprudence* / Q000592:standards; D011785:Quality Assurance, Health Care; D013038:Specialization