[Funding of obesity surgery: application, appeal and lawsuit].
Due to the fact that the statutory health insurance (GKV) follows a restrictive authorisation practice the German population is undersupplied with bariatric operations. The number of patients who refuse to accept this practice increases considerably. Negative decisions can be contested by appeal and lawsuit. The legal situation is yet unclear, those applying the law, such as lawyers, judges and the health insurance authorities, are confused and disorientated. In absolutely comparable cases different courts come to different decisions. Nevertheless the topic is worth the fight: The German social courts are passing more and more patient-friendly judgements. Cases are easily won by plaintiffs if the body mass index (BMI) is higher than 60 kg/m(2). .
Kanzlei Werner Rechtsanwälte, Frankfurt/M, Deutschland. werner@werner-rechtsanwaelte.de
Tim C
TC
Werner
D000328:Adult; D050110:Bariatric Surgery / Q000191:economics* / Q000331:legislation & jurisprudence; D015992:Body Mass Index; D005260:Female; D005858:Germany; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000191:economics* / Q000601:surgery; D010342:Patient Acceptance of Health Care