Not only the medical staff, but also every patient has to disinfect their hands in a doctor’s office. (Fabian Strauch / dpa)
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From the point of view of Hans Henning Hartmann, resident doctors are currently using the corona pandemic for “illegal fees”, as the retired attorney put it. “I should pay over 160 euros for additional hygiene measures,” he says. As a private patient, Hartmann receives bills from his doctors, which, from a formal point of view, he pays out of his own pocket before he can have the money reimbursed by the insurance company.
The 77-year-old was taken aback by the new items for the hygiene measures on his bills. Hartmann wanted to know the legal basis for this extra money. In fact, there is a corresponding agreement between the Association of Private Health Insurance (PKV) and the German Medical Association. This includes a billing recommendation of 6.41 euros per doctor’s visit. Until September 30 of last year, doctors were also free to charge the flat rate at 2.3 times the rate – that is, to collect 14.75 euros for hygiene for every patient contact. Since October 1, initially only the single sentence is allowed until the end of March. The agreement only applies to private patients. The statutory health insurance companies do not pay any additional fees to the resident doctors for additional hygiene measures due to Corona.
At the same time, the German Medical Association assures that when it comes to hygiene, no distinction is made between private patients and those with statutory health insurance. “So there is a special fee, but no special service at all,” says Hartmann and doubts the entire legal basis. “The insurance companies and the German Medical Association cannot simply agree payments with each other, which are then supposed to be made by a third party, namely me as a patient.” It is therefore irrelevant for Hartmann that the insurance companies reimburse him for the costs. “First of all, I am the debtor and the insurance company will in the end repeat the new expenses through increased contributions.” In addition, according to the lawyer, the legislature alone can create charges. “The German Medical Association is an unincorporated association of the state medical associations that supervise the doctors of the states.” You have nothing to say about the fee schedule.
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The German Medical Association sees it differently. In contrast to the fee schedule, your additional billing recommendations for privately insured persons are not automatically coordinated with the Federal Ministry of Health. “However, we have not received any objections from the ministry or any proposals for regulation that contradict a hygiene flat rate,” the chamber announced on request.
Additional costs for the practices
In this context, the PKV refers to the second paragraph of the statutory fee regulation. According to this, independent medical services that are not included in the list of fees can be charged in the same way as another service of the list of fees that is equivalent in terms of type, costs and time expenditure. In terms of the additional hygiene measures, PKV and the German Medical Association see the creation of a so-called Quengelverband as equivalent and thus came to the aforementioned 6.41 euros. Such an elastic bandage is used for injuries to tendons, for example. “That has no factual connection to hygiene, but actually results from the fee level found to be appropriate,” explains the PKV on request. For Hartmann this is a further indication of a “completely arbitrary” fee charged to the privately insured.
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If one follows the representations of the private health insurance and the German Medical Association, the legally insured are also indirectly involved. Both refer, for example, to the statutory rescue packages for practices. Doctors in private practice received lump-sum compensation payments from the statutory health insurances if patients avoided going to the doctor because of the pandemic. The new fee for hygiene, on the other hand, is always linked to medical services actually provided, because it is only applicable to direct, personal doctor-patient contact in the context of outpatient treatment. For the German Medical Association, there is no question that there are really additional costs. The practices use more disinfectants and protective clothing than before Corona, at the same time they are still treating fewer patients.
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