Health Reform Act 2005

Original Language Title: Gesundheitsreformgesetz 2005

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179. Federal law, with the the Federal law on hospitals and spas, the General Social Insurance Act, the commercial law of social insurance, the farmers social insurance law, the officials-sick and accident insurance Act, the social security Amendment Act, 1998 physician law and the Federal law on the documentation in health care changed and issued a federal law on the quality of health services and a federal law on telematics in health care (health reform Act 2005)

The National Council has decided:

Article 1

Federal law that modifies the Federal law on hospitals - and sanatoriums (KAKuG-Novelle 2005)

The Federal law on hospitals - and sanatoriums, Federal Law Gazette No. 1/1957, amended by the Federal Act Federal Law Gazette I no. 35/2004, is amended as follows:

1. title

(Policy requirements)

1 § 2a para 3 first sentence reads:



"The provincial legislation to determine that the requirements of paragraph 1 lit. b and c are also met, if the specified divisions or other organizational units are fixed separately housed, unless these divisions or other organizational units are organizationally and functionally connected."

2. in section 3 para 2 lit. a will after the phrase "an independent outpatient clinic also with regard to the provision by" the phrase "ambulances of these hospitals and" inserted.

3. in article 3, after paragraph 2, the following paragraph 2a is inserted:



"(2a) the institution of the hospital intends to funds on the basis of the agreement in accordance with article 15a B-VG on the Organization and financing of health care (in the following: the Fund needing) to take, so he has known this already in the application for the building permit to give." In this case the establishment permit also depends on that the establishment complies with the respective country hospital plan according to the stated purpose of the Institute and the range of services envisaged in addition to the requirements of paragraph 2."

4. in article 3, par. 4 get the lit. c and d the name of "d" and "e", lit. a are to c:



"(a) the authorisation for the establishment within the meaning of paragraph 2 and to fund hospitals also a permit referred to in paragraph 2a; granted

(b) that necessary medical equipment and technical facilities are available for the immediate operation of the hospital) and the operating system as well as all medical apparatus and equipment comply with the security and sanitary regulations and also the requirements of the respective country hospital plan are met;

(c) the envisaged structure quality criteria are satisfied;"

5. in section 3, para. 5 the following sentence is added after the second set:



"The first and second sentence shall apply even if the sickness insurance institution entrusted with the operation of ambulatory third parties."

6 4 paragraph 1 the following sentence is added to §:



"When Fund hospitals, the approval is in particular only be granted if the requirements of the respective country hospital plan and the envisaged structure quality criteria are met."

7 § 10 para 1 No. 4 is:



"4. the courts and administrative authorities in matters in which is the determination of health status for a decision or available in the public interest, also the social security institutions and institutions of country health fund in the sense of the agreement in accordance with section 15a B-VG on the Organization and financing of health care and of these commissioned experts, as far as this is required whether these tasks to carry out ", as well as admitting or referring physicians or hospitals free of charge to transmit copies of case histories and medical statements about the State of health of dogs;"

8 section 10a subsection 1 is as follows:



"(1) the provincial legislature has to commit the State Government, to adopt a country hospital plan, funds hospitals through regulation of itself within the framework of the Austrian Hospital plan including the major equipment plan or of this replacing Austrian structure plan health (hereafter: ÖSG) is."

9 paragraph 11 paragraph 2:



"(2) hospitals, the contributions to the operating disposal, or to the construction effort (section 34) or payments from the National Health Fund (section 27 b) receive, subject to economic regulation by the State Government and the management control by the Court of Auditors." The national legislation may provide that the economic supervision is carried out by the national health fund."

10. in section 11 paragraph 4 is the quote "§ 148 Z 7 ASVG" through "§ 148 Z 10 ASVG" replaced.

11 § 16 par. 1 lit. e is:



"(e) LKF fees pursuant to § 27 para 1 for equal benefits of the hospital or the maintenance fees for all Pfleglinge of same fees class, possibly taking on an outline in departments and other beds leading organizational units or groups of care for acute patients and long-term treatment (article 6 par. 1 lit. "(a) and day - or night-time operation, as well as the semi stationary applications (article 6 par. 1 lit. b) are set at the same height (section 28);"

12 in section 24 para 2, the following sentence is inserted after the second sentence:



"If necessary, a permit of the chef - and control medical service of the health insurance carrier is to catch up."

13. in article 26, the following paragraph 3 is attached pursuant to par. 2:



"(3) the carrier can meet its obligation pursuant to paragraph 1 by agreement with other entities of hospitals, group practices or other forms of medical cooperation. It is in particular to ensure compliance with all relevant provisions of this Federal Act. Such agreements require the approval of the State Government."

14 paragraph 27 together with the heading:



"LKF fee; Care and special fee



Section 27 (1) with the LKF or the maintenance charges of the General fees class all the hospital services are satisfied, without prejudice to paragraph 2 and article 27a.

(2) the cost of transportation of the Pfleglings in the hospital and from the same, providing a tooth replacement - if not with the treatment carried out in the hospital is related-, providing orthopedic AIDS (prostheses) - as far as they are not therapeutic remedies-, also the costs of the funerals of the deceased not are one in the hospital in the LKF- or the maintenance fees included. The same applies for additional services, which are provided at the explicit request of the Pfleglings with the medical services not related.

(3) expenses arising from the construction, transformation or extension of the Institute, Furthermore, write-downs of the value of real estate as well as pensions and the clinical overhead (article 55) may calculate the euro value per LKF point as a basis for the determination of the LKF fees as well as be the maintenance charge not to reason.

(4) by the provincial legislature is to determine:



1. whether and what further charges in special besides the LKF fees or maintenance fees; to be lifted up

2. whether and which charge for the case assistance may be dictated by a midwife asked not in the hospital

3. whether and to what extent contributions for the ambulatory treatment payable, provided that these services not be compensated through the national health fund.

4. to what extent and in what way the costs for which in paragraph 2 can be lifted up mentioned expenses except the cost of advanced medical care and the funeral.

(5) a different than the statutory charge (paras 1 to 4 inclusive, sections 27a and 46) must not be lifted by dogs or their families.

(6) in the cases of § 23 para 2 first sentence provided the LKF- or the maintenance fees only for a person charged. Besides escorts may be required in the General class of charges relating to the payment of a fee up to the amount of the costs incurred by their placement in the hospital."

15 according to § 27a, the following paragraph is inserted 27 b together with heading:



"Country health fund



b. (1) the services provided to socially insured dogs in fund hospitals are section 27 to settle with the exception of any special fees pursuant to § 27 para 4 on country health fund. The provincial legislature may provide that also services provided for uninsured social Pfleglinge in fund hospitals, are settled through the national health fund.

(2) services of Fund hospitals, provided to persons who need asylum, are to settle over the country Health Fund benefit through LKF fees dentures to be determined according to the following principles:



1. in the core area of the LKF the LKF points for the individual patient are determined on basis of the Austria-wide unified system of performance-oriented diagnostic case groups including the be spotting system in the respective current version.

2.

Within the scope of the LKF control, the performance-based allocation of resources from the National Health Fund on special supply features of certain hospitals can take into account. As special supply functions within the framework of the LKF-billing apply: a) central supply, b) focus supply, c) hospitals with special technical features of supply and d) hospitals with special regional supply functions.

Allocation to the supply levels are also the supply functions of individual departments according to their number and structure into account.

(3) pending the introduction of a uniform accounting system for the outpatient area is through the provincial legislature to determine in what form outpatient services of dogs in accordance with paragraph 1 and costs make services be compensated through the national health fund. This can be transmitted through the provincial legislature the national health fund.

(4) further funds can be provided within the framework of the national health fund for compensation.

"(5) the compliance with the objectives of the Austrian Hospital plan including the major equipment plan or of this replacement ÖSG and compliance with the respective national hospital plan and the fulfilment of commitments to the documentation due to the Federal Act on the documentation in healthcare, Federal Law Gazette No. 745/1996, as last amended by BGBl. No. 144/2003, is a prerequisite, that the institution of the hospital receives funding on the basis of the agreement in accordance with article 15a B-VG on the Organization and financing of health care."

16 paragraph 28:





section 28.

 (1) the euro value per LKF point as a basis for the determination of the LKF fees, which are to determine break even by the legal entity of the hospital for the estimates and the financial statements in accordance with § 27 ABS. 3 maintenance fees and any special charges (section 27 para. 4). The LKF fees calculated as a product of the LKF points calculated for the individual patient with the euro value per LKF-point set by the provincial government. LKF fees for clearing, reach is the Austria-wide uniform system of defined benefit diagnosis case groups including the be spotting system in an appropriate manner to be published. The transactions for the LKF fees for clearing euro value per LKF-point, the care and special fees are to be published by the Government in consideration of the facilities and equipment, as required by the function of the hospital, and to set the proper and economic management and in the national law journal. In these by-laws are also the break even determined euro value to record the break even determined care and special fees.

(2) the provincial legislature has for all public and nonprofit run according to § 16 private hospitals that are not fund hospitals, as well as for those patient groups in fund hospitals, which are not settled through the national health fund, to determine whether the services of the General class of fees are compensated by LKF fees or maintenance fees.

(3) in the case of multiple homogeneous in their equipment, device, and function public hospitals in the area of a municipality, the LKF fees are to assess the maintenance fees and any special fees uniformly for these institutions.

(4) the LKF fees, maintenance fees and any special charges in public hospitals, that is not managed by a local authority, may not be less than the LKF fees, maintenance and any special fees of the nearest public hospital operated by a local authority with equivalent or nearly equivalent facilities, as required by the function of this hospital. The determination of the similarity or approximate equivalence is the State Government.

The LKF fees or maintenance fees from the carriers of social security in the full amount to be paid are (5) in cases the diagnosis or evaluation pursuant to § 22 para 3 second half of sentence."

17 paragraph 29:





section 29.

 (1) by the provincial legislature the recording can be limited, by persons who have no residence in Germany and which does not impose the likely LKF fees or Pflege(Sonder)Gebühren and charges or the estimated actual cost of treatment in accordance with paragraph 2, or ensure the cases of peremptory (§ 22 para 4).

(2) in addition to determine the provincial legislature that the State Government when shooting may provide for payment of treatment costs actually therefrom foreign nationals instead of the LKF fees or Pflege(Sonder)Gebühren, as well as charges. This does not apply for



1. cases of peremptory (§ 22 para 4), provided they have entered the domestic, 2. refugees in the sense of the asylum Act 1997, Federal Law Gazette I no. 76/1997, amended by by-laws Federal Law Gazette I no. 105/2003 was granted asylum, and asylum seekers, which in 1997 confirmed a provisional residence permit within the meaning of the asylum Act, persons who are compulsorily insured in Austria in a statutory health insurance or contributions to such insurance pay 3. ", as well as people who are after the social security provisions in the health insurance as members, 4. persons who are associated with a carrier of social security on the basis of intergovernmental or überstaatlichem law on social security to the granting of benefits in kind provided under the legislation and 5 persons who are nationals of Contracting Parties to the agreement on the European economic area (EEA Agreement)."

18 paragraph 30 together with the heading:



"Introduction of the LKF fees, Pflege(Sonder)Gebühren and charges



section 30.

 (1) provisions for the contribution of LKF fees or Pflege(Sonder)Gebühren and cost contributions (§ 27a), in particular on the procedure for the insertion in the Rückstandsfall compared to the bird itself, about the claims against third parties and the calculation of charges for accompanying persons of hatchlings (§ 27 para 6 second sentence), should be adopted by the provincial legislature.

(2) the provincial legislature can set that for solvent Pfleglinge an advance payment on the expected LKF fee or an advance payment of Pflege(Sonder)Gebühren for each within 30 days and to pay the charges for up to 28 days in advance.

(3) in the provisions to be adopted pursuant to par. 1 of the provincial legislation is in any case to set enforcement administrative action is allowed on the basis of residue passes of public hospitals for LKF fees and Pflege(Sonder)Gebühren charges against Pfleglinge if enforceability is confirmed by the district administrative authority."

19 paragraph 32:





§ 32. The LKF fees and Pflege(Sonder)Gebühren charges are due upon the date of the notices of payment due. Statutory interest may be charged after six weeks of the due date."

20 paragraph 34:





Section 34 (1) by the provincial legislation is to arrange that in the formation of post counties and hospital districts in accordance with § 33 the entire resulting by the operating and maintenance costs compared to the revenue operation in a specific proportion of the legal entity of the Hospital of the District of the post, to cover the hospital district and the State is. Here, the shares of the post district are of the hospital district and the State as to establish that they cover up to at least half of the operation leaving.

(2) for hospitals that are operated by a State, can be determined in agreement with the municipality (seat municipality), the hospital is situated in their area, that this congregation takes place of the legal entity.

(3) national legislation may provide that the funds to cover the operation leaving be distributed through the national health fund."

21 § 35 para 2 last sentence reads:



"The Government has to put the Federal Ministry for health and women of the situation having regard to fund hospitals."

22 the following sentence is added to § the 42:



"Permits and approvals and their withdrawal are also immediately the Federal Health Agency (sections 56a ff) to announce."

2. title

(Directly applicable federal law)

1. paragraph 48:





section 48. Is the disease that has led to the inpatient treatment of Pfleglings due to a fault of a third party is liable for this according to legal regulations, the claim for damages is created from the essence of healing refunding passes up to the amount of balance LKF fees or maintenance fees on the legal entity of the hospital."

2. paragraph 55 No. 3:



"3. maintenance fees of the General class of fees or the costs actually incurred on the basis of the accommodation of persons drawn up for teaching purposes within the meaning of § 43."


3. According to article 56, the following section 56a and heading shall be inserted:



"Federal Health Agency



section 56a. To the performance of duties in terms of the following provisions is at the Federal Ministry for health and women. the Federal Health Agency as a fund with its own legal personality to set up"

4. sections 57 and 59a are:





Section 57 (1) which has Federal the Federal Health Agency in accordance with article 56a annually the following resources for the funding of public hospitals in accordance with § 2 para 1 Nos. 1 and 2 with exception of nursing departments in public hospitals of Psychiatry and private hospitals in § 2 para 1 Z 1 named type, which can be-run hospitals charitable according to § 16, grant:



1 1,416% of the volume of the sales tax in a given year after deduction of in § 8 par. 2 No. 1 of the fiscal equalization Act of 2005, Federal Law Gazette I no. 156/2004, mentioned amount.

2. 31.426.240,71 euro;

3. 127.000.000,00 euro.

(2) the main Association of Austrian social security institutions provides annually on behalf of social security institutions to the Federal Health Agency in accordance with article 56a summarized in his funds in the amount of 83.573.759,29 euro.

(3) the Federal Health Agency annually following contributes to the national health fund for the financing of the hospital referred to in paragraph 1:



1 1,416% of the volume of the sales tax in a given year after deduction of the in § 8 par. 2 No. 1 of the fiscal equalization Act of 2005, Federal Law Gazette I no. 156 / 2004 amount;

2. 24.000.000,00 euro;

3. 91.000.000,00 euro;

4. 127.000.000,00 euro in accordance with the § 59d and after deduction of the funds for the promotion of the transplant system, the funds for the financing of projects and plans, funding for essential prevention programs and treatment measures of supra-regional importance (E.g. comprehensive quality-based and systematic mammography screening program, molecular genetic analysis to identify families with hereditary breast and ovarian cancer, identification of congenital metabolic disorders in infants and measures concerning epidermolysis bullosa) and any funds for hospital care abroad.



58. (1) the resources referred to in article 57, paragraph 1 are Z 1 with effect from 1 January 2005 for each budget year in monthly advances, the amount of which is addressed under the rules for the calculation of advances on the income shares of the countries on the value added tax to transfer one week before the statutory appointments of advance benefits on the income shares of the countries in the community federal taxes to the Federal Health Agency. The shall and the final settlement FAG have in the context of the settlement of advances on the income shares of the community Federal duties referred to in article 12, paragraph 1 in 2005, Federal Law Gazette I no. 156/2004, to be carried out. Resulting excess pleasures or balance the Federal Health Agency are to compensate.

(2) the resources referred to in article 57, paragraph 1 are no. 2 to transfer one week in four equal instalments high before the end of each calendar quarter to the Federal Health Agency.

(3) the resources referred to in article 57, paragraph 1 are no. 3 in four equal instalments high on 15 April, 15 July, 15 October and 15 January of the following year to the Federal Health Agency to transfer.

(4) the resources referred to in article 57, paragraph 2 are in four equal instalments high on March 25, June 25, September 25 and December 25 at the Federal Health Agency to transfer.



59. (1) the resources referred to in article 57, paragraph 3 are Nos. 1 and 2 to divide the country health funds according to the following percentage ratio:



Burgenland





2,572







Carinthia





6,897







Lower Austria





14,451







Upper Austria





13,692







Salzburg





6,429







Styria





12,884







Tyrol





7,982







Vorarlberg





3,717







Vienna





31,376





(2) the resources referred to in article 57, paragraph 3 are Z 1 effective January 1, 2005 for each budget year in monthly advances, the amount of which is determined by the provisions relating to the calculation of advances on the income shares of the countries on the sales tax, to be transferred to the national health fund to the statutory appointments of advance benefits on the income shares of the countries on the common federal charges. The shall and the final settlement FAG have in the context of the settlement of advances on the income shares of the community Federal duties referred to in article 12, paragraph 1 in 2005, Federal Law Gazette I no. 156/2004, to be carried out. Resulting excess pleasures or the national health fund are to compensate.

(3) the resources referred to in article 57, paragraph 3 are to transfer at the end of each calendar quarter to the national health fund in four equal instalments high Z 2.

(4) the resources referred to in article 57 par. 3 Z 3 are split on the country health fund according to the following percentage ratio:



Burgenland





2,559







Carinthia





6,867







Lower Austria





14,406







Upper Austria





13,677







Salzburg





6,443







Styria





12,869







Tyrol





8,006







Vorarlberg





3,708







Vienna





31,465





(5) these funds are to pay in four equal instalments high at the end of each calendar quarter to the national health fund.

(6) the funds of the Federal Health Agency in accordance with article 57, paragraph 3 are no. 4 in accordance with the following provisions to split:



1 first are to withdraw preferential shares of the 127.000.000,00 euros annually and to distribute as follows: a) 3.630.000,00 euro for the national health fund Upper Austria b) 4.360.000,00 euros for the national health fund Styria c) 3.630.000,00 euro for the Tyrol country health fund.

2. then are the means of promoting the transplantation industry amounting to 2.9 million euros per year, the appropriations for the financing of projects and plans and structural reforms in the amount of EUR 3.5 million a year, to withdraw the funds to finance further projects and plans and for essential prevention programs and treatment measures of supra-regional importance in the amount of EUR 3.5 million annually and to withhold from the Federal Health Agency and to use in accordance with section 59d and section 59e of the remaining 115.380.000,00 euros. Of the then remaining amount possible for hospital care abroad are also annually to deduct required a means and in accordance with article 39 use paragraph 2 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care.

3. the remaining after the deduction referred to in item 2 are according to the number of people, the according to the by the Federal Statistics Austria on the basis of the annual census 2001 identified outcome determined, with the corresponding percentages to three decimal places to calculate commercial rounded, to transfer the Land Fund in accordance with § 59 c.

4. to the extent of country quotas in accordance with no. 3 are the income from assets of the Federal Health Agency and means not exhausted in a financial year to promote the transplant system, to assign the individual country health fund for projects and plans, as well as for essential prevention programs and treatment measures of supra-regional importance.

(7) the resources referred to in paragraph 6 are Nos. 1 and 3 in four equal instalments high on April 20, to transfer 20 July, 20 October and 20 January, with the first instalment is due on the 20th April 2005, subject to the conditions of § 59 c at the national health fund.



§ 59a. (1) the Federal Health Agency has in the framework of planning to carry out control and financing of health care in Austria following tasks taking into account overall economic impact, as well as regional and country-specific requirements:



1. development of quality standards for the provision of health services, 2. preparation of guidelines for the transparent representation of full budgeting, and the accounts of hospitals or hospital associations and by guidelines for the transparent presentation of estimates and accounts of social security for the extramural area, 3 power supply planning as a framework for the provision of health services in all sectors of the health care system, taking into account the quality requirements according to no. 1 are , and developing suitable forms of cooperation from providers, 4. development and further development of performance-based remuneration systems (result-oriented, flat and capped), taking into account all areas of health, 5.

Elaboration of guidelines for a nationwide, comprehensive with all sectors of the health-care documentation, as well as development of a documentation and information system for analysis in health care to observe developments in the Austrian health care, and ensure in particular on gender differentiation is, 6 frameworks for the management of the interface between the various sectors of the health care system, 7 participation in the field of e-health and the electronic health record (ELGA), 8 development of projects to promote health , 9 development of guidelines in the area of cooperation (reform pool) in accordance with article 26 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care, 10 requirements for the use of dedicated purpose means of the Federal Health Agency, 11 creation of the estimate and the closing of accounts and 12 evaluation of the tasks of the Federal Health Agency.

"(2) in carrying out the tasks, the Federal Health Agency in particular has to ensure that a high-quality, effective and efficient, free accessible and equal health care in Austria all assured and secured the financial viability of the Austrian health care, taking into account the financial conditions and possible costs losses is."

5. According to section 59a are following §§ 59 to add b to 59i:





2B. organs of the Federal Government and representatives of the Federal Health Agency can section 59 in the case histories and that the management of the hospitals inspect the documents in question and perform surveys of the Organization and the operation of hospitals, as far as this is required whether these tasks to carry out, and if it is to fund hospitals.



section 59c. Significant violations of defined plans (E.g. hospital plan including a large unit plan or ÖSG) and requirements relating to the quality or the documentation (E.g. the federal laws governing the documentation in healthcare, Federal Law Gazette No. 745/1996, as last amended by BGBl. I no. 144/2003) the Federal Health Agency has to withhold the corresponding country share of the funds pursuant to § 57 para 3 Z 4 the country health fund demonstrably has used the necessary measures for the production of the State corresponding to the requirements of this agreement.



§ 59d. (1) the Federal Health Agency has the means to promote the transplant system (section 59 para 6 to use Z 2) to achieve the following objectives:



1. in the field of organ donation is the continuity in the donors - and dispenser volume at a high level to make sure. In addition, an increase in the number of organ donors is aiming for (on 30 Organspenderinnen/organ donors per million inhabitants).

2. in the area of the Stammzelltransplantationswesens is to ensure that donors/donor in sufficient number are registered and available. The approach and the cooperation of all the institutions involved for donors/donor and patients/patients has to be done as safely and effectively as possible. Determining whether the national donor volume than is sufficient to consider, is whether the transplant Advisory Council established at the ÖBIG (domain registry).

(2) the Federal Health Agency has the means to promote the transplant system (section 59 para 6 No. 2) on the performance heritage wrestlers/service providers



1. for the range of the organ donation system, and 2. the area of Stammzellspendewesens referred to in paragraph 3 to 5 to distribute.

(3) the means of promoting the transplantation system (section 59 para 6 Z 2) are to achieve the objectives referred to in paragraph 1 in accordance with the following conditions for use:



Carry out the following measures are 1 in the field of organ donation: a) Zweckgewidmete, flat-rate promotion at the donor-patient hospitals or the relevant Department;

b) Setup and administration "Regional transplant speakers" or regional funding programmes, with the central mission of direct contact with the intensive units, to increase the willingness of donor reporting;

(c) Zweckgewidmete, flat-rate aid for the use of transplant coordinators in the centres;

(d) promote the establishment of mobile teams of brain death diagnosis, as well as appropriate measures relating to nationwide provision of brain death diagnosis, which corresponds to the current state of the science;

(e) promotion of transport incurred in connection with the extraction of the body;

(f) means for covering the expenses of ÖBIG transplant (donor area).

2. in the area of the Stammzellspendewesens are in particular the following measures: a) promotion of the HLA-typing. The number of HLA typing each year to be funded, as well as sharing them on the appropriate service providers are to set a year in advance to expert proposal of the transplant Advisory Board of ÖBIG (domain registry);

b) to promote the search and support of Stammzellspendern;

(c) means for covering the expenses of ÖBIG transplant (domain registry).

3. the funding bodies may decide on a proposal of the transplant Advisory Board set up in the ÖBIG (for each area), to use the funds for other than the measures mentioned under Nos. 1 and 2.

4. the settlement of contribution has to be made up to 30 June of the following year. At most untapped resources are according to the number of people according to a census in 2001 to transfer the individual country health fund.

(4) in the Federal Health Committee issued guidelines on the use of funds for the promotion of the transplant system.

(5) the means employed by annually carried out is to be documented in an annual statement of accounts and to evaluate in terms of efficiency.



section 59e. (1) for the financing of other projects and planning, as well as for essential prevention programs and treatment measures of supra-regional importance (E.g. comprehensive quality-based and systematic mammography Screeningprogramm, molecular genetic analysis to identify families with hereditary breast and ovarian cancer, identification of congenital metabolic disorders in infants and measures concerning epidermolysis bullosa) a maximum of 3.5 million euros can be used annually by the Federal Health Agency.

(2) the Federal Health Commission has guidelines on the use of these funds to adopt in case of need.

(3) the use of the funds referred to in paragraph 1 is set out in the Federal Health Commission in agreement with the countries and the main Association of Austrian social security institutions.

(4) the statement of benefits has to be made up to 30 June of the following year. At most untapped resources are according to the number of people according to a census in 2001 to transfer the individual country health fund.



section 59f. Use the for the financing of projects and plans in accordance with article 59, paragraph 6 Z 2 to keep funds (max. 3,5 million euro) decides about the Federal Health Agency.



section 59 g. (1) the institution of the Federal Health Agency is the Federal Health Commission.

(2) the Federal Health Commission consists of 27 members, who are appointed in accordance with the following provisions:



1. seven members ordered the Federal Government;

2. a member appointed each country;

3. six members ordered the main Association of Austrian social insurance institutions;

4 a member order the representatives of cities and municipalities;

5. a member appointed the Austrian Conference of bishops together with the Protestant upper Church Council;

6. a joint member order the patient representatives;

7. a member appointed the Austrian Medical Association;

8. for each of the so ordered members of the Federal Health Commission, a constant, a voting member of the replacement can be ordered. In addition, a representation by proxy is possible in individual cases.

(3) member of the Federal Health Commission may just be who is eligible to the National Council.

(4) the appointment of members of the Federal Health Committee is required, the Federal Ministry for health and women has to call on the points coming referred to in paragraph 2 into account in writing. Do not use the the appointment of members of the Federal Health Commission entitled to this right and no members, order the not ordered members of the quorum of the Federal Health Commission disregarded remain so.


(5) the Chairman of the Federal Health Commission has the Federal Minister responsible for public health or the Minister responsible for health care or, if these agendas by the Federal Minister or the Federal Minister transferred a Secretary of State or a Secretary of State to the independent care are to do this or this. Is the responsible federal Minister or the competent Federal Minister, or in the case of the transfer with the independent agency instructed Secretary of State or Secretary of State to hold the Presidency, so the responsible federal Minister or the competent Federal Minister has to appoint a representative or a representative from the circle of senior officials of the Federal Ministry for health and women with the chairmanship of the Federal Health Commission.

(6) the Federal Health Committee has to give their rules of procedure.

(7) the business of the Federal Health Agency leads the Federal Ministry for health and women.

(8) the Federal Health Commission resolutions with simple majority of the votes cast, with members appointed by the Federal Government three votes. Is for resolutions - except in matters pertaining to section 59a paragraph 1 Z 10, if it is funds for the financing of projects and plans in accordance with section 59f, and section 59a para 1 No. 11 - an agreement with the countries and the main Association of Austrian social security institutions needed.



section 59 h. The management of the Federal Health Agency is subject to supervision by the Court of Auditors.



section 59i.

 (1) the Federal Health Agency is exempt from all taxes except the Court and justice administration fees.

(2) the writings issued by the Federal Health Agency in their immediate tasks and the transactions concluded by it are exempt from the stamp and legal fees.

(3) the financial services of the Federal Health Agency of the national health fund and the funds in accordance with §§ 59d and 59e are subject to sales tax nor the taxes on income and assets."

6 paragraph 64:





section 64. The legal entity of public hospitals are exempt from the stamp and legal fees in terms of all inputs occurring in the context of this Federal Act, inserts, written copies and legal documents. The contributions of the costs to be paid by the hatchlings (§ 27a) are not a consideration within the meaning of the law on turnover tax. The national health fund are exempt from all deadline regulated taxes with the exception of the Court and justice administration fees."

7 paragraph 67 paragraph 2:



"(2) with the enforcement



1 of sections 43 and 44 of the Federal Ministry of education is, science and culture, 2. of section 46 is the Federal Minister for education, science and culture in consultation with the Federal Minister of finance, 3. the sections 48 and 50 is the Federal Minister for Justice, 4. the sections 55 to 59 h is the Federal Minister for health and women in agreement with the Federal Minister of finance, 5 of section 59i and 64 is the Federal Minister of finance and 6 is indeed in terms of the second part Federal Minister for health and women entrusted."

3. title

(1) the assets of the amendment to the CISA 2000, Federal Law Gazette I no. 5/2001, structural fund goes with all rights and liabilities that with sections 56a ff this Federal Act about federal health agency. Decisions the Federal Law Gazette I no. 5/2001, decorated structure Commission (section 59f) and derived rights and liabilities remain upright, otherwise decides if the Federal Health Committee to strike 59 g para 1 of the Federal Act in accordance with § 2000, amendment to the CISA. To the establishment of the Federal Health Commission pursuant to section 59 g para 1 takes its tasks amendment to the CISA 2000, Federal Law Gazette I no. 5/2001, a structure Commission true.

(2) the provincial legislature has 1 according to the par. 2 of six months to enact, and January 1, 2005, power to the implementing provisions title.

(3) until the expiry of the December 31, 2005 I continues to apply para 2 subpara 2 and 3 in the version of Federal Law Gazette with regard to the LKF-control area section 27 No. 5/2001. To the establishment of country health fund by countries, the Land Fund perform the tasks and functions of the national health fund.

(4) the exercise of the rights of the Federal Government in accordance with article 15 paragraph 8 B-VG in terms of 1 title the Federal Minister for health and women shall be entitled to.

(5) the 2nd title shall enter into force 1 January 2005.

(6) with the completion of the 2nd title, it is entrusted to the Federal Minister for health and women.

Article 2

Federal law that modifies the general social security law

The General Social Security Act, Federal Law Gazette No. 189/1955, amended by Federal Law Gazette I no. 171/2004, is amended as follows:

1. in the first part, section V, a seventh subsection with heading is inserted after section 84:



"7 UNDER SECTION

Participation of the social security system in the planning and management of health care

Principles section 84a. (1) ensuring sustainable supply of insured persons have become the main Association and the social security institutions with the participation of (in particular health economic) science on a regional - and cross-sectoral planning, to participate in the management and financing of health care. The main Association and the social security institutions have the results in coordinated (E.g. Austrian structural plan health) to note in their governance and in planning and implementing the supply of insured persons with the aim of an optimised use of resources through coordinated action.

(2) the Association has to send a representative/representatives in the Federal Health Commission of the Federal Health Agency.

(3) the competent local health insurance fund has to send a representative/representatives in the respective country health fund health platform; this connection, she has carefully to take the interests of company health insurance funds. The insurance institution for railroads and mining, the General accident insurance institution, the pension insurance institution, the social insurance institution of the commercial economy, the social insurance institution of the farmers and the public servant insurance company have to send a representative/representatives in the national health fund health platforms. Considering number of agents/representatives of the country in the respective health platform have their agents/representatives together to send the mentioned social security institutions which respect the betriebsgesellschaft from the Government's rights to make sure.

(4) the social insurance institutions have as a contribution to the reform pool (section 59a para 1 No. 9 KAKuG) measures for performance shifts by joint structural changes or related projects in the intra - and extramural sector within the framework of the national health fund in case of need (article 26, paragraph 2 of the agreement in accordance with section 15a B-VG on the Organization and financing of health care) to transfer the necessary funds.

(5) the social insurance institutions are obliged to provide the Federal Health Agency, and the national health fund pseudonymised diagnostic and performance data from the field of contract medical supply in the form of a standard and encrypted. In addition, the Association and the social security institutions are obliged to provide the necessary for the fulfilment of their tasks data in anonymised form the Federal Health Agency, and the National Health Fund on their request. To ensure compliance with the data protection regulations, all data prior to submission to the Federal Health Agency, and the National Health Fund on a Datenpseudonymisierungsstelle decorated with the main Association have to flow.

Interface management



§ 84 b. The Federal Minister for health and women may set criteria to ensure a treatment process of a disease for the transition between a hospital care and medical treatment corresponding to the State of medical science, which include in particular with regard to economic principles and the requirements of a uniform quality assurance:



1. the exchange of information about the medical treatment records, 2. the responsible performance heritage wrestlers and 3. the provision of appropriate coordination forms for the entire treatment process of a disease.

2. in the heading of section 144, the expression "Land Fund" is replaced by the expression "Land Fund".

3. in the section 144, paragraph 1, the expression "Country funds" by the expression "Land Fund" and "Land-Fund-financed hospital" is replaced by the expression "country health fund financed hospital".

4. in the heading to § 145, the expression "Country funds" is replaced by the expression "Land Fund".

5. in article 145 par. 1 and 2, the expression "Land Fund funded hospital" is replaced by the expression "country health fund financed hospital".

6. (principle of determination) § 148 including heading is as follows:




"Relations with the hospitals, funded by national health fund



§ 148.

(Determination of principle of) The relations of the insurance carrier for the entities of hospitals, which are financed, on country health fund according to article 14 of the agreement in accordance with section 15a B-VG on the Organization and financing of health care are under article 12 par. 1 Z 1 B-VG after following principles to govern:



1. the hospitals are required to record the assigned according to § 145 patients in the General class of fees.

2. which are 27 b of the Federal law on proper hospitals and sanatoria (KAKuG) payments pursuant to § the hospitals to be paid entirely by the national health fund.

3. all services of the hospitals, particularly in the stationary, semi in-patient, day clinical and hospital outpatient area including benefits resulting from medical progress, are satisfied with the following payments: a) LKF-charges sets of the country health fund under § 27 para 2 KAKuG, b) payments of the country health fund under § 27 b paragraph 3 KAKuG, c) charges according to § 27a KAKuG, d) compensation according to § 27 b paragraph 4 KAKuG.

Benefits under the mother-child pass examinations, in the agreement between the Federation and the countries concerned are excluded KAKuG excluded services (article 20 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care) and in section 27 par. 2-led services.

4. the fee is according to section 447f paragraph 7 to raise by the hospital on behalf of the national health fund.

5. the insurance carrier have following rights against the legal entity of the hospital without the intervention of the national health fund: a) the right of access to all documents relating to sickness by the Hospital (E.g. history, x-rays, results);

(b) the right to obtain copies of these documents (§ 10 par. 1 Z 4 KAKuG);

(c) the right to by a commissioned / n doctor/specialist in the hospital in agreement with this study the patient / patient;

(d) the right to obtain copies of all documents by electronic means, on the basis of which payments a country health fund or any other body for services of hospitals will be charged (in particular recording indicator and release display including diagnoses, insurance Declaration of competence, allocation data); This right includes also the corresponding statistics; In addition, the right to delivery of data of services to the patient on the basis of the LKF/LDF system; These rights may be asserted only compared to hospitals, if these documents or data are not provided in due time by the national health fund available.

6. the entire data exchange between hospitals and insurers for the inpatient and outpatient area is electronically, the data set structures and code directories to make nationwide uniform.

7. the insurer is entitled to ongoing information on the preliminary and final point values set by the national health fund.

8. for the billing of services compared to the hospitals and in proceedings before courts and administrative authorities relating to the settlement of payments in accordance with § 27 b KAKuG to the entities of the hospitals, the respective national health fund is regarded as insurance carrier. However the country health fund can take actions which would increase the cost of the insurance carrier, legally only in agreement with the Confederation. This agreement can be made valid only in writing.

9. if granted benefits pursuant to no. 3, the legal entity of the hospital or the State Health Fund compared to the is not entitled to return insured persons, the patient, the patient or the debtor for him/her people from this; subject are excluded only the contribution to costs in accordance with § 27a of the KAKuG and the fee in accordance with section 447f, paragraph 7.

10. the relations of insurance carriers to the hospitals are governed by private contract. Not legally justified claims for payments through these contracts provided to services after no. 3, second sentence, is not it. The contracts are between the Association in consultation with the relevant insurance bodies on the one hand, and the legal entity of the hospital on the other hand, in agreement with the competent national health fund to complete. These contracts are only valid. When you have completed writing"

7 § 149 para  3 second is up to fourth set:



"This amount is to be transferred to the Fund established under the private hospitals Financing Fund Act. The Fund has to be the services provided by the hospitals according to the principles of section 27 b KAKuG. The Fund § 148 is apply by analogy to Z 8."

8 in the article 150, paragraph 1 Z 1, the expression is "Land Fund funded" replaces "country Health Fund funded" expression.

9. (principle provision) Article 189, paragraph 3 States:



(3) (principle provision) According to article 12 par. 1 Z 1 B-VG is regarded as principle that the accident insurance institutions in the framework of relations with the country health funded hospitals regulated in § 148 are assimilated to the health insurance bodies."

10. (principle provision) article 302, paragraph 3 States:



(3) (principle provision) According to article 12 par. 1 Z 1 B-VG is regarded as principle that the accident insurance institutions in the framework of relations with the country health funded hospitals regulated in § 148 are assimilated to the health insurance bodies."

11. in the section 322a, paragraph 1, the expression "Agreement in accordance with section 15a B-VG about the restructuring of health care and the hospital financing" is replaced by the expression "Agreement in accordance with article 15a B-VG on the Organization and financing of health care".

12 in the section 322a para 2 fifth set replaces the expression "2004" "2008" the expression.

13. in the section 322a para 4 second sentence replaces the expression "2004" "2008" the expression.

14. in section 332 paragraph 1, second and third sentences is replaced by the expression "Land Fund" the expression "Land Fund".

15 § repeals 590 para 5.

16. in the section 609, paragraph 7, the point will be replaced at the end of the No. 9 by a comma; following Z 10 is added:



"10. the expenses relating to the construction and management of Datenpseudonymisierungsstelle according to § 84a para 5."

17 the following § 621 including heading is added to § the 620:



"Final provisions to article 2 of the Federal Act Federal Law Gazette I no. 179/2004"



621. (1) the seventh subsection, including heading in section V of the first part, the heading to section 144, the article 144, paragraph 1, including the heading to § 145, §§ 145 par. 1 and 2, 148 heading, 149 para 3, 150 para 1 Z 1, 189 para 3, 302 para 3, 322a para 1, 2 and 4, 332 paragraph of 1 and 609 para 7 Nos. 9 and 10 in the version of Federal Law Gazette I no. 179/2004 become January 1 2005 Force.

(2) Section 590 para 5 occurs with expiry of the 31 December 2004 except force.

(3) at the end of December 31, 2008 are you entering referred to the section 567, para 2 regulations in force on December 31, 2008 except power and amended stomped on December 31, 1996, in force - with the exception of lit. d of § 148 No. 3, as well as the section 322a - again in force.

"(4) the State regulations to §§ 148, 189 para 3 as amended by Federal Law Gazette No. 179/2004 para 3 and 302 to adopt within six months and are retroactively with effect to set January 1, 2005."

Article 3

Federal law that modifies the commercial social security law

The commercial Social Security Act, Federal Law Gazette No. 560/1978, amended by Federal Law Gazette I no. 171/2004, is amended as follows:

1. in the section 86, paragraph 1, the expression "Country funds" is replaced by the expression "Land Fund".

2. in the section 91 paragraph 2, the expression "Country funds" by the expression "Land Fund" and "Land Fund financed hospitals" is replaced by the expression "country health fund financed hospitals".

3. (determination of principle of) Article 97 and heading is as follows:



"Relations with the hospitals, funded by national health fund



Article 97.

(Determination of principle of) For regulating the relations of the insurance carrier to the national health fund financed hospitals section 148 shall apply ASVG."

4. (principle of determination) section 160, paragraph 3 reads:



(3) (principle provision) "According to article 12 par. 1 Z 1 B-VG applies as a principle, that the insurance carrier in the context of in § 148 ASVG regulated relations with the country health fund financed hospitals the health insurance bodies after the ASVG equivalent is."


5. in article 182a, the term "Agreement in accordance with section 15a B-VG about the restructuring of health care and the hospital financing" is replaced by the expression "Agreement in accordance with article 15a B-VG on the Organization and financing of health care".

6. in article 190 paragraph 1, the expression "Country funds" is replaced by the expression "Land Fund".

7 § repeals 288 par. 3.

8. after Article 308, 309 the following paragraph and heading is attached:



"Final provisions article 3 of the Federal Act Federal Law Gazette I no. 179/2004"



309 (1) the article 86 paragraph 1, 91 paragraph 2, 97 including heading, 160 para 3, 182a and 190 para 1 as amended by Federal Law Gazette I no. 179/2004 apply with 1 January 2005.

(2) article 288 par. 3 occurs with expiry of the 31 December 2004 except force.

(3) upon expiry of the 31 December 2008 article 182a and the provisions referred to in article 269 paragraph 2 in force on December 31, 2008 and amended stomped on December 31, 1996 in force - with the exception of article 182a - back into force.

(4) that no. 179/2004 are State regulations to the § § 97 and 160 paragraph 3 as amended by Federal Law Gazette be adopted within six months, and retroactively with effect to set 1 January 2005.

Article 4

Federal law that modifies the farmers social insurance law

The peasants Social Security Act, Federal Law Gazette No. 559/1978, amended by Federal Law Gazette I no. 171/2004, is amended as follows:

1. in the section 80, paragraph 2, the expression "Country funds" is replaced by the expression "Land Fund".

2. in the heading to § 89 and in paragraph 1, the expression "Land Fund" is replaced by the expression "Land Fund", and in paragraph 1, the expression is "Land Fund funded" replaces "country Health Fund funded" expression.

3. in the heading is the expression "Land Fund" by the expression "Land Fund", as well as in paragraph 1 to article 90 and 2 each is the expression "Land Fund funded" replaces "country Health Fund funded" expression.

4. (principle of determination) section 91 including heading is as follows:



"Relations with the hospitals, funded by national health fund



section 91.

(Determination of principle of) For regulating the relations of the insurance carrier to the national health fund financed hospitals section 148 shall apply ASVG."

5. (principle of determination) section 152 subsection 3 is as follows:



(3) (principle provision) "According to article 12 par. 1 Z 1 B-VG applies as a principle, that the insurance carrier in the context of in § 148 ASVG regulated relations with the country health fund financed hospitals the health insurance bodies after the ASVG equivalent is."

6. in section 170a, the expression "Agreement in accordance with section 15a B-VG about the restructuring of health care and the hospital financing" is replaced by the expression "Agreement in accordance with article 15a B-VG on the Organization and financing of health care".

7. in the section 178, paragraph 1, the expression "Country funds" is replaced by the expression "Land Fund".

8 § repeals 277 para 3.

9. after paragraph 297, 298 the following section including headline is attached:



"Final provisions to article 4 of the Federal Act Federal Law Gazette I no. 179/2004"



298. (1) paragraphs 80 paragraph 2, heading to 89, 89 para 1, heading to 90, 90 para 1 and 2, 91 including heading, 152 subsection 3, 170a and 178 paragraph 1 as amended by Federal Law Gazette I no. 179/2004 with 1 January 2005 into force.

(2) section 277, paragraph 3 occurs with expiry of the 31 December 2004 except force.

(3) at the end of December 31, 2008 § 170a and the provisions referred to in section 258 subsection 2 in force on December 31, 2008 and amended stomped on December 31, 1996 in force - with the exception of § 170a - come back into force.

(4) that no. 179/2004 are State regulations to the § § 91 and 152 para 3 as amended by Federal Law Gazette be adopted within six months, and retroactively with effect to set January 1, 2004.

Article 5

Federal law that modifies the officials-sick and accident insurance law

The officials of sickness and accident insurance Act, Federal Law Gazette No. 200/1967, amended by Federal Law Gazette I no. 171/2004, is amended as follows:

1. in the section 63 para 4, the expression "Country funds" is replaced by the expression "Land Fund".

2. in the section 68, paragraph 1 of the expression will be replaced "country Health Fund funded" "land funds financed" by the expression.

3. (principle provision) section 96 paragraph 4 States:



(4) (principle provision) "Z apply for regulating the relations of the insurance as carrier of accident insurance to the national health fund financed hospitals under article 12 para 1 1 B-VG the principles established in article 68, paragraph 1."

4. in Article 118a, the term "Agreement in accordance with section 15a B-VG about the restructuring of health care and the hospital financing" is replaced by the expression "Agreement in accordance with article 15a B-VG on the Organization and financing of health care".

5. in article 125 par. 1, the expression "Country funds" is replaced by the expression "Land Fund".

6 § is lifted 198 paragraph 4.

7. after section 211, 212 the following section including headline is attached:



"Final provisions article 5 of the Federal Act Federal Law Gazette I no. 179/2004"



212. (1) the section 63 para 4, 68 para 1, 96 paragraph 4 and 118a as amended by Federal Law Gazette I no. 5/2001 apply with 1 January 2005.

(2) section 198 paragraph 4 occurs with expiry of the 31 December 2004 except force.

(3) section 118a and the provisions referred to in section 184 subsection 2 in force on December 31, 2008 except power and amended stomped on December 31, 1996, in force - with the exception of lit occur at the end of December 31, 2008. c of § 68 No. 3 and of Article 118a - again in force.

(4) that I no. 179/2004 are State regulations to section 96 as amended by Federal Law Gazette be adopted within six months, and retroactively with effect to set January 1, 2004.

Article 6

Federal law, which amends the social security Amendment Act

The social security supplement Act, Federal Law Gazette No. 154/1994, as last amended by Federal Law Gazette I no. 67/2001, is amended as follows:

1. in the heading to Section 7a, the expression "Land Fund" is replaced by the expression "Land Fund".

2. Section 7a para 1 and 2 are:



"(1) that have the country health fund on the basis of the agreement in accordance with art. 15a B-VG on the Organization and financing of health care for the years 2005 to 2008 as the carrier of stay or residence costs for a treatment of persons, benefit entitlement under the regulation or an agreement, be made to the competent foreign institutions in the way of locally each concerned area health. The gebietskrankenkassen pass these claims as appropriate its own intergovernmental claims and transfer the costs reimbursed by the competent foreign institutions the country health fund, para 2 Save as otherwise provided, as soon as they have arrived with them.

"(2) in cases a lump-sum refund or a renunciation of expenses transfer the gebietskrankenkassen the country health fund these costs therefrom as carrier of stay or residence with the end of exercise, taking into account according to a general reduction of the Pauschbetrages."

3. Section 7a para 4 is as follows:



"(4) the cost of hospital care abroad, who spend the Austrian institution of social security on the basis of domestic law or on the basis of the regulation or an agreement or to refund because the person in question"



1 for medical reasons from a domestic in a foreign hospital was moved or 2. not or not could get domestic treatment appropriate to their condition in a period, is usually needed for this treatment,


are the carriers of social security by the Federal Health Agency in accordance with article 39 to replace paragraph 2 No. 2 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care to the extent these costs exceed a certain amount. This amount is for 2005 on the basis of the amount in 2003 (article 32 paragraph 3 of the Agreement Federal Law Gazette I no. 60/2002) plus the increases in accordance with the provisional one hundred records in 2004 and 2005 to calculate, with the revenue from the budget bill in 2003 to include are in the percentages. The preliminary and final amounts arise in analog valorisation provisions pursuant to article 17 paragraph 6 Nos. 2 and 3 of the agreement in accordance with article 15a B-VG on the Organization and financing of health care. The winners of the social security system have to report the expenses in these cases immediately to the main Association of Austrian social security institutions. The Confederation has continually to monitor the development of the expenses and to report twice a year currently on nature and extent of the services provided in accordance with paragraph 2 for hospital care abroad the Federal Health Commission. He has, where appropriate, to claim reimbursement from the funds of the Federal Health Agency on behalf of the concerned carrier. The refunds from the funds of the German Federal Health Agency are to be transferred at the end of the year of the assertion on the affected carriers in the ratio of the amounts applied in these cases."

5. after section 9f, the following section shall be inserted 9 g:





§ 9 g. I no. 179/2004 the heading to § 7a and Article 7a, paragraph 1, 2 and 4 in the version of Federal Law Gazette 1 January 2005 into force."

Article 7

Federal law, which the doctor Law 1998 changes (6 doctor Law Amendment)

The medical act of 1998, Federal Law Gazette I no. 169, amended by Federal Law Gazette I no. 140/2003, is amended as follows:

1. in the table of contents is after the content entry "§ 128... Executive Committee"of the content item"section 128a... Education Commission"added.

2. in article 5, paragraph 1 Z 3 is the phrase "pursuant to article 9 para 1, 3 or 5" by the phrase "pursuant to article 9 para 1, 3 or 5 or Article 9a" as well as in § 5 para 2 Z 4 the phrase "pursuant to article 9 para 2, 2a, 4 or 5" by the phrase "pursuant to article 9 para 2, 2a, 4 or 5 or Article 9a" replaced.

3. paragraph 19 Nos. 3 and 4:



"3. in possession of a diploma, certificate or other evidence of formal qualifications of dental practitioner including a certificate referred to in article 7 paragraph 1 or 3, Article 7a, paragraph 1 or article 7 b of paragraph 1, 2, 3 or 4 of Directive 78/686/EEC or 4th in the possession of a diploma, certificate or other evidence of formal qualifications of doctor including a certificate referred to in article 19, 19a, 19 c or 19d of Directive 78/686/EEC or" 4. § 27 para 1 second sentence reads :



"The list is contracts with social insurance institutions and health care institution and registration number, based, place of employment, address or - doctors according to § 47 - home address job titles together with any officially conferred titles and accessories in accordance with section 43 (4), diplomas of medical associations in the provinces, with respect to name, publicly."

5. According to article 27, paragraph 2, the following paragraph 2a is inserted:



"(2a) citizens of the Republic of Estonia, the Republic of Latvia, the Republic of Lithuania, the Republic of Poland, the Slovak Republic, the Republic of Slovenia, the Czech Republic and the Republic of Hungary, certified striving for an exercise of the medical profession as a general practitioner, doctor, medical specialist, dentist or every doctor in the context of a service relationship, have in the application for registration in the physician list the conditions for employment in accordance with article 3 in conjunction with § 32a of the aliens Employment Act (aliens)" , Federal Law Gazette No. 218/1975, to provide evidence. This proof is regarded as a requirement in accordance with §§ 4 para 2 or 18 para 2 for the exercise of the medical profession."

6 paragraph 27 paragraph 7:



"(7) the person meets the requirements prescribed for the type of profession, so she has to enter the Austrian Medical Chamber in the list and to issue you a card bearing her photo (medical certificate). If the fulfilment of the conditions for employment in accordance with article 3 in conjunction with § 32a aliens is temporary, also the entry in the list has temporary appropriately timed to take place. This is the person on the occasion of the entry in the list under the note that their medical professional qualifications shall expire after the deadline by law in writing. In this case may be waived by the issue of a notice of assessment pursuant to article 59, paragraph 3. The medical activity may be recorded only after receipt of the confirmation of registration in the physician list (medical certificate). As of the date of registration people who are nationals of one of the other parties to the agreement on the European economic area, same rights and obligations as the Austrian doctors registered in the list."

7 paragraph 32 section 1:



"(1) the Austrian Medical Association has people, the"



1 abroad a permission to the independent exercise of the medical profession, have acquired 2. not in accordance with §§ 4, 5, 5a, 18, 19 or 19a to the independent exercise of the medical profession are entitled to 3 Z 2 to 5 or § 18 para 2 meet the General requirements of section 4 paragraph 2 Z 2 to 5 and one 4. qualification in accordance with § 4 para 3 in conjunction with § 4 para 4 Z 2 or § 4 paragraph 5 Z 2 or in accordance with §§ 5 ", 5a, 18 paragraph 3 or 4, 19 or 19a provide, to grant a licence limited to a maximum of three years to the independent exercise of the medical profession in the framework of an employment relationship as a doctor for general medicine, physician or dentist in hospitals or prisons."

8 § 32 para 5 No. 2 is:



"2. a requirement referred to in paragraph 1 Z 1, 3 or 4 has been removed."

9 paragraph 33 section 1:



"(1) the Austrian Medical Association has people, the"



1 abroad a permission to the independent exercise of the medical profession, have acquired 2. not in accordance with §§ 4, 5, 5a, 18, 19 or 19a to the independent exercise of the medical profession are entitled to 3 Z 2 to 5 or § 18 para 2 meet the General requirements of section 4 paragraph 2 Z 2 to 5 and one 4. qualification in accordance with § 4 para 3 in conjunction with § 4 para 4 Z 2 or § 4 paragraph 5 Z 2 or in accordance with §§ 5 ", 5a, 18 paragraph 3 or 4, 19 or 19a provide, to grant a permit to the professional exercise of the medical profession as a doctor for general medicine, physician or dentist fixed-term not exceeding three years."

10 § 33 para 5 No. 2 is:



"2. a requirement referred to in paragraph 1 Z 1, 3 or 4 has been removed."

11 § 35 par. 1 No. 2 is:



"2. doctors, the Austrian nationals or nationals of one of the other parties to the agreement on the European economic area, but not in accordance with the sections 4, 5, 5a, 18, 19 or 19a to the exercise of the medical profession are entitled or whose medical or dental degrees not to meet the requirements of § 4 para 3 Z 1 or paragraph 3 Nos. 1 and 2 or § 18 para 3 or 4 Z 1 match."

12. According to article 66, paragraph 2, Z 11 following Z 11a is inserted:



"11a. refund of opinions in accordance with section 20, paragraph 2, of the aliens;"

13 68 paragraph 4, the following sentence is added at §:



"A transfer of service centre in accordance with subpara 1 not exists if the doctor due to grade or contract provisions, in particular on the basis of Karen cation and service allocation, is temporarily in the area of other medical association or by doctors working abroad."

14 91 paragraph 4, the following sentence is added at §:



"In this case, the levy order can the payment of a one-time late payment surcharge, which may not exceed 10 vH of determined Chamber assessment and its setting all significant circumstances, in particular the economic performance of the members of the Chamber, are taken into account, see above."

15. at the end of the article 97 Z 3 is the point by the word 'and' replaced and added following Z 4:



"4. to former Board members and survivors of members of the Chamber, where their contributions have been referred to an other medical association nor refunded the Chamber members (§ 115)."

16 paragraph 98 section 1:



"Welfare Fund following retirement benefits are (1) to grant:"



"1. Altersversorgung, 2. Invaliditätsversorgung, 3. Kinderunterstützung, 4. Hinterbliebenenversorgung: a) widow's and widower's care, b) orphan care, c) survivor's support, 5. funeral allowance."

17. in article 98, paragraph 2, the sequence of digits is "Z 3 to 6" by the sequence of digits "Z 3, 4 lit." replaced a and b", the sequence of digits in article 98, paragraph 3"Z 1-5"by the sequence of digits"No. 1 until 3, 4 lit. replaced a and b"and in article 98, paragraph 5 the following sentence is added:




"Achieve the benefits pursuant to para 1 No. 1 to 3, 4 lit. a and b less than a tenth of the basic power stated in para 3, so can the Statute a one-time, calculated in accordance with actuarial principles, lump-sum settlement provide.'

18. According to § 98 article 6, the following paragraph 6a is inserted:



"(6a) the statutes may provide for additional unique services, taking into account the volume of post."

19 paragraph 104:





Section 104 (1) when the death of a members of the Chamber or recipient of an old-age or disability care is



1. the funeral aid and 2. to grant the survivor's support. The funeral aid is used to cover the costs associated with the funeral. The survivor's support is part of the survivor's benefit and serves as a unique financial abutment the bereaved.

(2) the extent of the burial grant and the survivor's assistance is to set in article 92 par. 1 of the Statute, taking into consideration.

(3) on the burial grant and the survivor's assistance have provided the late Chamber members or recipients of old-age or disability care has made another payment receiver not designating and thereof deposited a written and personally signed statement to the Welfare Fund, one after the other claim:



1. the widow (widower), 2. orphans and 3 other legal heirs.

(4) several beneficiaries in accordance with § 3 Z 2 or 3 there are, is this to pay performance severally.

(5) an eligible person for the purposes of paragraph 3 does not exist and carried the cost of the funeral of another person, so the replacement of the proven costs to this on request up to the amount of the provided burial aid."

20 § 109 paragraph 1 third sentence reads:



"An interruption of this activity for less than six months, as well as a medical practice in the area of other medical association or from abroad on the basis of grade or contract provisions (section 68 (4) last sentence) in this respect is considered continuous professional practice."

20A. § 109 paragraph 5 the following sentence is added:



"In this case, the subscription rules can the payment of a one-time late payment surcharge, which may not exceed 10 vH of the welfare fund contribution to be determined and its setting all significant circumstances, in particular the economic performance of the members of the Chamber, are taken into account, see above."

21 paragraph 109 paragraph 8:



"(8) in the event that the actuarial cover of individual groups of services, calculated according to the recognised rules of insurance mathematics, is omitted, the Statute may require as long a pension assurance contribution recipients of services of the concerned group until the actuarial required cover is reached. Pension assurance contribution shall not exceed that percentage, the Chamber members to raise pension ineffective make actuarial cover of the Fund and shall be a maximum of 20 vH of the pension benefits of the respective group. The shortfall is to be determined by the existence of two independent expert reports by actuarial experts (Actuaries). Despite the existence of these conditions a pension assurance contribution must be not lifted up, if the contribution provided for in the fee structure, which annually to pay is by the members of the Chamber for the services of the concerned group of retirement benefits, has been lowered over the last five years before decision on the contribution of the pension protection."

22 paragraph 112:





112. (1) a full member of the Chamber provides the proof that an equivalent Ruhe(Versorgungs)genuss due to a non-cancelable service relationship with a local authority or other public body entitled to him and his surviving by a law or by the pension provisions of a service order to such a corporation, as this in relation to the Welfare Fund, is he on application in accordance with the application is sought and the following provisions of the obligation according to § 109 to liberate. The applicant exerts no medical activity within the meaning of § 45 para 2, the articles of association may provide that the obligation to contribute to the death of aid and support services will remain. The applicant has a medical practice in the sense of § 45 para 2, anyway, remains the obligation to contribute to the basic service. The articles of association may provide that the obligation to contribute in addition to the supplementary benefits, funeral aid and support services will remain.

(2) a full member of the Chamber provides the proof that a similar Ruhe(Versorgungs)genuss on the basis of belonging to the Welfare Fund of other Medical Association entitled to him and his survivors, like this in relation to the Welfare Fund, he is free on request fully from the contribution requirement in section 109.

(3) Board members who are only contributions after age of 35 years, are committed to a payment in the sense of paragraph 4 from the age of 35. If this provides for the Statute. This payment obligation shall not apply to those periods in which the Chamber members in another Contracting State to the agreement on the European economic area or the Swiss Confederation in a prescribed system of social security in a branch was insured, provides benefits for invalidity, old age or survivors.

(4) for the calculation of the amount of the payment is attributable to a Chamber member average contribution of each calendar year to attract. Also has to determine whether to revalue in the calculation of the payment amount on the post level of the current calendar year is, or shall be payable on the percentage of the average yield of the Fund's assets during the period of payment according to the principles of a Zinseszinsrechnung is whether the Statute. However, the contributions collected during the payment period for the burial grant and the support services remain except approach.

(5) in the case of exemption from the obligation to contribute, the provision of services according to the extent of the exemption is wholly or partially closed.

(6) the fee structure has to regulate how the posts not refunded in accordance with the provisions of article 115 used if the Chamber membership or dues again. Competence and obligations of other medical association the transfer provisions of section 115 shall apply mutatis mutandis."

23 § 115 para 1 second sentence reads:



"The post parts articles of association provided for certain purposes, in particular funeral aid, survivor support and medical support, remain in the calculation of the transfer amount not taken into consideration."

24 § 115 paragraph 2 is added the following paragraph 3:



"(3) a Radebe set of contributions under paragraph 1 or 2 is only possible, if the members of the Board in writing that he is not recognised in another Contracting State to the agreement on the European economic area or the Swiss Confederation by a branch of a prescribed system of social security for employed or self-employed persons, provides benefits for invalidity, old age or survivors."

24A. is section 118c together with the heading:



"Regulation for the quality assurance of medical and dental care



section 118c. (1) the Austrian Medical Association has the criteria to be evaluated (Article 118a par. 2 No. 1), the control of evaluation results, by regulation to fix registry of quality leading to the criteria for the relevant electronic data transmission, as well as by the company for a period of five years after referral to the Scientific Committee for quality assurance, the Federal Curia of practising doctors and dentists Federal Curia. This regulation is to develop further within the meaning of paragraph 49. The regulation is no later than 1 January 2005 for the first time the approval to submit and regularly as a result, if necessary before the end of the five-year period, the above requirements to adapt.

(2) that regulation is no later than three months before the expiry of five years (paragraph 1) for regulatory approval to submit the Federal Minister for health and women.

25. pursuant to paragraph, following paragraph 6a is inserted 120 Z 6:



' 6a. the Education Commission (section 128a), "26. The following section 128a and heading shall be inserted after article 128:



"Education Committee



section 128a. (1) the Education Committee consists of one representative of the education commissions set up in the medical associations in the Federal States (§ 82 par. 2) as well as members from two of the Executive Board of the Austrian Medical Association from among its nominees. The Chairman of the Education Committee and the Deputy Chairman are nominated by the Board of Directors. For each additional member, an appropriate alternate member is appointed.


(2) the Chairman shall convene the meetings of the Education Committee, sets the agenda and chairs the meetings. In the case of the prevention of the Chairman and the Deputy, the oldest years Member of the Education Committee in the capacity of Chairman of the occurs for the duration of the prevention.

(3) the President of the Austrian Medical Association and the Chairman of the Education Committee shall be entitled to participate in the meetings of the Education Committee and to make submissions.

(4) the Education Commission is responsible



1. the decision in proceedings referred to in articles 9 to 13, 14, 14a, 15, 32, 33 and 35, 2. the determination of equivalence in accordance with §§ 5a Z 3, 19a No. of 3 and 39 para 2, 3. Replying to individual to the Education Commission put up requests, if they have additional importance on individual cases, as well as 4. reimbursement of reports and proposals to other organs of the Austrian Medical Chamber.

(5) the Education Committee is resolutionable, if at least seven members are present. Each Member has one vote.

(6) for the Education Commission, the two-thirds majority of the valid votes cast is required. Every request is to vote separately.

(7) for more are set by rules by the Austrian Medical Association. rules concerning the structure and tasks of the Education Commission"

26A. § 195 para 6f is as follows:



"(6f) the issuing of a regulation in accordance with section 118c requires the approval of the Federal Minister for health and women. The approval is granted if the regulation to be approved complies with this federal law, in particular the the doctor or dentist, obligations set out in paragraph 49. The reference to the decision-making process of the regulation referred to in section 118 c is published in the Austrian medical journal. At the same time with the by-laws in the Austrian medical journal the decree by the Austrian Medical Association in full text on the Internet is generally available to be published. As far as the regulation provides for no in force appearance later, the regulation by the end of the day of the by-laws on the Internet into force."

27. in section 208 subsection 2 is the phrase "as amended by Federal Law Gazette I no. 110/2001 (2nd doctor Law Amendment)" by the phrase "as amended by Federal Law Gazette I no. 140/2003 (5th doctor Law Amendment)" replaced.

28 article 210 paragraph 6 be added following paragraph 7 and 8:



"(7) on 1 May 2004 into force related grants in accordance with sections 32, 33 and 35 for nationals of the Republic of Estonia, the Republic of Latvia, the Republic of Lithuania, the Republic of Malta, the Republic of Poland, the Slovak Republic, the Republic of Slovenia, the Czech Republic, the Republic of Hungary and the Republic of Cyprus, 5, 5a, remain despite a possible permission to practice in accordance with articles 4, 18, 19 or 19a unaffected."

(8) nationals of the Republic of Estonia, the Republic of Latvia, the Republic of Lithuania, the Republic of Malta, the Republic of Poland, the Slovak Republic, the Republic of Slovenia, the Czech Republic, the Republic of Hungary and the Republic of Cyprus, which are available on the 1 May 2004 in accordance with §§ 7 para 6 and 8 par. 4 and 5 in training to become a doctor, general practitioner, specialist, majoring in a special compartment or in an additive ", are entitled to complete their training according to the legal situation prior to this date."

29 § 214 paragraph 13 is added the following paragraph 14:



"(14) § 5 para 1 Nos. 3 and para. 2 Z 4, 19 Z 3 and 4, 27 par. 2a and 7, § 32 para 1, § 32 para 5 Z 2, § 33 para 1, § 33 para 5 Z 2, § 35 par. 1 Z 2, § 66 ABS 2 Z 11a and article 210, paragraph 7 and 8 with 1 May 2004 into force." Section 208 subsection 2 in the version of Federal Law Gazette I is no. 179/2004 31 December 2003 in force."

Article 8 amendment to the Federal Act on the documentation in healthcare

The law on the documentation in healthcare, Federal Law Gazette No. 745/1996, as last amended by Federal Law Gazette I no. 144/2003, is amended as follows:

1. in article 2, paragraph 1 and 2, article 3, paragraph 1 and 2, § 4, as well as in article 7, paragraph 1, 2 and 3 the word "Country funds" is substituted with the word "Country health fund".

2. paragraph 5 paragraph 2:



"(2) the Federal Ministry for health and women has to deliver the submitted reports of the Federal Health Agency, the national health fund, the countries, the main Association of Austrian social security institutions and the institutions of social security than this which is necessary to carry out this statutory tasks whether in this respect."

3. paragraph 8a:





§ 8a. The Federal Ministry for health and women has to transmit submitted reports in accordance with paragraphs 7 and 8 of the Federal Health Agency, the national health fund, the countries, the main Association of Austrian social security institutions and the institutions of social security than this which is necessary to carry out this statutory tasks whether in this respect."

4. paragraph 10:





§ 10. The bearer of not country health funded hospitals that the imposed obligations in accordance with §§ 1, 2, or 8 or I no. 165/2004, does not comply with the obligations under sections 4 or 6 of the private hospitals Financing Fund Act, Federal Law Gazette, commit an administrative offence, unless the Act constitutes not a criminal offence falling within the jurisdiction of the courts and are fined to punish up to EUR 5 000."

5. in article 12 the following paragraph 3 is added:



"(3) paragraphs 2, 3, 5, 7, 8a and 10 as amended by this federal law enter into force 1 January 2005." To the establishment of country health fund by countries the country funds perceive the tasks and functions of the national health fund."

Article 9

Federal law on the quality of health services

(Health quality Act - GGQ)

Objectives and principles



§ 1 (1) comprehensive backup and improve the quality in the Austrian healthcare system is to implement systematic quality work and intensify. A total Austrian quality system is based on the principles of patients - and patient orientation, transparency, to develop, implement and regularly to evaluate effectiveness and efficiency. This is in particular the quality of the provision of health services, taking into account the patients - and to ensure patient safety.

(2) the Federal Minister / the Federal Minister for health and women has to ensure that the work to build, to the development of assurance and evaluation a comprehensive Austrian quality system be nationally, Bundesländer -, sector - and across the profession. The levels of the structure are in terms of the quality system take into account process and quality results.

(3) for the purpose of ensuring the principles laid down in paragraphs 1 and 2, the Federal Minister / the Federal Minister for health and women for a corresponding coordination of the actors involved in the overall Austrian quality system and actors has to take care. In addition, the Federal Minister / the Federal Minister for health and women has to ensure nationwide coordination of quality measures for the purpose of national and international comparability of health services.

(4) the data required for the continuous quality work must be at least pseudonymisiert if they are not required for specific goals and purposes personal data in a trustworthy way.

Definitions



§ 2. The terms mean in the sense of this federal law:



1. "Quality system": including a coordination, promotion, support and monitoring system of the Covenant is understood, with the aim to improve the quality of health services.

2. "Quality": degree of meet the characteristics of patientinnen - and patient-oriented, more transparent, more effective and more efficient provision of the health service. The central concern in this context are the optimization of structure quality, process quality and result quality.

3. "Patients - and patient orientation": In the sense of improvement of quality of life concerned people at the Centre of decisions and actions will stand and be empowered to participate Koproduzentinnen and co-producers on this process of improving the quality of life as.

4. "Patients - and patient safety": includes measures to prevent adverse events, which may lead to the detriment of the patient / patient.

5. "Transparency": traceability by documentation and analysis of performance and results and their systematic review. Basis for continuous and systematic comparisons to improve quality.

6 'Effectiveness': degree of target achievement between a set goal and its realization with the goal in health care is ideally the preservation or restoration of the health of citizens, as well as patients, and patients.

7 'Efficiency': relationship between the insert and the result of a performance according to the principle of economic efficiency, taking into account the cost containment.

8.


"Structural quality": total factual and personnel facilities in quantitative and qualitative terms.

9 "Process quality": work processes and procedures, which according to comprehensible and verifiable rules systematized and correspond to the level of professional knowledge, are evaluated regularly and continuously improved.

10 "Earnings quality": measurable changes of in professionally estimated health, quality of life and the satisfaction of a patient or a patient population group as a result of certain framework conditions and measures.

11 "Health service": each by a member or a member of a legally recognized health profession on or for the people provided action that serves the promotion, preservation, restoration, or improvement in physical and mental health.

12 'Quality standards': recordable regularities and requirements with regard to equipment, procedures or behaviour.

13 "Federal quality guidelines": the Federal Minister / standards adopted by regulation of the Federal Minister for health and women and thus binding made.

14 "Federal quality guidelines": the Federal Minister / standards recommended by the Federal Minister for health and women as an orientation aid.

15 "Quality indicator": measurable size which is suitable to observe the quality of the health services, as well as to compare and evaluate.

16 'Reference value, reference range': a reference range is the interval within which the expression of a quality indicator is defined as good or as unobtrusive. A benchmark is a reference area, whose upper and lower limits falling together.

17 "Core principles of health promotion" in the framework of the provision of health services: health promotion aims at the process, to allow the people a high degree of self-determination over their health and to enable them to strengthen their health.

Scope of application



The provisions of this Act are section 3 (1) in the provision of health services to keep regardless of the form of organization of the service provider / host. The health services must comply with the requirements applicable on the basis of this Act and the recognized State of scientific knowledge and experience, as well as provided in the technical quality and a health-promoting environment.

(2) in the provision of health services, the transparency concerning structural funds is to ensure process and quality results to patients and patients to their demand.

Quality standards



4. (1) the Federal Minister / the Federal Minister for health and women can support the development of quality standards for the provision of certain healthcare services, including each concerned, in particular the relevant health professionals and patients and patients.

(2) the Federal Minister / the Federal Minister for health and women can in connection with the provision of health services of quality standards than federal quality guidelines recommend or by regulation enacted as Federal quality standards, which is in particular to ensure the following:



1. Bundeseinheitlichkeit, 2. consideration on cross-sectoral and Interprofessional approach, 3 patients and patient orientation, 4. fundamental principles of health promotion, 5. transparency, 6 current state of knowledge and experience regarding the effectiveness and efficiency.

The Federal quality standards include specifications for one or more of the dimensions referred to in § 5 quality work (structure, process or outcome). To implement the Federal quality standards, the Federal Government in addition to binding instruments may provide also non-binding instruments that can be replaced by equivalent measures - in verification of compliance.

(3) on Federal quality guidelines or federal quality standards, quality indicators can be coupled, whose Inhalte represent elements of the Austrian quality reporting. In the development of quality indicators is to ensure international comparability.

Dimensions of quality work



5. (1) the Federal Minister / the Federal Minister for health and women has to ensure that the quality standards for the provision of health services in the sense of a systematic quality work of structural, process and outcome quality into account. This caution is to take on the further development of appropriate method work, as well as on reporting and documentation requirements. These targets have wisely on international developments to take place.

(2) in terms of the quality of the structures, the Federal Minister / the Federal Minister for health and women has to develop binding structure quality criteria for the provision of health services. This structure quality criteria are to comply with the provision of health services, regardless of which form of organization that will be provided. Appropriate reporting requirements are to do so by the Federal Minister / to be determined by the Federal Minister for health and women.

(3) in the area of process quality, the Federal Minister / the Federal Minister for health and women has to develop mandatory requirements as well as to provide support through the provision of appropriate instruments. The Federal Minister / the Federal Minister for health and women has to ensure, that indicators on the quality of the process and reporting requirements the process quality indicators are set, among others in the framework of the Austrian quality reporting.

(4) in terms of the quality of the results the Federal Minister / the Federal Minister for health and women has to ensure that indicators and reference levels for the quality of the results and corresponding reporting obligations, lays down, inter alia within the framework of the Austrian quality reporting.

Quality reporting



6. (1) the Federal Minister / the Federal Minister for health and women has with regard to the design, development, to make the backup and the evaluation of a nationwide Austrian quality system requirements for the establishment of a nationwide, cross-sectoral, Bundesländer - and professional quality reporting. For in this regard required documentation and data reporting are to comply with the following principles:



1. definition and capture those data which are necessary for the verification of compliance with the requirements of this federal law;

2. ensure the nationwide collection of the data relevant for the monitoring of the quality of the Austrian health care system;

3. the low stance of in administrative expenses for documentation and quality reporting and the extensive involvement of existing documentation.

(2) the Federal Minister / the Federal Minister for health and women may lay down by regulation detailed provisions with regard to the documentation and quality reporting. These include in particular:



1 scope of the data, data quality, data flow, 2nd report time, 3rd period and 4 establishment of committed to the documentation, data reporting and quality reporting.

This Ordinance shall in particular on the guidelines referred to in paragraph 1 to take.

(3) the Federal Minister / the Federal Minister for health and women has known the intensity of the participation of actors and players in the Austrian system of quality to the interested public in an appropriate manner in the spirit of enhanced transparency to make. / He has to take care in addition, that appropriate feedback systems on the quality reporting duties be established.

Support measures and incentive mechanisms



§ 7. The Federal Minister / the Federal Minister for health and women can support the development of measures and incentive mechanisms in the field of quality work. The Federal Minister / the Federal Minister for health and women can provide even support measures and incentive mechanisms to the sustainable improvement and ensuring the quality of health services.

Control



8. (1) the Federal Minister / the Federal Minister for health and women has to ensure a nationwide monitoring and control in connection with the securing and enhancing the quality of health services. This includes at least



1. the review of participation in the Austrian quality reporting, 2. the review of the implementation of Federal quality rules and 3. the evaluation of the implementation and application of Federal quality guidelines or the use of equivalent instruments.


(2) the Federal Minister / the Federal Minister for health and women has to ensure that accompanying external controls for quality work in the health care sector are carried out. To this end, the Federal Minister / the Federal Minister for health and women, as well as the persons responsible for her / him have to require institutions and authorities the right to information and messages, to inspect relevant documents including the data quality in all for the quality work and perform surveys on the spot if necessary, insofar as this is necessary for carrying out the tasks incumbent on him / her. Copies of documents examined are free of charge to the persons receiving knowledge, institutions and authorities. Other monitoring and control duties and rights on the basis of other legislation remain unaffected.

Support by the Federal Institute for quality in health care



§ 9 (1) is to establish a "Federal Institute for quality in health care". The Federal Minister / the Federal Minister for health and women can serve in the performance of its / his tasks on the basis of this Act of this "Federal Institute for quality in health care".

(2) this Institute has taking on the Bundeseinheitlichkeit the Bundesländer -, cross-sectoral and multidisciplinary approach, the patients - and patient orientation, transparency, effectiveness, efficiency and in accordance with international standards in particular the following tasks:



1 participation in the creation of general rules and principles of a) for the development of standards in the area of structure, process and result quality, b) for the documentation of quality reporting and for quality reporting, c) for assistance and incentive mechanisms, d) for the control referred to in section 8, paragraph 1;

2. review, recommendation and development of quality standards, by the Federal Minister / by the Federal Minister for health and women adopted (Federal quality guidelines) or as a guide (German quality guideline) recommended;

3. preparation of the annual quality report;

4. implementation of or participation in the establishment of support measures and incentive schemes;

5. implementation of or participation in the control of the compliance with the provisions of this Act and the regulations adopted on the basis of this Act or other requirements;

6. support the Federal Minister / the Federal Minister for health and women in the nationwide coordination of quality measures for the purpose of national and international comparability of health services.

Penal provisions



10. (1) who in the provision of health services of a federal quality policy that is made binding on the basis of this Act contravenes commits, if not a judicially punishable act, an administrative offence and is to punish, in case of repeated up to Euro 20.000,--with an administrative penalty up to Euro 10,000.

(2) a person who does not comply with the rules on the reporting of the quality or the documentation, commits an administrative offence and is to punish, in case of repeated up to 5,000 Euro Euro 3.000,--with an administrative sanction.

(3) a person who obstructs the control rights of the Minister / the Federal Minister for health and women according to § 8 par. 2, second and third sentences, or the persons responsible for her / him, bodies or authorities, commits an administrative offence and is with an administrative penalty to punish repeated up to Euro 7.000,--Euro 5,000.

(4) of the impugned administrative offences, the Federal Minister / the Federal Minister for health and women in knowledge must be set.

Final and in force Tretensbestimmungen



§ 11 (1) with the execution of this Federal Act is the Federal Minister / the Federal Minister for health and women entrusted.

(2) this Federal Act with the exception of the section 10 on the 1st 2005 enter into force. § 10 enters into force on January 1, 2006.

Article 10

Federal Act concerning data security measures for electronic transactions with health data and establishment of information management (health tele-matikgesetz - GTelG)

Table of contents


1 article: Subject matter and definitions article 1 subject to § 2 definitions 2. section: data security for electronic health data exchange section 3 proof of identity and role section 4 identity § 5 role § 6 confidentiality § 7 integrity section 8 documentation 3. section: information management section 9 eHealth directory service § 10 contents § 11 recording § 12 registration procedure article 13 registrars § 14 monitoring § 15 quality assurance health-related Web information section 16 information service 4. section: final provisions article 17 administrative penal provisions article 18 in force article 19 transitional provisions article 20 issue and in force regulations section 21 references section 22 enforcement 1 section

Subject matter and definitions

Subject



§ 1.

 (1) with this federal law, supplemental privacy policy be set for e-health data and set up an information management for matters of health.

(2) the objectives of this Federal Act are increasing data security in electronic transactions with health data by federal minimum standards, as well as to create the necessary information base for the development and management of e-health in the context of international or to widen.

(3) the statutory provisions concerning the permissibility of data uses, on the rights of the persons concerned, as well as about the legal protection remain unaffected by this federal law.

Definitions



§ 2. In the meaning of this federal law mean



1. health data: directly personal data pursuant to § 4 Z 1 DSG 2000 on the physical or psychological situation of a people, including in connection with the survey of the causes of this state of mind as well as the medical care or supply, the care, the allocation of health services or health insurance data. These include the a particular data) the mental state, b) the structure, the function or the condition of the body or parts of the body, c) the health-related lifestyle or environmental factors,) the related or prescribed medicines, medical AIDS or AIDS, e) Diagnostics, therapy or treatments, or f) relate to the nature, the number, the duration or the cost of health care or health-related insurance services.

2. health service provider/health service providers: clients/client and service bar channel/service providers in accordance with DSG 2000, whose regular using health data is part of their employment, its operational purpose or their services.

3. electronic exchange of health data: passing by or the granting of access rights to data applications automation-supported in the context used health data by means of communication technologies by a health service provider / a health service provider, both to clients/client (§ 4 Z 4 DSG 2000) as well as service bar channel/service provider (§ 4 Z 5 DSG 2000).

4. role: Classification of health care providers/health service providers according to the nature of their employment, their operating purpose or their services.

2. section

Data security in electronic health data exchange

Proof of identity and role



§ 3

.

 Be transmitted in electronic transactions between health service providers/health service providers, health information or access rights granted to it, so this may happen only if identity and role of the recipient / addressee or those health service provider that health service provider, who will take a granted right of access to health data, are demonstrated. The evidence is to provide in accordance with the articles 4 and 5 in electronic form and to consider.

Identity



§ 4.

 (1) proof of identity is through an electronic certificate (certificate), which established identity of the health service provider of the health service provider confirming E-government law in accordance with sections 3 to 6 is to provide and check. The certificate must be laid down minimum requirements in accordance with article 7, par. 5.

(2) the evidence referred to in paragraph 1 can be avoided if the health service provider of health service providers in the eHealth directory service is registered and this of / from the surrounding further the health data or be a access to health service provider/health service provider is verified by inspection in the eHealth directory service.

(3) if the electronic exchange of health data is handled only programmatically, is - by way of derogation from paragraph 1 and 2 - the proof of identity by means of server certificates to provide and to examine programmatically. Server certificates must comply with the established minimum requirements pursuant to § 7 para 5.


(4) is operated within the framework of the electronic exchange of health data a data application directly from a distance and is not proof or the examination of identity in accordance with paragraph 1 or 2 in a particular case for technical or economic reasons, is to prove the identity in the course of the implementation of the access authorization and check. During the existence of the access permission is the identity at periodic intervals.

(5) for the inspection of identity in the context of electronic health data exchange during an existing access permission in accordance with para 4, health service providers/health service provider have the reason to document the periodicity, which may not exceed one month, the procedure to be followed in the examination, as well as the mechanisms to ensure and control of their implementation.

Role



§ 5.

 (1) that has Federal Minister for health and women / the Federal Minister for health and women roles coming for electronic health data exchange considering and those places, the mapping of roles to a health service provider / a health service provider authentic confirm to set by regulation.

(2) evidence of the role is to provide an electronic certificate (certificate) a body established in accordance with paragraph 1 and to examine. The certificate must be laid down minimum requirements in accordance with article 7, par. 5.

(3) the evidence referred to in paragraph 2 can be avoided if the health service provider of health service providers in the eHealth directory service is registered and the role of the / from the surrounding further the health data or be a access to health service provider/health service provider is verified by inspection in the eHealth directory service.

(4) the electronic health data exchange only programmatically handled and is inappropriate, the evidence and the examination of the role in a particular case for technical or economic reasons the proof or the examination of the role of the recipient / addressee of health data from the initial implementation of health data exchange shall be made. During operation, check the role at periodic intervals.

(5) is served in the context of electronic health data exchange a data application directly from a distance and is inappropriate, the evidence and the examination of the role in a particular case for technical or economic reasons evidence and the examination of the role prior to implementing the access permission to the data application has to be made. During the existence of the access permission, check the role at periodic intervals.

(6) for the testing of the role in the context of electronic health data exchange in operation in accordance with paragraph 4 or during an existing access permission in accordance with para 5, health service providers/health service provider have the reason to document the periodicity, which may not exceed one month, the procedure to be followed in the examination, as well as the mechanisms to ensure and control of their implementation.

Confidentiality



§ 6.

 (1) without prejudice to the data safety existing for the use of personal data according to the DSG 2000 health service providers/health service providers for electronic health data exchange over a medium that is not her exclusive access have to exclude various third parties by the knowledge of health data by content encryption of the data from them. The content encryption is to use cryptographic methods can not be compromised after the respective State of the art with a commercially reasonable effort.

(2) the encryption has to be the decryption on the systems of the recipient / addressee of the health data on the equipment of the sender / shipper.

Integrity



§ 7.

 (1) the integrity (authenticity) to be transferred health data is by using electronic signatures, which must comply with the minimum standards established in accordance with paragraph 5, or by checking for them to prove.

(2) the use of electronic signatures referred to in paragraph 1 can be avoided if the electronic health data exchange only programmatically or through direct operation of a data application from a distance. May have health service providers/health service providers that perform the programmatic exchange of health data, as well as allow health service providers/health service providers, the rights to operate their data application from a distance, documenting the reasons and the measures taken by them, must ensure a comparable level of data security, as well as the mechanisms to ensure and check of compliance.

(3) attaching electronic signatures can be done automatically.

(4) in the case of a failed signature verification received health data may not be used.

(5) the quality requirements for certificates referred to in sections 4 and 5, for encryption in accordance with article 5, as well as for electronic signatures are from the Federal Minister for health and women / to be determined by the Federal Minister for health and women with regulation.

Documentation



§ 8.

 (1) the safety measures taken by health service providers/health service providers for electronic health data exchange in their internal area including effective mechanisms for monitoring and ensuring compliance are DSG in the intra-organisational data protection or data security regulations in accordance with the regulations, in particular in accordance with § 14 2000, document.

(2) health care providers/health service providers who are subject to documentation requirements in accordance with § 4 para 4, § 5 ABS. 4 or paragraph 5 or § 7 paragraph 2, have the Federal Minister for health and women / the Federal Minister for health and women or a his or hers commissioned § 4 paragraph 5, § 5 section 6 or section 7 para 2 documented regulations as well as the way third party in accordance with , the scope and the results of checks carried out in this connection request information to give.

3. section

Information management

eHealth directory service



§ 9.

 (1) the Federal Minister for health and women / the Federal Minister for health and women can set up an eHealth directory service for the promotion of electronic health data exchange, to improve access to information about health-related services, as well as for planning and reporting purposes.

(2) the eHealth directory service must include a search function, designed according to different criteria, which ensures the discoverability of information about health service providers/health service providers, in particular for the data referred to in article 10.

(3) access to the data contained in the eHealth directory service on the health service providers/health service providers recorded in the eHealth directory service is to restrict the registration authorities, as well as public law bodies entrusted with the management of health. The technical design of the search function, effective mechanisms for preventing the abuse of data are about to implement.

(4) the eHealth directory service does not participate in the replication mechanism with other directory services. The Federal Minister for health and women / the Federal Minister for health and women may provide for such participation but with regulation, which shall include in particular the date for the start of the replication, as well as the necessary technical conditions.

(5) health service providers/health service providers registered in the eHealth directory service, as well as registrars are authorized to store the data stored in the eHealth directory service on their systems (mirroring or replication). This data may be used solely for the purpose of electronic health data exchange and to ensure the timeliness and accuracy of the eHealth directory service and are regularly, at the latest however within weeks two to update.

(6) the Federal Minister for health and women / the Federal Minister for health and women may adopt further provisions to be recorded in the eHealth directory service data, the registration procedure as well as the leadership of the eHealth directory service regulation.

Content



§ 10.

 (1) in the eHealth directory service in particular the following data are to include:



1. name or designation, as well as unique electronic identification (§ 8 E-GovG) the health service provider of the health service provider, 2. information concerning the availability of postal and electronic, 3. the unique identifier (OID) and the symbolic identifier, 4. the role of the health service provider / health service provider (s), 5 information for geographical localization of the health service provider / health service provider, 6 the electronic address to which the information required for the encryption of health information can be found on ,

7.

the name of that body or bodies, which has confirmed the assignment of the role (s) to the health service provider (), 8 the last date of registration and the rectification, as well as the name of the registration authority, which has carried out these directory entries.

(2) the unique identifier (par. 1 Z 3) A is based on ÖNORM 2642, to derive 'communication of open systems, procedures for the registration of information objects in Austria"by March 1, 1997, from the identifier (OID) of the Federal Ministry for health and women.

(3) in addition to the data already recorded in accordance with paragraph 1 may organizational subdivisions of a health service provider / a health service provider in the eHealth directory service be included, if they participate in the electronic exchange of health data, and that the organizational parent health service provider/health service provider agrees to. In this respect, the information referred to in paragraphs 1 and 2 shall record that the unique identifier of the organizational subdivision of the ID / parent organizational health service provider/health service provider to infer is are in the eHealth directory service.

(4) in the directory service, additional data on the relevant health service provider / the relevant health service provider or health-related electronic services offered by him can be recorded in. This additional information must relate their/his role-specific services to the more detailed description or represent information that are required for finding or the use of an electronic service.

Recording



§ 11.

 (1) the inclusion in the eHealth directory service takes place only at the request of a health service provider / a health service provider and is free of charge. If costs for providing any required evidence of adult the health service provider / the health service provider, he has to wear this myself.

(2) the data on the health service provider / health service provider are subject to the obligation to be truthful. This also applies to circumstances which require a subsequent correction of the eHealth directory service.

(3) the request of the health service provider / health service provider has the Z 1, Z 2, in article 10, paragraph 1 to include no. 4 and Z 6 designated data. In addition, the health service provider / the health service provider has to specify the symbolic identifier provided in accordance with section 10, paragraph 2, if different from the designation pursuant to § 10 para 1 subpara 1. Health service providers/health service providers that provide their role-specific health services not domestically have also specify that place that is authorized under the applicable legislation to the confirmation of the role.

(4) the health service provider / the health service provider § 5 para 1 cannot determine their role on the basis of the regulation in accordance with he has to explain the relevant circumstances (legal status, job title, description of health-related services provided by him or her) for the determination of the Registrar.

(5) supplementary or complementary applications have, if they not carried at the instigation by the Registrar, in addition to our data to include the assigned identifier (OID).

Registration procedure



§ 12.

 (1) the registration authority has to verify the details of the health service provider / health service provider for completeness and plausibility in appropriate manner and to convince yourself of their / his identity. If it is not entitled to the authentic map of the specified role, she has the confirmation authorized to request body or its submission by the health service provider / to request the health service provider. The information is incomplete or inaccurate, the health service provider / the health service provider, stating the reasons for improving to ask is. The improvement attempt is unsuccessful, the inclusion in the eHealth directory service (registration) is informally to reject.

(2) when the registration of health service providers/health service providers, who provide their health-related services in the domestic, the Registrar has to check the Gleichwertigung of the given role with a role laid down in the regulation referred to in article 5, paragraph 1 and making the necessary surveys.

(3) reaches the registry despite the supplementary surveys referred to in paragraph 2 considers that the conditions for registration are not given, it has to cede the registration to the Federal Minister for health and women and the Federal Minister for health and women. The Federal Minister for health and women / the Federal Minister for health and women has perform the registration after examination of the documents and any other surveys or informally refuse due to lack of existence of the prerequisites.

(4) the registration is to disable, if not within this period either by the health service provider after the expiration of three years from registration or of the last adjustment of a registry / the health service provider or by the Registrar on the basis of their own perceptions upgrading of the data stock has occurred. After another two years, the registration is to delete, if no update is also within this period. The Registrar has also on the basis of a corresponding application for a health service provider / a health service provider to delete the registry immediately.

(5) the health care provider of the health service provider is to communicate informally by the Registrar over the registration or the lock, specifying the identifier (OID) allocated for him or her, as well as connection of information about the obligation to update the DataSet or the consequences associated with the failure of. The health service provider / the health service provider from the registry about an antragsgemäße deletion is also informally to inform.

Registrars



§ 13.

 (1) the Federal Minister for health and women / the Federal Minister for health and women can contractually natural or legal persons on request, authorize making registrations in the eHealth directory service. The application can be restricted on a regional or role-specific activities as a Registrar. An authorization is allowed only if the applicant / applicant proves their / his human and technical capacity to carry out the registrations and corrections and commits



1. a possible termination of registration activity to display the Federal Minister for health and women / the Federal Minister for health and women three months in advance and 2 free to perform the tasks incumbent on him as a registration authority.

(2) in the authorization, the Minister for health and women / the Federal Minister for health and women has to describe the scope of the permissions of the applicant for the activity as a registration authority.

(3) the Federal Minister for health and women / the Federal Minister for health and women has the registrars, as well as the extent of their empowerment in a suitable way to publish.

Monitoring



§ 14.

 (1) the Federal Minister for health and women / the Federal Minister for health and women has to observe the use of information and communication technologies, taking into consideration the requirements of the European environment and to analyze their impact in the Austrian healthcare system. This purpose is a nationwide and sectors the overall reporting to establish, on the basis of standardized requirements in particular information on



1. the availability of technical infrastructure, including the communication infrastructure, 2. the nature and scope of the employed e-health applications and procedures, 3. the type and volume of electronic health data exchange and 4 allows the economic conditions of the e-health.

The type and extent of surveys associated can be set due to have role-specific features with varying degrees of detail.

(2) in order to ensure of a proper reporting system, the Federal Minister for health and women / the Federal Minister for health and women is entitled to evaluate the data stored in the eHealth directory service and use.

(3) the data collected in accordance with paragraphs 1 and 2 are summarized in a report on the status of e-health in Austria. The Federal Minister for health and women the Federal Minister for health and women is entitled to use the results of this report for the reporting bodies of the European Union or other international organisations.


(4) the Federal Minister for health and women / the Federal Minister for health and women can evaluate also the use of information and communication technologies in the health sector, particularly with regard to the socio-political implications, their influence on the quality of the supply of the population and its economic impact (impact on effectiveness and efficiency of health care). The evaluation can be limited to issues to be determined in the individual case.

(5) the health service providers/health service providers as well as the facilities of the health administration are obliged to comply with the reporting obligations referred to in paragraph 1 in the set or in the established periodicity and to provide necessary information in the context of evaluation activities in accordance with paragraph 4, or to provide the requested documents.

Quality of health-related Web information



§ 15.

 (1) the Federal Minister for health and women / the Federal Minister for health and women considered a relevant demand for granted, it may publish guidelines on the assessment of the quality of health-related information on the Internet as a guide for information.

(2) these guidelines have in addition to the presentation of quality criteria to provide for the establishment of a complaint management. The guidelines, as well as any results in the context of the complaint management are to be published in the information service.

(3) excluded from the scope of application of the guidelines are health information offerings, which are certified on the basis of comparable quality criteria (yet). The relevant quality criteria, as well as the relevant service bar channel/service providers are to publish in any appropriate medium.

Information service



§ 16.

 (1) the Federal Minister for health and women / the Federal Minister for health and women can set up a publicly accessible, Web-based information service to improve the information base on the e-health.

(2) in particular representations about health telematic procedures or methods (best practices), as well as further information can be recorded in the information service if this information deemed appropriate to improve the information or knowledge about the use of information and communication technologies in the health sector.

(3) also information on by health service providers/health service providers developed or recommended by recognised standardisation institutions to use information objects (E.g. encoding schemes or code list), descriptions standardized technical processes or communications can be recorded in the information service.

(4) will set up an information service, the results of the reporting and the evaluation pursuant to § 14, as well as the reports to bodies of the European Union, or international organizations are in it to absorb. Otherwise, these documents in other appropriate electronic form are to publish.

(5) publications in the information service contain personal data or are thereby affected other rights, such as intellectual property rights, the publication of the agreement requires of the person concerned or of the owner / the holder of these rights.

4 section

Final provisions

Administrative penal provisions



§ 17.

 (1) unless the fact constitutes not a criminal offence falling within the jurisdiction of the courts or threatened after other administrative penal provisions more stringent punishment, who during the electronic health data exchange after December 31, 2007 commits an administrative offence, with fine up to 5,000 euros to punish is,



1. neglects contrary to the provisions of sections 3 to 5, the evidence of identity and the role to provide or to examine this evidence or 2. contrary to the provisions of section 6 that fails encryption health data or used / methods and procedures that do not comply with the qualitative requirements laid down in article 7, par. 5, no electronic signature used 3. contrary to the provisions of section 7, or uses an electronic signature , which does not meet the qualitative requirements or disclose health information despite failed signature verification or used.

(2) an administrative offence referred to in paragraph 1 is not punishable if the Act to avert a present or imminent danger to the life of a third party or to avert a present or imminent risk of a significant impairment of the physical or psychological integrity a / a third party was committed.

(3) unless the fact constitutes not a criminal offence falling within the jurisdiction of the courts or threatened after other administrative penal provisions more stringent punishment, commits an administrative offence, which punished up to 50,000 euro is fine, who used contrary to the provision of § 9 5 data or parts of such data for other purposes.

(4) the authority in whose area the administrative offence was committed is responsible for decisions under paragraphs 1 to 3.

In force



§ 18.

 This federal law shall enter into force 1 January 2005.

Transitional provisions



§ 19.

 (1) the operational readiness of the eHealth directory service (articles 9 to 13) must be given no later than July 1, 2006. However, registrations or the sharing of access to the eHealth directory service can the date by the Federal Minister of health pursuant to a previous operational readiness, and publish women / way by the Federal Minister for health and women in the information service or other appropriate is to be carried out.

(2) the electronic exchange of health data must perform even up to December 31, 2007, if he does not comply with the provisions of the 2nd section of this Federal Act.

Enactment and regulations in force



§ 20.

 Regulations on the basis of this Federal Act as amended should be adopted from the day following the proclamation of the performed Act provisions; they may not however into force prior to the required legal provisions.

References



§ 21.

 As far as other federal laws is referenced in this federal law provisions, these are amended to apply.

Enforcement



section 22.

 The Federal Minister for health and women / the Federal Minister for health and women is entrusted with the execution of this Federal Act.

Fischer

Bowl

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