Change Of The General Social Security Act, The Commercial Law On Social Insurance, The Farmers Social Insurance Act And The Officials Sick - And Accident Insurance Act

Original Language Title: Änderung des Allgemeinen Sozialversicherungsgesetzes, des Gewerblichen Sozialversicherungsgesetzes, des Bauern-Sozialversicherungsgesetzes und des Beamten-Kranken- und Unfallversicherungsgesetzes

Read the untranslated law here: http://www.ris.bka.gv.at/Dokumente/BgblAuth/BGBLA_2014_I_28/BGBLA_2014_I_28.html

28 federal law that modifies the General Social Insurance Act, the commercial law of social insurance, the farmers social insurance law and the officials-sick and accident insurance law

The National Council has decided:

Table of contents



Article 1 amendment to the General Social Security Act article 2 amendment of the commercial law on social insurance article 3 amendment of the farmers Social Insurance Act article 4 change of officials-sick and accident insurance Act article 1

Change of the General Social Security Act

The General Social Insurance - ASVG, Federal Law Gazette No. 189/1955, amended by Federal Law Gazette I no. 187/2013, is amended as follows:

1 80 b the following § 80 c and heading is added section:

"Contribution of the Federal Government to finance jaw regulation

§ 80c. (1) the Federal Government has until 31 January of each year, to transfer EUR 80 million on the Dental Health Fund (§ 447i) furnished with the main Association for the first time until January 31, 2016 for jaw regulation.

(2) until July 31, 2015, the Federal Government has to pay 20 million euros to the Dental Health Fund (§ 447i) furnished with the main Association. This has measured these agents on the health insurance carrier to divide.

(3) the transfer of funds under paragraph 1 and 2 with the proviso of effect of the overall contract according to § 343e para 1.

(4) after the sections 153a of this Federal Act, 94a GSVG, 95a BSVG and 69 B-KUVG on the basis of contracts provided the benefits in kind according to § 343e para 2, so the Federal Government has the funds for these services in the amount of the expected to be incurred expenses, to transfer to the Dental Health Fund (§ 447i) furnished with the main Association but no more than the amount referred to in paragraph 1,".

2. after section 153, the following section 153a and heading shall be inserted:

"Pine regulations for children and young people

section 153a. (1) treatment the appropriate dental care grants until the age of 18 without prejudice to a claim according to § 153 children and adolescents jaw adjustment in specie. § 153 para 3 are third and fourth sentence does not apply. Treatment means is if there is a substantial tooth or jaw misalignment.

(2) the need for treatment, the appropriate dental supplies and the quality requirements for the provision of benefits in kind are referred to in paragraph 1 to regulate nationwide uniform in the statutes of the health insurance carrier according to the rules of the model statute (§ 455 para 2) according to the position of dental science.

(3) the Association has a quality assurance system to provide for the services referred to in paragraph 1. The health insurance carriers have quality compliance, to verify in particular the structure and the quality of the result (success) and report the Confederation.

(4) entitlement to reimbursement of costs under section 131 is for services under this provision, provided that



1 pine settlement payments (fees) will be published including their changes by the provider in the Internet indefinitely, and 2. an overall agreement on setting tariffs is according to § 343 c, if and as long as as the total contract pursuant to § 343e para 1, ensures a kind of coverage or the kind of supply is given according to § 343e para 3.

(5) the not-State Convention and the Elimination of a total contract according to § 343e is to be published by the Association on the Internet. Reimbursement for treatments referred to in paragraph 1, which were begun at the time of the announcement of the Confederation shall remain unaffected. A total contract falls away after § 343e, § 131a shall not apply.

(6) the claim, the amount and the quality requirements for the award of grants are to govern according to the rules of the model statute (§ 455 para 2) in case of the absence of a regionally balanced nationwide in kind services (§ 343e) nationwide uniform in the statutes of the health insurance carrier. § 131b is not applicable."

3. in paragraph 343, the expression "for services of the fixed prosthetic" c para 1 is replaced by the expression "for jaw regulation according to section 153a and services of fixed dental prosthesis".

4 following §§ 343e and 343f including heading be added section the 343d:

"Arrangement for the implementation of pine regulations for children and young people

§ 343e. (1) there is a total contract, which regulates the provision of the service according to section 153a between the Confederation and the Austrian Chamber of dentists. This overall agreement will only be effective if one has completed contracts in it under number to be determined taking into consideration to a regionally balanced supply of tooth doctors/dentists this overall agreement, and thus a kind of coverage can be guaranteed according to section 153a.

(2) a total contract pursuant to par. 1 with beginning of effectiveness not concluded until 31 December 2014 1 July 2015 or thereafter enters a vertragsloser State, so the health insurance carriers have - on the basis of a plan to be created by the Confederation - the power according to section 153a, special contracts of same performance content with service providers, in particular dental doctors/dentists and group practices independent outpatient clinics as well as in facilities of the health insurance carrier to provide. No entitlement to reimbursement of costs article 131 and article 60 is B-KUVG on the basis of existing special contracts.

(3) by way of derogation from paragraph 1 the total contracts may be off also effective, if through individual contracts on the basis of this overall contract, significantly more than two-thirds of the power requirement of the children and adolescents makes sure to section 153a and a regionally balanced supply is given. In this case, the health insurance institution in the sense of a nationwide kind services performance in addition to section 153a have to provide through special contracts of same performance content with service providers, in particular dental doctors/dentists and group practices independent outpatient clinics as well as in facilities of the health insurance institution in the sense of the plan referred to in paragraph 2.

(4) the balanced coverage of the kind is according to paragraph 1 or 3, in particular on the basis of the resolution of contractual relationships no longer holds, the total contract is considered terminated. This is then to assume if the kind supply through individual contracts on the basis of the overall contract covers less than two-thirds of the power requirement of the children and young people. The Federation has to make known this fact on the Internet. § 348 is to apply subject to the proviso that circumference, height and scale of the power requirement is not subject to the proceeding, may be subject to any amendment of the treaties and the submission of four weeks after the announcement by the main Association to be made.

Price transparency

§ 343f. The vendors/providers of jaw regulation should annually announce prices for the services offered by the jaw adjustment to section 153a, 94a GSVG, 95a BSVG and 69 B-KUVG Association or the Austrian Chamber of dentists. The Austrian dental Chamber has to provide the messages came to her Association. The Association has to publish all information reported to him in this respect on the Internet."

5. § 447 h is inserted after 447i the following section together with the heading:

"Dental health fund

§ 447i. (1) when the Association is to build a Fund for dental health. The assets of this Fund is to manage separately from the other assets of the Confederation. For each year, there is a clearance of accounts to create, which in any case must consist of an income statement and a closing balance at the end of the year. Furthermore is an annual report at the end of each year to write and submit the Federal Ministry of health with the clearance of accounts.

(2) the resources of the Fund are applied:



1. resources of the Federal Government under section 80c and 2. other revenue.

(3) the resources of the Fund in the amount of EUR 80 million are annually for jaw regulation for children and young people in accordance with the sections 153a of this Federal Act, 94a GSVG, use 95a BSVG and 69 B-KUVG. Remaining funds can be used for other services in the field of dental health.

(4) the Association has the means according to paragraph 2, taking into consideration the expenses for jaw regulation after the sections 153a of this Federal Act, 94a GSVG, appropriately notify 95a BSVG and 69 B-KUVG. Paragraph 4 occurs the case § 80 c, the actually incurred costs to be used is according to the final results.

(5) the transfer is on the health insurance carrier under this Federal Act, the social insurance institution of for trade and industry, the social insurance institution of the farmers and the public servant as a carrier of health insurance insurance institution at least twice a year by decision of the Conference of the carrier."

6. in the section 545 paragraph 7, the expression "of the section 447a para 10" is replaced by the expression "the § § 80 c and 447a paragraph 10".

7. after section 681, 682 the following section including headline is attached:


"Final provision Article 1 of the Federal Act Federal Law Gazette I no. 28/2014"

§ 48p. I no. 28/2014 will take the sections 153a (1) and 343 c para 1 as amended by Federal Law Gazette 1 July 2015 effect."

Article 2

Amendment of the commercial law on social insurance

The commercial law of social insurance - GSVG, BGBl. No. 560/1978, amended by Federal Law Gazette I no. 139/2013, is amended as follows:

1. in section 86, paragraph 5 lit. e is the expression except "Pine regulations" with the expression "except not covered by section 94a jaw regulation" replaced.

2. According to § 94 the following section 94a and heading shall be inserted:

"Pine regulations for children and young people

section 94a. (1) treatment supply up to appropriate the age of 18 without prejudice to a claim according to § 94 Dental grants children and adolescents jaw adjustment in specie. Treatment means is if there is a substantial tooth or jaw misalignment.

(2) the need for treatment, the appropriate dental supplies and the quality requirements for the provision of the benefits in kind referred to in paragraph 1 are nationwide uniform in the articles of association according to the rules of the model statute (§ 455 para 2 ASVG) to regulate according to the position of dental science.

(3) entitlement to reimbursement of costs pursuant to § 85 para 4 - without prejudice to the provisions referred to in § 85 para 2 - for services under this provision only exists, and as long as the total contract ensures a kind of coverage according to § 343e ASVG. A total contract falls away after § 343e ASVG, so § 85 para 4 is second sentence does not apply.

(4) the claim, the amount and the quality requirements for the granting of a refunding are to govern in case of the absence of a nationwide kind services (§ 343e ASVG) nationwide uniform in the articles of Association of the insurance carrier."

3. According to Article 353, 354 the following section including headline is attached:

"Final provision to article 2 of the Federal Act Federal Law Gazette I no. 28/2014"

§ 354. The § 86 para 5 lit. I 28/2014 will take no. e and 94a para 1 as amended by Federal Law Gazette 1 July 2015 effect."

Article 3

Change of the farmers social insurance law

The farmers social insurance law – BSVG, Federal Law Gazette No. 559/1978, amended by Federal Law Gazette I no. 139/2013, is amended as follows:

1. in section 80, paragraph 3 lit. the expression "except for jaw regulation" is replaced by the expression "except not covered by § 95a pine regulations" h.

2. According to § 95, 95a the following paragraph and heading shall be inserted:

"Pine regulations for children and young people

§ 95a. (1) treatment supply up to appropriate the age of 18 without prejudice to a claim according to § 95 Dental grants children and adolescents jaw adjustment in specie. Section 95 para 4 first and second sentences are not applicable. Treatment means is if there is a substantial tooth or jaw misalignment.

(2) the need for treatment, the appropriate dental supplies and the quality requirements for the provision of the benefits in kind referred to in paragraph 1 are nationwide uniform in the articles of association according to the rules of the model statute (§ 455 para 2 ASVG) to regulate according to the position of dental science.

(3) entitlement to reimbursement or allowance pursuant to article 80 paragraph 2 fourth final and antepenultimate is set for services under this provision only, and as long as the total contract ensures a kind of coverage according to § 343e ASVG.

(4) the claim, the amount and the quality requirements for the granting of a refunding in the event of the absence of a nationwide kind services (§ 343e ASVG) nationwide uniform in the articles of Association of the insurance institution to regulate. § 239 is not to apply."

3. According to § 345, 346 the following section including headline is attached:

"Final provision to article 3 of the Federal Act Federal Law Gazette I no. 28/2014"

§ 346. The § 80 para 3 lit. I 28/2014 will take no. h and 95a para 1 as amended by Federal Law Gazette 1 July 2015 effect."

Article 4

Change of officers sick and accident insurance act

The officials-sick and accident insurance law - B-KUVG, Federal Law Gazette No. 200/1967, amended by Federal Law Gazette I no. 139/2013, is amended as follows:

1. According to article 69, the following article 69a and heading shall be inserted:

"Pine regulations for children and young people

section 69a. (1) treatment supply up to appropriate the age of 18 without prejudice to a claim according to § 69 Dental grants children and adolescents jaw adjustment in specie. § 69 paragraph 3 are third and fourth sentence does not apply. Treatment means is if there is a substantial tooth or jaw misalignment.

(2) the need for treatment, the appropriate dental supplies and the quality requirements for the provision of the benefits in kind referred to in paragraph 1 are nationwide uniform in the articles of association according to the rules of the model statute (§ 455 para 2 ASVG in conjunction with § 158) to regulate according to the position of dental science.

(3) entitlement to reimbursement of costs pursuant to § 59 for services under this provision only exists, and as long as the total contract ensures a kind of coverage according to § 343e ASVG. A total contract falls away after § 343e ASVG, § 60 shall not apply.

(4) the claim, the amount and the quality requirements for the award of grants are to regulate nationwide uniform in the articles of Association of the insurance company in case of the absence of a nationwide kind services (§ 343e ASVG). § 60a is not to apply."

2. According to § 238, 239 the following section including headline is attached:

"Final provision to article 4 of the Federal Act Federal Law Gazette I no. 28/2014"

"239 § § 69 para 1 as amended by Federal Law Gazette I no. 28/2014 1 July 2015 into force."

Fischer

Faymann