Modification Of The Agreement In Accordance With Article 15A B-Vg On The Organization And Financing Of Health Care

Original Language Title: Änderung der Vereinbarung gemäß Art. 15a B-VG über die Organisation und Finanzierung des Gesundheitswesens

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Agreement in accordance with Art. 15a B-VG, by which the agreement in accordance with Art. 15a B-VG on the organisation and financing of the health care system, BGBl. I No 105/2008 is amended

The Federal Government, represented by the Federal Government,

the country of Burgenland, represented by the governor of the country,

the Land of Carinthia, represented by the provincial governor,

the Land of Lower Austria, represented by the regional governor,

the Land of Upper Austria, represented by the governor of the country,

the Land of Salzburg, represented by the country's main wife,

the Province of Styria, represented by the Governor of the State,

the Land Tirol, represented by the provincial governor,

the State of Vorarlberg, represented by the provincial governor and

the Land of Vienna, represented by the provincial governor,

in the following Contracting Parties, agree to conclude the following agreement in accordance with Art. 15a B-VG:

The agreement in accordance with Art. 15a B-VG on the organisation and financing of the health care system, BGBl. I n ° 105/2008, shall be amended as follows.

1. The table of contents is:

" CONTENTS

PREAMBLE

Section 1

General provisions

Article 1

Subject matter and priorities

Article 2

Scope

Section 2

Planning, interface management, health telematics, performance-oriented financing systems, cross-sector financing of the outpatient sector and health economics

Article 3

Integrated health structure planning

Article 4

Austrian structural plan Health and regional structural plans Health

Article 5

Joint management in the interests of patients and patients

Article 7

Health telematics (e-Health) and electronic health records (ELGA)

Article 8

Financial systems

Article 9

Cross-sectoral financing of the outpatient sector

Article 10

Health Economics

Section 4

Federal Health Agency and State Health Fund

Subsection A) Federal Health Agency

Article 14

Establishment of the Federal Health Agency

Article 17

Federal Health Agency

Subsection B) National Health Fund

Article 18

Establishment of the State Health Fund

Article 20

Task of health care platforms at country level within the framework of the State Health Fund

Article 21

Funds from the State Health Fund

Article 22

Increase in health insurance contributions

Article 23

Cost contribution

Article 24

Calculation of national quotas

Section 5

Cooperation between the institutions

Article 25

Relations between the institutions of the social security system and the institutions of the hospitals and the State Health Funds

6.

Transparency of the estimates and financial statements

Article 26

Transparency of the estimates and financial statements

Section 7

Performance-based financing in the healthcare sector

Article 27

Performance-based financing

Article 28

Hospital-specific calculation of LKF points

8. Section

Domestic guest patients and guest patients

Article 29

Compensation for domestic guest patients and guest patients

Section 9

Other financing measures

Article 30

Funds for Health Austria GmbH (GÖG) and financing of projects and planning

Article 31

Cooperation Area (Reform Pool)

Article 32

Promotion of the transplant system

Article 33

Financing of nationally significant health promotion and prevention programmes as well as treatment measures

Article 34

Evaluation of precautionary measures

11.

Evaluation of all measures

Article 36

Evaluation

12.

Documentation

Article 37

Ensuring and further developing the documentation

Article 38

Collection of additional data

Article 39

Surveys and on-the-job

Section 13

Penalties

Article 40

Sanctions intramural

Article 41

Extramural Sanctions

14.

Other provisions

Article 42

Protection clause for the federal government and the social insurance institution

Article 43

Safeguard clause for cities and municipalities

Article 44

Medical training

Article 45

Foreign claimers, hospital care abroad for medical reasons

Article 46

Knowledge of the Constitutional Court (Zams)

Article 47

Arbitration Commission

Section 15

Legal implementation of the agreement

Article 48

Legal implementation

Section 16

Final provisions

Article 49

entry into force

Article 50

Implementation of the agreement

Article 51

Period of validity, termination

Article 52

Communications

Article 53

Original text "

2. The Preamble is:

" PREAMBLE

The contracting parties are committed to providing comprehensive medical care for all people regardless of age and income. The principles of solidarity-based financing, equal and low-threshold access to services, as well as high quality and efficiency in the provision of services apply. In addition, the objective of the agreement is to connect patients and patients with the objective of designing health processes in such a way that prevention, diagnosis, treatment, rehabilitation and care should be carried out in a suitable manner. The sequence and the right place, in reasonable time, with assured quality and with the best possible result. The contracting parties also agree to orient themselves to the framework health objectives and to the central public health principles.

The agreement in accordance with Art. 15a B-VG on the organisation and financing of the health care system is now in a close connexe with the agreement under Art. 15a B-VG Target Tax Health, BGBl. I No xx/2013. This agreement, which is now amended, is subject to the consistent continuation of the previous agreement in accordance with Art. 15a B-VG on the organisation and financing of the health care system (BGBl. I n ° 105/2008), which has been adapted to the requirements of the target management health and has remained unchanged with regard to FAG provisions 2008.

The continuation and intensification of the measures already agreed upon and begun in the previous agreement period of joint management and planning are carried out. Planning objectives and principles are in principle jointly defined in an Austrian structural plan health and the planning is carried out in the regional structural plans at the country level. The Contracting Parties therefore agree that, with the inclusion of the intra-and extra-murals, in particular the necessary steps are taken to:

to ensure joint integrated and cross-sectoral planning and management in the health sector,

to increase the degree of liability in health planning at the country level through mutual coordination of intra-and extramural supply planning; and

to establish cross-sectoral financing. "

Article 1 reads as follows:

" Article 1

Subject matter and priorities

1. The Contracting Parties agree to comply with this Agreement in accordance with the following provisions:

1.

continue to provide a federal health agency and state health fund at country level to plan, manage and ensure overall funding for the entire healthcare sector in the area of regional and cross-sectoral planning, with due regard for the to establish an agreement in accordance with Art. 15a B-VG Target Control-Health and the resulting stipulations;

3.

to provide funding for planning and projects designed to ensure and improve the quality, efficiency and effectiveness of health care;

4.

to promote transplantation and other essential health promotion and prevention programmes, as well as treatment measures of national importance,

5.

the relations of the State Health Fund, the social security institution, the main association of the Austrian social insurance institutions (hereinafter referred to as the main association) and the institutions of the hospitals referred to in Article 18 (3) and (4) (hereinafter referred to as 'the main body'), management of hospitals), and

6.

the institutions of the hospitals, on behalf of the State Health Fund, on behalf of the social security institutions, pay for the treatment of patients who have a duty to benefit from social security; ,

(2) Content priorities of this agreement are in mutual agreement with the agreement in accordance with Art. 15a B-VG Target Control-Health and with special consideration of the patient orientation are in particular

1.

Intensification of the necessary structural changes in the intra-and extramural area,

3.

Cross-sectoral financing of outpatient services,

4.

Promote measures to ensure integrated and cross-sectoral planning, management and financing of the whole health system;

5.

to increase the effectiveness and efficiency of a comprehensive, binding anchoring of quality work at all levels of the health care system,

6.

the improvement of the interface management between the various service providers,

7.

support for work to develop and develop information and communication technologies (such as ELGA, eCard, e-Health), which are relevant to health care;

8.

the promotion of health-economic approaches,

9.

In the joint management and development of the Austrian health care system, the principle must be observed that the decision-makers responsible for the planning must also be responsible for the financing and that between the Health sectors the principle "money follows performance" applies. "

4. The title of the second section is:

"Planning, interface management, health telematics, performance-oriented financing systems, cross-sector financing of the outpatient sector and health economy"

5. Article 3 (1) reads as follows:

" (1) The integrated planning of the Austrian health care structure has to meet the requirements of the target control health and takes place on the basis of existing evidences and cross-sector. It covers all levels and sub-areas of healthcare and adjacent areas. An integral part of this agreement shall be to ensure the implementation of integrated planning, in particular in the following areas:

1.

a stationary area, provided that it is wholly or partly financed by local authorities and/or social security funds;

2.

Outpatient area, i.e. hospital bullets, self-employed outpatients with cash contracts, including their own institutions of insurance institutions, established doctors and dentists/dentists with cash contracts, group practices with cash contracts and other occupational groups freely practising in the healthcare sector, with cash contracts;

3.

Rehabilitation area with the aim of further building and building an Austria-wide equivalent, nationwide graduated care in the sense of a needs-based offer in all areas and at all levels of healthcare, i.e. stationary and outpatient, with special consideration of the rehabilitation of children and adolescents;

4.

Care area, insofar as this is important in the context of the interface management for health care. "

6. Article 3 (4) reads as follows:

"(4) Health-structure planning shall be binding on quality criteria in accordance with Art. 7 of the Agreement in accordance with Art. 15a B-VG Target Control-Health and Seam Management according to Art. 5."

Article 4, together with the heading, reads as follows:

" Article 4

Austrian structural plan Health and regional structural plans Health

(1) The orientation of the Austrian structural plan health (ÖSG) is determined by the higher-level target control-health. The relationship between target control-health and the ÖSG is regulated in Article 9 of the agreement according to Art. 15a B-VG Target Control-Health. The binding basis for the integrated planning of the Austrian health care structure is laid down in the ÖSG. The ÖSG represents the framework planning for the inpatient and outpatient care planning in the Regional Structural Plans Health (RSG) as well as for the rehabilitation area and the seam areas to the care area.

(2) According to its objective as a planning basis for the entire healthcare system, the ÖSG comprises quantitative and qualitative planning statements for all health care areas. A service plan is to be planned in those areas where the data bases make this possible. In addition, the ÖSG contains the presentation of the actual state of the supply structures in the inpatient area, in the outpatient area and at the interfaces to the care area at the level of the supply regions, in the rehabilitation area at the level of Supply zones. Binding quality criteria represent an integral part of the planning statements.

(3) The Federal Health Agency shall continuously develop the ÖSG in accordance with the objectives of the target control health during the term of this agreement. Planning principles and planning requirements are priority for the outpatient sector, the non-acute inpatient area of the hospitals, the rehabilitation area (including rehabilitation of children and adolescents) and for the To progressively lay down and enter into the ÖSG seamless care areas until the end of the agreement period. The Contracting Parties agree to make available the necessary data bases in sufficient quality.

(4) Extensions or Revisions of the ÖSG shall be carried out in accordance with the determinations of the overall target control health and shall be made available in a suitable manner. In any case, the following development steps are included:

1.

Continuous updating of the information on the actual situation and the forecast of needs in the various supply areas,

2.

Annual maintenance and further development of the performance matrix of the ÖSG, taking into account the changes in the documentation basis (in particular service catalogue) of the LKF model,

3.

Concretization of the regional supply planning in the field of complex medical services, as contained in the ÖSG 2012, in quantitative terms, as well as complementing further areas to be agreed upon in accordance with the provisions of the Target-tax health,

4.

Revision and redimensioning of the structural quality criteria contained in the ÖSG 2012 to the necessary requirements as well as increased focus on the criteria of process and result quality in the intra-and extramural sector based on the conception the target tax health; in the context of future ÖSG revisions, structural quality criteria for the outpatient sector are to be supplemented by necessary requirements.

Revisions to the ÖSG content will be made on the current data basis at a distance of two years in each case.

(5) The orientation of the Regional Structure Plan for Health (RSG) is determined by the higher level of target control-health at the country level. The relationship between target control-health and RSG is regulated in Article 9 of the agreement according to Art. 15a B-VG Target Control-Health. The integrated supply planning in the framework of the RSG as well as adjustments, maintenance and further developments of this planning are to be agreed between the respective country and the social security system at the country level, in particular with regard to Capacity requirements for the provision of health services in all sectors of health care. In terms of structure, minimum content, structure and presentation form, the RSG will be further developed in an Austrian-wide comparable form. The RSG are to be made available in a suitable manner. The hospital planning of the RSG is to be issued by a regulation of the respective country. The RSG or the country-hospitals ' plans are the basis for the health-care requirements assessment and/or for the conclusion of social security contracts. Appropriate adjustments must be made in hospitals and in social security law. Social security legislation is to ensure that the total contract partners in the extramural sector are negotiating their negotiations. All capacity-building capacities must be taken into account in the granting of authorisations and operating licences (requirements assessment procedures).

(6) In the case of detailed planning, the guidelines and guide values contained in the respective version in the ÖSG shall be complied with. Detailed planning is to be brought to the attention of the Federal Health Agency as soon as possible through the State Health Fund.

(7) In accordance with the ÖSG and the detailed plans agreed with it, in particular with the RSG, they are granted to the service providers or service providers respectively. , to amend existing permits with the greatest possible protection of the rights of a person or to withdraw them at most. The corresponding federal and state regulations have to be made possible.

(8) The accountability of benefits within the framework of the State Health Fund or by the health insurance institutions, it is necessary to lay down legally binding adherence to the qualitative contents of the ÖSG and to the regional detailed planning, in particular the RSG by the service providers.

(9) An all-due provision of investment grants to the service providers shall be carried out in accordance with the ÖSG and the detailed planning, in particular the RSG, which has been agreed with them.

(10) The stipulations in the ÖSG and in the detailed planning, in particular in the RSG, are to be continuously reviewed and evaluated with regard to their implementation (ÖSG monitoring and RSG monitoring, which is comparative Austria-wide). This monitoring is to be designed in such a way that it can provide an appropriate basis for monitoring within the framework of target control health. "

(8) In Article 5, paragraphs 2 and 6 are deleted.

9. Article 5 (3) reads as follows:

"(3) The functioning of the information transfer to ensure the organisational assurance of a seamless transition of patients ' and patient care between performance-generating facilities is to be ensured."

10. Article 5 (5) reads as follows:

" (5) The Federal Health Agency has to support an appropriate exchange of experience between the State Health Funds as well as to carry out information and advisory functions. The State Health Fund reports the Federal Health Agency reports on the fulfilment of the framework conditions. This information also flows into annual Austrian reporting on quality in the healthcare sector. "

11. Article 6 is deleted.

12. Article 7 (1) reads:

' (1) The Contracting Parties agree that measures in the field of health telematics shall, as a matter of priority, be based on the following objectives:

1.

Improving the quality of care,

2.

Exploiting the economic potential of information and communication technologies,

3.

Harmonisation of the national approach with programmes and activities at European level and

4.

Ensuring the right of citizens to electronic access to their personal health data and to quality-assured public health information. "

Article 7 (3) reads as follows:

"(3) The Contracting Parties shall commit themselves to the implementation and further development of the Electronic Health Act (ELGA), whereby the social security system shall be included as an equal system partner in all measures and decisions."

Article 7 (6) reads as follows:

" (6) The Federal Health Agency has to evaluate the progress made in accordance with paragraphs 3 and 4. The system partners and the ELGA GmbH report to the Federal Health Agency at least annually on the state of development. "

15. Article 8 and title reads as follows:

" Article 8

Financial systems

In analogy to the stationary sector, financing systems need to be developed and coordinated for all areas of health care. The performance-oriented hospital financing system in the stationary sector will be continued and further developed. In a further step, a federal uniform model for the retributive system is also developed for the outpatient sector. The existing models in the outpatient sector are to be evaluated with regard to their incentive and control effect. Within the framework of the State Health Fund, the implementation of the financing systems from the respective financing partners is intended to take into account possible effects on the performance of the other supply areas. "

16. Article 9 and headline reads:

" Article 9

Cross-sectoral financing of the outpatient sector

(1) The Contracting Parties agree to develop cross-sectoral accounting models for the outpatient sector. For this purpose, a working group of the Federal Health Agency is set up, which in any case includes the federal, state and social insurance companies. The result of this working group must be available by the end of 2013 as the basis for a decision in 2014 on a possible conversion of the billing system in the outpatient sector.

(2) In order to ensure the basis for decision-making for cross-sector financing of the outpatient sector, this working group has to do the following work up to 2013 and to vote on a regular basis in the Federal Health Commission:

1.

Accompanying the ongoing work to ensure a nationwide uniform documentation in the outpatient sector (pursuant to Art. 37),

2.

Clarification of essential preliminary questions (e.g. (b) calculatory principles, service-related questions) and elaboration of the framework conditions for changes in the financing of the outpatient sector,

3.

Elaboration of a concept for the settlement of the outpatient sector according to criteria laid down jointly by the Federal Health Commission (e.g. B. Quality, accessibility, efficiency),

4.

Concrete model developments for selected performance ranges up to selected areas of expertise (e.g. B. Calculations, adaptations of the daily hospital catalogue),

5.

Monitoring of agreed pilot projects,

6.

Determination of the total volume of funding required for the financing of the outpatient sector, in particular the assessment of the hospital-based coverage area,

7.

Simulation calculations for the presentation of the expected financial impact on changes in the financing of the outpatient sector.

(3) Priority should be given to performance areas or Subject areas with cross-sectoral relevance, with secured data bases, with self-contained manageable services and with corresponding intra-/extramural overlap potential are processed.

(4) The Contracting Parties agree that, pending a final decision on the conversion of the settlement system in the outpatient sector, cross-sectoral financing of outpatient services in the context of the target control-health shall be made. "

(17) In Article 10, paragraph 2 shall be taken after the word "Requirements" the phrase "and with regard to the target tax health" inserted.

18. Article 11 is deleted.

19. The 3. Section is omitted.

Article 14, together with the heading, reads as follows:

" Article 14

Establishment of the Federal Health Agency

(1) In order to carry out tasks under this Agreement and the Agreement pursuant to Art. 15a B-VG Target Control-Health, the Federal Government continues to have a Federal Health Agency in the form of a public-law fund with its own to establish legal personality.

(2) The tasks and organisation of the Federal Health Agency are regulated in the agreement according to Art. 15a B-VG Target Control-Health. "

21. Articles 15 and 16 are deleted.

22. In Article 17 (2), the expression shall be as follows:

"(from 2009)"

23. Article 17 (4) Z 2 lit. (c) and (d) is:

" (c)

EUR 3.5 million to finance further projects and planning in the sense of the lit. (a) and for essential health promotion and prevention programmes, as well as treatment measures of superregional importance, the use of which shall be established in agreement with the countries and the social security system;

d)

After the existence of a cost-benefit assessment and in accordance with decisions of the Federal Health Commission agreed between the Federal Government, the Länder and the Social Insurance, a maximum total of 10 million euros (for the period 2008 to 2013) for the design, implementation and operation of the architecture components in accordance with the planning for the first implementation phase of the electronic health records (ELGA) pursuant to Art. 30 (6) (1) and in accordance with decisions of the Federal Health Commission a maximum total of 10 million euros (for the period 2014 to 2016) Financing of the ELGA pursuant to Art. 30 (6) (2) and (2)

Article 18 (1) and (2) reads as follows:

" (1) In order to carry out tasks under this Agreement and the Agreement in accordance with Art. 15a B-VG Target Control-Health, the Länder continue to have a State Health Fund in the form of a public-law fund for each Land. to set up its own legal personality.

(2) In the case of the establishment and operation of State Health Funds, in any event, accrued accounting rules which have been accrued between the countries and the comparability shall apply, and shall have an accrual definition of the funds of the National Health Fund to be implemented. These rules shall, in particular, comply with the requirements of financial target management in accordance with the agreement under Art. 15a B-VG Target Control-Health. "

25. The following paragraph 5 is added to Article 18:

"(5) The tasks and organisation of the State Health Funds are regulated in the agreement according to Art. 15a B-VG Target Control-Health."

26. Article 19 is deleted.

27. Article 20, together with the heading, reads:

" Article 20

Task of health care platforms at country level within the framework of the State Health Fund

In the event of restrictions on the service provision, it is necessary to act by common accord The relevant contractual situation has to be taken into consideration. The financial consequences of unplanned and non-contractual performance restrictions in the inpatient, outpatient and nursing care sector must be borne by the institution that caused it. "

28. Article 21 (1) (4) reads as follows:

" 4.

additional funds to be made available for health care reform under the financial compensation agreement 2005 to 2008 (these funds will continue to be available in the previous form until the end of the period of this agreement) and distributed to the State Health Fund, as in 2007), "

29. Article 21 (6) (2) and (3) reads as follows:

" 2.

The provisional payments made by the social security institutions from 2009 onwards shall be calculated from the annual amount of the payment in accordance with the final settlement for the second preceding year, multiplied by the provisional hundreds of years of the following years. These are the estimated percentage increases in the contribution income of the sickness insurance institutions compared to the previous year.

3.

The final annual accounts are up to the 31. In the following calendar year, it must be made in the form that the final annual amount of the previous year is to be increased by that percentage by which the contribution income of the sickness insurance institution shall be increased in relation to that in each case. the percentage increase in the previous year, although the agreement on the financial compensation provided for in paragraph 1 (4) does not take into account agreed contribution-related receipts in social health insurance. "

30. Article 21 (6) Z 5 reads:

" 5.

From 2008 until the end of the term of this Agreement, the social insurance institutions shall make an annual amount of the variable financial volume to the State Health Fund, which is based on the legal position existing on 31 December 1996. with regard to the cost contributions (cost shares) in the inpatient sector provided for in the social security laws. Cost contributions (cost shares) for (in) installation care due to provisions in the social security laws are raised by the institutions of the hospitals on behalf of the social insurance institutions for the State Health Fund. These cost contributions (cost shares) are valorized according to Z 2. "

31. In Article 22, the expression in brackets is deleted.

(32) In Article 25 (8), the word "Required" .

(33) In Article 25, the following paragraph (8a) is inserted:

"(8a) The social insurance institutions shall, by electronic means, submit to the State Health Fund, on request, the data required for the performance of their tasks, in a manner which is appropriately prepared and comprehensible."

34. The following paragraph 3 is added to Article 26:

"(3) These representations shall, in particular, meet the requirements of financial target management in accordance with the agreement referred to in Art. 15a B-VG target control health."

35. In Article 27, the following paragraph 3a is inserted after paragraph 3:

" (3a) The Contracting Parties agree that countries shall ensure that the State Health Fund financed by the State Health Fund is not subject to the legal support of local authorities or social security institutions. In the case of settlement of LKF points, hospitals shall be guaranteed equal remuneration for the same benefit in respect of the point value for this part. "

36. Article 27 (6) reads as follows:

" (6) The work begun in 2012 for the comprehensive updating and further development of the LKF model is with the objective of a model conversion with 1. Jänner 2016 in time for 1. This will be completed in the first half of 2015 and will be supplemented by corresponding simulation calculations on the effects of a model change. The focal points of this LKF model development are, among other things,

1.

Calculation with revised calculation guidelines based on the updated and further developed hospitals cost accounting,

2.

Further development of the LKF model, including the reference system for intensive units, and for specific performance areas, taking into account the usability of the generated data for quality reporting,

3.

Coordination of the LKF model with the supply possibilities in the most acute and established areas (harmonization of documentation, delimitation of the contents and the puncturation of the case packages to the other supply areas). "

37. Article 27 (10) reads as follows:

" (10) The further development of the LKF system has to meet the requirements of the target control health. In addition, the results of the evaluation "10 years of LKF system in Austria" must be taken into account and a gradual increase in the proportion of funds made available via LKF will be made on the basis of the LKF evaluation results. "

38. Article 30 (6) reads as follows:

" (6) The federal and state governments agree

1.

on the basis of a cost-benefit assessment and in accordance with decisions taken by the Federal Health Commission on joint financing of the design, implementation and operation of the Federal Health Commission in accordance with joint decisions between the Federal Government, the Länder and the Social Insurance Commission to make available to the ELGA a total of a maximum of EUR 30 million in the duration of this agreement, in accordance with the plans for the first implementation phase (2008 to 2013),

2.

to provide a further maximum of 30 million euros in total for measures to be financed by the Community, relating to the establishment, maintenance, operation and further development of the ELGA in the years 2014 to 2016,

3.

that the application of the shares of the countries according to Z 1 and 2 within the framework of the Federal Health Agency by way of forework (according to Art. 17 para. 4 Z 2 lit. d). "

39. The following paragraph 6 is added to Article 31:

" (6) After 31 December 2012, there are no longer any new reform pool projects. Before the 1. Reform pool projects decided on January 2013 can be part of the country's target tax treaties. "

40. The title of Article 33 reads as follows:

"Financing of nationally significant health promotion and prevention programmes as well as treatment measures"

41. Article 33 (1) and (2) reads as follows:

' (1) The Parties agree to promote essential health promotion and prevention programmes, as well as treatment measures of paramount importance, in particular with regard to the framework health objectives and to the financing of further To make projects and plans available annually within the meaning of Article 30 (1) within the framework of the Federal Health Agency (Bundeshealthsagentur) to the maximum extent of 3.5 million euros.

(2) The measures supported shall be based on the principles of the allocation of funds adopted by the Federal Health Commission and on the award and quality criteria of the "Strategy for the use of the precautionary measures". In addition, supplementary directives adopted by the Federal Health Commission must be complied with. The measures have to be used for the implementation of the framework health objectives. "

42. The 10. Section is omitted.

43. Article 37, together with the heading, reads:

" Article 37

Ensuring and further developing the documentation

(1) The documentation and information system for health analysis, which is also accessible to the countries (State Health Fund) and the social security system, is to be developed and developed.

(2) The current diagnostic and performance documentation (including intensive documentation) in the inpatient sector of hospitals, as well as the documentation of statistics (hospital statistics), cost data (cost centre account) and Data from the reporting system on the financial statements of hospitals by the institutions of the hospitals must be ensured and developed further.

(3) All provisions concerning documentation and reporting in the inpatient and outpatient sector shall, in any case, also comply with the requirements of the target control health and in particular the monitoring provided for in it.

(4) As a prerequisite for the planning, realization and monitoring of the success of the concept of integrated healthcare, a performance and diagnostic documentation compatible with the acute care area is available in the intra-and extramural outpatient care. To ensure the supply area. In this case, the performance documentation must be implemented as a priority in terms of time, and the diagnostic documentation will only be documented in the next sequence.

(5) The Contracting Parties agree that medical services covering the entire outpatient sector (i.e. hospital bullets, self-employed outpatients with cash contracts, including their own bodies of insurance institutions, Qualified medical specialists with cash contracts, group practices with cash contracts and other occupational groups in the healthcare sector with cash contracts) from 1. January 2014 nationwide after the catalogue of outpatient services (KAL) tested in pilot projects since 2010 in the context of a reporting system in pseudonymised form to be reported to the federal government. The current transfer (mapping) is to be considered in terms of improvement possibilities. In order to achieve the highest possible data quality, the original documentation should be sought according to the catalogue of outpatient services. The catalogue of outpatient services is subject to periodic maintenance and further development.

(6) The Federal Government, the Länder and the Social Security Fund provide the necessary framework conditions in technical, legal, organisational and technical terms in time and thus provide comparable data bases for the whole of 2014. Ambulant area safe.

(7) In the design and development of documentation systems, compatibility with the already agreed and/or agreed upon comply with the standards of the ELGA project which are yet to be established. The documentation is to be carried out as far as possible within the framework of the routine data acquisition and data processing processes of the service providers.

(8) The Contracting Parties agree to ensure a cross-cutting data transparency of 1. January 2015 the entire outpatient and inpatient documentation in a way that is identical for all areas to pseudonymise. The pseudonymisation site will provide the pseudonymisation of personal data required for the purposes of data protection for the diagnostic and performance reports from the inpatient and outpatient areas. The pseudonymisation is carried out by the pseudonymisation site established at the main association.

(9) In the case of joint monitoring, planning, management and financing in the health sector, the social security institutions and the health care institutions shall, in so far as they are settled within the framework of the State Health Fund, have the following: Federal Health Agency and the State Health Fund in the way of the pseudonymisation site set up by the main association pseudonymised diagnostic and performance data from the area of contract medical care in a standardized and to provide encrypted form.

(10) The Federal Health Agency (Bundessanitary Agency) is standardized reports on their building by the State Health Fund and the social insurance institutions on the basis of a nationally and uniformly structured preliminary estimate and accounts and Transmit further essential key data at periodic intervals. The structure and content of these reports will be determined by the Federal Health Agency. "

44. Article 42 (1) reads as follows:

" (1) The countries undertake, within the framework of their competence, to ensure that no financial claims relating to hospitals within the meaning of Article 18 (3) and (4) of this Agreement exceed this agreement for the duration of the agreement. The federal government or the institutions of social security are to be provided. "

45. Article 44 and title reads as follows:

" Article 44

Medical training

The Contracting Parties agree that, with the participation of the countries, the institutions of the social security system, the Austrian Medical Association and the institutions of the medical training centres, the Federal Ministry of Health shall be subject to a Commission pursuant to § 8. Federal Ministries Act 1986, BGBl. No. 76, is established. The task of this Commission is to provide advice on the following matters concerning medical training:

1.

planning,

2.

control,

3.

Quality assurance and

4.

Further development. "

46. In Article 46, the word sequence shall be: "31 December 2013" through the phrase "at the end of the term of this Agreement" replaced.

(47) In Article 48 (1), paragraphs 1 to 3 and 6 and 7 are deleted.

48. In Article 48 (2), the word sequence shall be deleted "the adjustment to the extension of the tasks of the reform pool or" .

49. The following paragraph 3 is added to Article 49:

" (3) The changes due to the agreement in accordance with Art. 15a B-VG, with which the agreement BGBl. I n ° 105/2008, after the notification by all contracting parties to the Federal Ministry of Health, that the information provided by the Federal Republic of Germany or the Federal Republic of Germany shall be amended after the notification the conditions necessary for entry into force in accordance with the country's constitutions are met by 1. Jänner 2013 in force. "

50. The following sentence shall be added to Article 50 (1):

" The implementation of the agreement in accordance with Art. 15a B-VG, BGBl. I n ° 199/2013, the necessary federal and state regulations are retroactive with 1. Jänner 2013 in force. "

51. Article 51 with headline reads:

" Article 51

Period of validity, termination

(1) This agreement shall be waiving a right of termination for the duration of the validity of the 2008 Finance Equalization Act (FAG 2008), BGBl. I n ° 103/2007, in the current version, but in any case closed until 31 December 2014. If the period of validity of FAG 2008 is extended on the basis of an agreement between the Federal Government and the Länder on the financial compensation, the period of validity of this agreement shall also extend to the same period, without any right to terminate the agreement.

(2) The Contracting Parties undertake to enter into negotiations on a new regime in good time.

(3) Where no agreement is reached in these negotiations on a new settlement, the provisions of this Agreement, which are in force on 31 December 1977, shall be adopted by the expiry of this Agreement, in so far as they are implemented in the implementation of this Agreement , the additional appropriations planned for the duration of the agreement would not be made available from that date. '

52. The previous text of Article 52 shall be replaced by the sales designation "(1)" , the following paragraph 2 is added:

"(2) The Federal Ministry of Health shall immediately inform the Contracting Parties as soon as all notifications have been received pursuant to Art. 49 (3)."

53. The previous text of Article 53 is given the sales designation "(1)" , the following paragraph 2 is added:

" (2) The agreement in accordance with Art. 15a B-VG, with which the agreement BGBl. I n ° 105/2008 is being made in a single original. The original text will be deposited with the Federal Ministry of Health. This shall transmit certified copies of the agreement to all the Contracting Parties. "

In accordance with Article 49 (3) of the Agreement, the Agreement is 1. Jänner entered into force in 2013.

Faymann