Regulation on the regulation of hospital care rates (Bundespflegesatzverordnung-Bundespflegesatzverordnung-BPflV)
Unofficial table of contents
BPflV
Date of completion: 26.09.1994
Full quote:
" Federal Government Ordinance of 26 September 1994 (BGBl. I p. 2750), most recently by Article 12 of the Law of 16 July 2015 (BGBl. 1211).
| Status: |
Last amended by Art. 12 G v. 16.7.2015 I 1211 |
For more details, please refer to the menu under
Notes
Footnote
(+ + + Text evidence from: 1.1.1995 + + +)
The V was adopted as Article 1 V v 26.9.1994 I 2750 (PflNV) by the Federal Government with the consent of the Federal Council. It occurs gem. Article 10 (4), first sentence, of this V in force on 1 January 1995 (derogation from the provisions of this Regulation, see Art. 10 (1) to (3)).
Unofficial table of contents
Content Summary
| First section |
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General provisions |
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§ 1 |
Scope |
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§ 2 |
Hospital services |
| Second section |
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Remuneration of hospital services |
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§ 3 |
Agreement of a total amount for the years 2013 to 2016 |
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§ 4 |
Agreement of a revenue budget for the years 2017 to 2021 |
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§ 5 |
Agreement of insurations and surcharges |
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§ 6 |
Agreement of other charges |
| Third Section |
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Disguised and billing |
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§ 7 |
Charges for general hospital services |
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§ 8 |
Calculation of charges |
| Fourth Section |
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Agreement procedure |
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§ 9 |
Federal Level Agreement |
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§ 10 |
State-level agreement |
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§ 11 |
Agreement for the individual hospital |
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§ 12 |
Provisional agreement |
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§ 13 |
Arbitration |
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§ 14 |
Approval |
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§ 15 |
Runtime |
| Fifth Section |
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Other provisions |
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§ 16 |
Separately calculable medical and other services |
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§ 17 |
Responsibility of health insurance funds at the country level |
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§ 18 |
Transitional provisions |
| Annex: |
Establishment of charges and budgeting (AEB-Psych) |
| Annex 1 to the LKA: |
Betting-leading specialist departments |
| Annex 2 to the LKA: |
Footnotes |
| Annex 3 to the LKA: |
Separate ID card for foreign patients according to § 3 (4) |
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First section
General provisions
Unofficial table of contents
§ 1 Scope
(1) According to this Regulation, the full-time and part-inpatient services of the hospitals are remunerated, which are not included in the DRG compensation system according to § 17b para. 1 sentence 1 second half-sentence of the hospital finance law. Hospital within the meaning of this Regulation is also the totality of the self-employed, area-based departments for the subject areas of psychiatry and psychotherapy, child and adolescent psychiatry and psychotherapy (psychiatric (2) This Regulation shall not apply to: (a) the treatment of psychosomatic medicine and psychosomatic medicine (psychosomatic) in a somatic hospital. (2)
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the hospitals to which the hospital finance law does not apply in accordance with the provisions of the first sentence of Article 3 (1) to (4);
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the hospitals which are not eligible under § 5 (1) (2), (4) or (7) of the Hospital Finance Act.
(3) The pre-and post-hospital treatment shall be remunerated uniformly for all users according to § 115a of the Fifth Book of the Social Code.
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§ 2 Hospital services
(1) Hospital services in accordance with § 1 (1) are, in particular, medical treatment, also by non-determined medical doctors, nursing care, medical care, medical care and ancillaries, which are necessary for the hospital care, , as well as accommodation and meals; they include general hospital services and electoral services. The hospital services do not include the services of the staff doctors (§ 18 of the Hospital Law). (2) General hospital services are the hospital services, which take account of the hospital's performance in the hospital. Individual cases of the type and severity of the disease are necessary for the medical purpose and adequate care of the patient. These conditions also include:
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the measures taken during the hospital stay for the early detection of diseases within the meaning of the Fifth Book of the Social Code,
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the services of third parties assessed by the hospital,
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the need for medical staff to be taken into account for medical reasons, or to take care of the patient in accordance with Article 11 (3) of the Fifth Book of the Social Code,
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the management of the discharge within the meaning of § 39 (1) sentence 4 of the Fifth Book of the Social Code.
A dialysis is not part of the hospital services. (3) In the provision of general hospital services by doctors who are not permanently employed in the hospital, the hospital has to ensure that they are responsible for their activities in the hospital. Hospital meet the same requirements as they apply to doctors and doctors who are permanently employed in hospital.
Second section
Remuneration of hospital services
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§ 3 Agreement of a total amount for the years 2013 to 2018
(1) The remuneration system in accordance with § 17d of the Hospital Financing Act will be introduced in budget-neutral for the hospital for the years 2013 to 2018. For the years 2013, 2014, 2015 or 2016 (option years), the introduction will take place at the request of the hospital. The hospital has its request at the time of the invitation to negotiate by the social service providers, but at the earliest by 31 December of the respective previous year, the other Contracting Parties pursuant to § 18 paragraph 2 number 1 or 2 of the Notification of hospital finance law in writing. As of 1 January 2017, the application of the remuneration system shall be binding on all hospitals. For the years 2013 to 2018, the evidence to be submitted pursuant to Article 11 (4) on the type and number of charges in accordance with § 7, first sentence, points 1 and 2 may be used only in order to ensure that the basic remuneration of the hospital in accordance with the conditions laid down in paragraph 3 of this Article is applied. (2) From the hospital-specific introductory year to the year 2018, a total amount for a hospital in accordance with § 6 (1) of the German The Federal Council Regulation shall be agreed in the version in force on 31 December 2012, subject to the proviso that: in lieu of the rate of change in accordance with Article 6 (1), second sentence, of the German Federal Government Regulations (Bundespflegesatzverordnung) in the version in force on 31 December 2012 according to § 9 (1) (5) in 2015 and 2016 in twofold and in the years 2017 and 2018 in a simple amount shall be considered as the definitive rate for the increase in the total amount; for the year 2013, in addition to the second sentence of Article 18 (1), the second sentence shall apply accordingly. The initial basis of the agreement is the total amount agreed for the previous year. In the case of the agreement referred to in the first sentence, the
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reduced by
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Pro-rata costs for services that are transferred to other areas of supply during the agreement period,
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the costs of benefits for foreign patients, in so far as they are broken down in accordance with paragraph 6 of the total amount,
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Adjusted for the same and compensatory payments resulting from corrections for previous years,
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modified to include the breakdown or reintegration of
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other surcharges in accordance with section 7, first sentence, point 3,
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Costs of benefits for the first time within the scope of the agreement period in the context of model projects according to § 63 of the Fifth Book of the Social Code or of contracts for integrated supply according to § 140a of the Fifth Book of Social Code or for the first time in the framework of of the hospital budget.
The total agreed amount shall be allocated in a proper way to:
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Proceeds for charges in accordance with § 7, first sentence, points 1 and 2 (revenue budget), including non-breakdown of other charges in accordance with § 7 sentence 1 (3); the revenue budget also includes the effective valuation ratios;
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Proceeds for charges pursuant to § 7 sentence 1, point 4 (proceeds of proceeds pursuant to § 6 (3)).
The total and revenue budgets set out in the first sentence of the fourth subparagraph shall be adjusted for the same period of previous years and, in addition to the correction of the previous budget (basic correction), a correction should be made to compensate for the adjustment and adjustments for previous years. (3) For the settlement of charges in accordance with § 7 sentence 1 (1) (1), for the years 2013 to 2018, individual basic pay values shall be determined by 2018. For this purpose, the sum of the additional charges and the proceeds for the superiors shall be deducted from the respective modified revenue budget referred to in the second sentence of paragraph 2, and the resulting amount shall be divided by the agreed sum of the effective valuation ratios. The base rate applicable for each year shall be based on the accounting of the charges assessed by valuation ratios. (4) At the request of a hospital not sponsored under the Hospital Financing Act, the following shall be applied: investment costs for new investment measures in the total amount referred to in the first sentence of paragraph 2 shall be taken into account in addition to the extent to which the basic paid-in value of the hospital is lower than the estimated average base rate of the Hospitals in the country. Consideration shall be given in accordance with § 17 (5) sentence 3 of the Hospital Finance Act in conjunction with Section 8 of the German Federal Government Regulations (Bundespflegesatzverordnung) in the version in force on 31 December 2012. The first and second sentences apply to hospitals, which are only partially funded on the basis of an agreement under Section 8 (1) sentence 2 of the Hospital Finance Act. (5) For the years 2013 to 2018, the sum of the In the event of a calendar year falling proceeds from the hospital arising out of charges in accordance with section 7, first sentence, points 1, 2 and 4, from the amended total amount referred to in the fifth sentence of paragraph 2, the more or less the proceeds shall be offset as follows:
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In 2013, 2014, 2015 and 2016, 95 percent of minority income will be offset by 20 percent from 2017,
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Multiple revenues resulting from changes in the coding of diagnoses and procedures will be fully compensated,
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other additional revenues will be offset by 65 percent for the years 2013, 2014, 2015 and 2016; from the year 2017 other additional revenues up to the amount of 5 percent of the changed total amount in accordance with paragraph 2 sentence 5 will be 85 percent and beyond that 90 percent Percent balanced.
The Contracting Parties may agree to deviate compensation rates in advance if this is better in accordance with the assumed development of benefits and their costs. For the range of charges assessed by valuation ratios, the other additional revenue referred to in the first sentence of paragraph 3 shall be determined in a simplified manner by multiplying the following factors:
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the number of calculation and occupancy days provided in addition to those calculation and occupancy days used in the determination of the individual base rate of the hospital in accordance with the third sentence of paragraph 3,
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Average of the agreed assessment ratios for each calculation and occupancy date; the mean value shall be determined by dividing the sum of the effective valuation ratios referred to in the second sentence of paragraph 3 by the agreed calculation and occupancy days and, and
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The basic health value of the hospital in accordance with the third sentence of paragraph 3.
In so far as the hospital or another Contracting Party proves that the other additional revenues as set out in point 3 of the first sentence are too low or too high as a result of changes in the structure of performance with the simplified determination as set out in the third sentence, the hospital or other party shall be entitled to: to adjust the amount of other additional revenue accordingly. The additional revenue in accordance with the first sentence of the first sentence shall be determined by deducting from the total number of charges incurred in the case of charges which are assessed by valuation ratios, the additional revenue shall be deducted in accordance with the third sentence or sentence 4. (6) At the request of the hospital Benefits for foreign patients who enter the Federal Republic of Germany with the aim of hospital treatment are not reimbursed within the overall amount. (7) The parties are bound by the total amount. At the request of one of the Contracting Parties, the total amount of the total amount for the current calendar year shall be rearranged in the event of substantial changes to the assumptions underlying the agreement of the total amount. The Contracting Parties may agree in advance that, in certain cases, the total amount will be re-agreed only in part. The amount of the difference to the previous total amount shall be deducted from the newly agreed total amount; § 15 (2) sentence 3 shall apply accordingly.
Unofficial table of contents
§ 4 Agreement of a revenue budget for the years 2019 to 2023
(1) In each case as of 1 January 2019, 2020, 2021, 2022 and 2023, the hospital-specific basic pay and the revenue budget of the hospital (§ 3 (2) sentence 4 (1)) shall be gradually applied to the country base pay value according to § 10 and the resulting (2) The initial value for the calculation of the revenue budget for 2019 is the agreed revenue budget in accordance with § 3, second sentence, sentence 4, point 1, for the year 2018, the basis of which is corrected in accordance with § 3, paragraph 2, sentence 5; this shall be the
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reduced by
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Pro-rata costs for services that are transferred to other areas of supply during the agreement period,
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the benefits to foreign patients to be broken down in accordance with paragraph 9, to the extent that they are included in the total amount for 2018;
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Adjusted for the same and compensatory payments resulting from corrections for previous years,
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increased by the anticipated proceeds of charges pursuant to § 7 sentence 1 (1) and (2), insofar as benefits paid in accordance with § 6 (2) are included in the remuneration system in accordance with § 17d of the Hospital Finance Act,
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modified to include the breakdown or reintegration of
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other surcharges in accordance with section 7, first sentence, point 3,
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Redeem for benefits in accordance with § 6 (1),
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Costs of benefits for the first time within the scope of the agreement period in the context of model projects according to § 63 of the Fifth Book of the Social Code or of contracts for integrated supply according to § 140a of the Fifth Book of Social Code or for the first time in the framework of of the hospital budget.
The initial value for the determination of the revenue budgets for the years 2020 to 2023 is the revenue budget for the previous year; the requirements of the first sentence shall be applied accordingly. (3) The initial value referred to in paragraph 2 shall be modified by applying for a future Period (period of agreement pursuant to § 11 (2)) the following facts shall be taken into consideration:
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changes in the type and quantity of the full and part-time services likely to be provided, which are covered by the national remuneration catalogues in accordance with Article 9 (1) (1) and (2),
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the value of the change in accordance with section 9 (1) (5).
Additional services according to the first sentence number 1 will be 45 percent for 2019, 55 percent for the year 2020, 60 percent for 2021, 70 percent for 2022, and 80 percent for 2023, and therefore with the following The share of the amount of the fee, which is calculated in the case of charges in accordance with § 7 sentence 1, point 1, using the country base fee value, shall be taken into account in the initial value:
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38.9 percent for the year 2019,
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46 percent for the year 2020,
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50 percent for the year 2021,
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55 percent for the year 2022 and
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60 per cent for the year 2023;
the same shares shall be taken into account in so far as such benefits are not already to be taken into account in accordance with the provisions of point 1 of the first sentence of paragraph 2 of the budgetary procedure. In order to simplify the negotiations, the Contracting Parties shall apply the provisions of the second sentence in a lump-sum manner to the corresponding change in the sum of the effective assessment ratios, in so far as they do not apply to changes in the remuneration catalogues, the the accounting regulations or the coding guidelines. To the extent that, in individual cases, the costs of additional services cannot be covered by these percentages, the Contracting Parties shall, by way of derogation from the provisions of sentences 2 and 3, agree to take account of the level of one of the second sentence of the second sentence of Percentage; where larger organizational units are closed and services are no longer provided, the initial value should be reduced accordingly. Additional charges for medicinal products must be taken into account at 100%. (4) The target value for the adjustment referred to in paragraph 1 shall be for the years 2019 to 2023, respectively, a volume of revenue for the hospital, by means of which the type and quantity of the hospital shall be expected to be (5) The adjustment in accordance with the provisions of paragraph 7, first sentence, point 1, shall be assessed in accordance with Section 10, and the calculated sum of the proceeds shall be increased by the estimated sum of the revenues from additional charges. 1 is 10 per cent for 2019, 15 per cent for 2020 and 2021 respectively, and for the years 2022 and 2023, 20 percent each. The amount of the adjustment applicable to the adjustment referred to in paragraph 1 for the years 2019 to 2023 shall be determined by deducting from the target value in accordance with paragraph 4 the difference in the initial value referred to in paragraph 3, and by the intermediate result of this intermediate result. the following percentages are calculated:
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10.0 percent for the year 2019,
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16.7 percent for the year 2020,
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20.0 percent for the year 2021,
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33.3 percent for the year 2022 and
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50.0 percent for the year 2023.
For the purpose of determining the revenue budgets for the years 2019 to 2023, the relevant changes in the initial value referred to in paragraph 3 for the year in question and the amount of the same year as determined for the same year shall be added in accordance with the first sentence, taking into account the sign. In the case of previous special facilities pursuant to § 6 (1), which shall negotiate for the first time in accordance with § 4, the percentage referred to in the second sentence for the respective year shall be applied. In the case of hospitals whose revenue budget is reduced, the approximation according to the rates 2 and 3 shall be limited to a maximum of the following shares of the modified initial value referred to in paragraph 3 (capping limit):
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1.0 percent for the year 2019,
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1.5 percent for the year 2020,
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2.0 percent for the year 2021,
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2.5 percent for the year 2022 and
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3.0 percent for the year 2023.
(6) The respective revenue budget referred to in paragraph 5, sentence 3, shall be determined for the determination of the individual basic pay values applicable for the years 2019 to 2023.
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In order to reduce the expected revenues from additional costs and revenue for superseers and
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to change the prescribed level for previous years to be carried out, even in so far as this is the result of a correction.
The modified revenue budget according to the first sentence is divided by the agreed sum of the effective evaluation ratios for the treatment cases. The resulting base fee is based on the accounting of the charges assessed with valuation ratios. (7) On the request of a hospital not funded under the Hospital Finance Act, investment costs for new In addition, investment measures in the revenue budget shall be taken into account in so far as the hospital-specific base pay value is lower than the country base pay value in accordance with § 10. Consideration shall be given in accordance with § 17 (5) sentence 3 of the Hospital Finance Act in conjunction with Section 8 of the German Federal Government Regulations (Bundespflegesatzverordnung) in the version in force on 31 December 2012. The rates 1 and 2 shall apply to hospitals which are only partially funded under an agreement under Section 8 (1), second sentence, of the Hospital Finance Act. (8) The revenue budget agreed under paragraph 5, sentence 3, and the revenue budget according to § 6. Paragraph 3 shall be summarised for the purpose of determining a total amount for the purpose of determining the amount of the proceeds or the reduction of the amount of the proceeds. If the total amount of the hospital proceeds from the charges pursuant to Article 7 (1) (1), (2) and (4) which has been paid for the calendar year differs from this total amount, the more or less the proceeds shall be offset as follows:
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20 percent of the lower income is offset,
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Up to 5 per cent of the total amount after the first sentence of 1 to 85 per cent and in excess of 90 per cent of the total amount will be compensated.
The contracting parties may agree to deviate compensation rates in advance if this is better in accordance with the assumed development of services and their costs. (9) Services for foreign patients will be provided at the request of the hospital. Patients entering the Federal Republic of Germany with the aim of hospital treatment shall not be reimbursed within the limits of the total amount referred to in the first sentence of paragraph 8. (10) The Contracting Parties according to § 11 shall be bound by the revenue budget. At the request of one of the Contracting Parties, the revenue budget for the current calendar year shall be rearranged in the event of substantial changes to the assumptions underlying the agreement of the revenue budget. The Contracting Parties may agree in advance that in certain cases the revenue budget shall be only partially rearranged. The amount of the difference to the previous revenue budget is to be deducted from the newly agreed revenue budget; § 15, second sentence, sentence 3 shall apply. (11) If no other statutory regulation has entered into force for the period beginning in 2024, the amount of the difference shall be To determine the revenue budget, paragraph 4, and to take account of the adjustments and adjustments for previous years, paragraph 6, sentence 1. Paragraphs 8, 9 and 10 shall apply.
Unofficial table of contents
§ 5 Agreement of consents and surcharges
(1) The provisions of the German Federal Act on Hospitalisation And Surcharges pursuant to Section 9 (1) (3) pursuant to Section 17d (2) sentence 4 of the Hospital Finance Act shall be binding on the Contracting Parties in accordance with § 11. At the request of one of the Contracting Parties, it is necessary to consider whether the hospital has the necessary conditions for an increase or a drop. If the amount of a crime has been set at a national level for the purpose of invoicing in relation to the patients or the cost carriers, the amount to be converted to an individual reference quantity shall be determined by the individual national or total number of patients. The Contracting Parties shall, in accordance with the uniform provisions of the Federal Convention, agree to the resulting amount or percentage of the amount or percentage of the sickness allowance resulting therefrom. (2) The provisions of § 17d (2) sentence shall apply to the agreement of seizations 5 of the Hospital Finance Act.
Unofficial table of contents
§ 6 Agreement of other charges
(1) For services which cannot be properly remunerated with the charges assessed under § 17d of the Hospital Finance Act at the federal level, and from 2019 for special facilities pursuant to § 17d (2) sentence 4 of the In accordance with Article 11 of the Law on Hospital Finance, the contracting parties agree on charges related to hospital financing, provided that the services or the special facilities according to the determination of the contracting parties pursuant to § 9 or in a regulation according to § 17d (6), first sentence, point 3 of the Hospital Finance Act, from the application of the Federal level assessed fees are excluded. In very limited exceptional cases, the Contracting Parties agree on additional charges. The fees are to be calculated correctly; the recommendations according to § 9 (1) (4) must be taken into account. (2) For the remuneration of new examination and treatment methods, which are carried out in accordance with § 17d of the Hospital Finance Act at the federal level In accordance with § 137c of the Fifth Book of the Social Code, the contracting parties are not to be reimbursed for the first time in accordance with § 137c of the Fifth Book of Social Code, for the first time in the calendar year 2019 Temporary charges outside the revenue budget according to § 4 and the proceeds of the proceeds according to paragraph 3. For the details of the procedure, § 6 (2) sentences 2 to 9 of the Hospital Remuneration Act must be applied accordingly. (3) If the hospital-specific charges for services or special facilities are agreed upon in accordance with the first sentence of the first paragraph of paragraph 1 and the second sentence is agreed, then the following shall be taken into account: for these charges, in the appropriate application of Article 6 (1) of the German Federal Government Regulation (Bundespflegesatzverordnung) in the version in force on 31 December 2012, to form a redemption sum, with the proviso that, instead of the rate of change in accordance with Article 6 (1), sentence 3 of the Federal ordinance in the version of the amendment in force on 31 December 2012 In accordance with Section 9 (1) (5), the rate shall be deemed to be the decisive rate for the increase in revenue. It does not include the fees referred to in paragraph 2. For the agreement of the charges and the proceeds of the proceeds, calculation documents shall be submitted in accordance with section 9 (1) (4). If the proceeds actually enter into force from the agreed proceeds, the more or less proceeds shall be determined and compensated in accordance with the provisions of § 4 paragraph 8.
Third Section
Disguised and billing
Unofficial table of contents
Section 7 Charges for general hospital services
The general hospital services shall be deducted from the patients or their payers with the following charges:
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Charges assessed by valuation ratios in accordance with the draft catalogue agreed at the federal level (§ 9),
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Additional charges in accordance with the catalogue of remuneration agreed at the federal level (§ 9),
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Training surcharge (Section 17a (6) of the Hospital Finance Act) and other surcharges (§ 17d (2) sentence 4 and 5 of the Hospital Financing Act and quality assurance surcharges pursuant to § 8 (4)),
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charges for special facilities and for services not yet covered by the charges agreed at the federal level (Article 6 (1));
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Charges for new examination and treatment methods which have not yet been included in the fee catalogues according to § 9 (section 6 (2)).
With these charges, all the general hospital services required for the care of patients will be remunerated. In addition, the following surcharges will be billed:
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the DRG system surcharge in accordance with Section 17b (5) of the Hospital Finance Act,
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the system surcharge for the Joint Federal Committee and the Institute for Quality and Efficiency in Health Care pursuant to § 91 (3) sentence 1 in conjunction with § 139c of the Fifth Book of the Social Code and
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Telematics surcharge pursuant to § 291a (7a) sentences 1 and 2 of the Fifth Book of Social Law.
Unofficial table of contents
Section 8 Calculation of charges
(1) The charges for general hospital services shall be calculated in a uniform manner for all patients in the hospital; Section 17 (5) of the Hospital Finance Act shall remain unaffected. In patients treated as part of a clinical trial, the charges for general hospital benefits are to be calculated in accordance with § 7, including in clinical trials with medicinal products. The charges may only be calculated in the context of the supply contract; this does not apply to the treatment of emergency patients. The hospital supply contract results
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in the case of a planning hospital from the provisions of the hospital plan in connection with the charges for its implementation in accordance with § 6 (1) in conjunction with Section 8 (1) sentence 3 of the Hospital Financing Act as well as from a supplementary Agreement pursuant to § 109, paragraph 1, sentence 4 of the Fifth Book of Social Code,
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at a university hospital from the recognition according to the national law, the hospital plan in accordance with § 6 (1) of the Hospital Finance Act and a supplementary agreement pursuant to § 109, paragraph 1, sentence 4 of the Fifth Book Social Code,
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in the case of other hospitals in the supply contract in accordance with Section 108 (3) of the Fifth Book of Social Code.
(2) Day-related fees for full-or part-time services are calculated for the day of admission and every other day of the hospital stay (calculation date); the day of posting or relegation, which is not the same day of admission, will only be made in the case of partial-stage treatment. The first half-sentence shall apply in the case of internal transfers; if a patient or a patient is transferred on several occasions in one day, only the last-receiving department shall calculate the day-related payment. The provisions of § 8 (2) sentence 3 (1), (2) and (4) of the Hospital Remuneration Act apply accordingly to the charges which can be calculated in addition to daily-related charges. If case-related charges are to be calculated, the provisions of Section 8 (2) sentence 3, paragraphs 5 and 6 of the Hospital Pay Law apply accordingly. In accordance with Section 17b (2) sentence 1 of the Hospital Financing Act, the Contracting Parties shall agree or deviate in accordance with the provisions of Section 17b (2) sentence 1 of the Hospital Financing Act, or shall be regulated in accordance with Section 17d (6) of the Hospital Finance Act Separate charges shall be calculated for the patients and patients of the staff. (3) Hospitals in the area referred to in Article 3 of the Unification Treaty shall calculate the investment surcharge until 31 December 2014 for each day of calculation. pursuant to Article 14 (3) of the Health Structure Act. In case of partial inpatient treatment, the surcharge is also calculated for the day of discharge. (4) If the hospital does not comply with its quality assurance obligations, the charges pursuant to § 7 sentence 1 number 1 and 2 surcharges pursuant to section 137 (1) shall apply. (5) The hospital may require patients and patients to make an appropriate advance payment in so far as a health insurance cover is not established. From the eighth day of the hospital stay, the hospital may require a reasonable payment of the amount, the amount of which is based on the services provided so far in connection with the charges to be paid. The rates 1 to 2 shall not apply to the extent that other provisions concerning the time-related remuneration of general hospital services in regulations binding the hospital in accordance with § § 112 to 114 of the Fifth Book of Social Code or in the The hospital has self-paying patients or their legal representative to announce the relevant charges in writing as soon as possible, unless: the patient is fully insured for the hospital treatment. In addition, each patient and each patient may require that the charges which are likely to be deducted be communicated without obligation. If the charges are not yet definitively established when a self-paying patient or a self-paying patient is received, it shall be pointed out. In this case, it should be reported that the fee to be paid increases if the new charge enters into force during the patient's treatment of the patient or the patient. The expected increase shall be indicated.
Fourth Section
Agreement procedure
Unofficial table of contents
§ 9 Agreement at the federal level
(1) The Leading Association of the Health Insurance Funds and the Association of Private Health Insurance jointly agree with the German Hospital Association (Contracting Parties at the federal level) with effect for the Contracting Parties in accordance with § 11 in particular
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a catalogue in accordance with Section 17d (1) of the Hospital Finance Act, including, in particular, day-related fees, including valuation ratios, and, in appropriate cases, arrangements for overshooting or surrender, may be subject to disease-typical treatment times,
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a catalogue of supplementary charges in accordance with Section 17d (2) sentence 2 of the Hospital Finance Act, including the remuneration level,
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the accounting rules for the charges referred to in points 1 and 2, as well as the arrangements for surcharges and surcharges,
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recommendations for the calculation and the hospital-specific remuneration of benefits and new examination and treatment methods, for which separate charges can be agreed in accordance with § 6,
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up to the 31. October each year, for the first time in 2013, the value of change in accordance with § 10 (6) sentence 5 or 6 of the Hospital Charges Act for the limitation of the development of the basic earnings value in accordance with § 10 paragraph 3, whereby already elsewhere shall be taken into account, insofar as this does not fall below the rate of change in accordance with § 71 (3) of the Fifth Book of the Social Code; in the case of § 10 (6) sentence 6 of the Hospital Pay Law, the Rate of change according to § 71 (3) of the Fifth Book of Social Code by 40 per cent of this to increase the difference,
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6.
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the uniform structure of the data sets and the procedure for the transmission of the data in accordance with Article 11 (4) sentence 1, as well as the further development of sections E1 to E3 and B1 and B2 following the installation of this Regulation.
By way of derogation from the first sentence of point 5, second half-sentence, for the years 2014 and 2015, the rate of change in accordance with Section 71 (3) of the Fifth Book of the Social Code is in the case of Section 10 (6) sentence 6 of the Hospital Pay Law, taking into account the To ensure the necessary medical care and personnel and material cost increases up to the full amount of this difference, but at least 40 per cent of this difference. (2) If an agreement is reached, paragraph 1 (1) to 3 in whole or in part shall not be established, § 17d (6) of the Hospital Finance Act. In the other cases, at the request of one of the Contracting Parties, the arbitral body shall decide in accordance with Article 18a (6) of the Hospital Finance Act; a decision on paragraph 1 (5) shall be taken by the Arbitration Board until 15 November of each year. meet.
Unofficial table of contents
§ 10 Agreement at the State level
(1) In order to determine the level of charges assessed by valuation ratios in accordance with section 9 (1) (1), the parties referred to in § 18 (1) sentence 2 of the Hospital Finance Act (Contracting Parties at the country level) shall agree with effect for the Contracting Parties according to § 11 annually, for the first time for the year 2019, a country-wide base pay value (country base pay value) for the following calendar year. In doing so, they shall be based on the agreement values of the hospitals in the country for the current calendar year following the annex to this Regulation, in particular the sum of the effective valuation ratios and the sum of the proceeds. for charges in accordance with section 7, first sentence, point 1, and on this basis estimate the expected development in the following calendar year; if there are not yet available values for individual hospitals, these are to be estimated. The Contracting Parties at the country level agree that misestimates of the facts on which the agreement of the Land base pay value is based shall be adjusted in the agreement of the country base pay for the following year. They shall specify in the agreement the circumstances under which a correction will be made in the following year and under which conditions. In addition to the correction of the agreed volume of proceeds (basic adjustment), a correction should be made in the case of a correction. The correction shall be carried out only if, in the context of the change value referred to in paragraph 3, the agreement to be amended in the previous year, even without a misestimation, would have been allowed to take account of the amount of the basic adjustment. (2) In particular, the agreement shall take account of:
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1.
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expected general cost developments,
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2.
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possibilities for exploiting economic reserves, in so far as these have not already been covered by the further development of the valuation ratios,
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3.
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Changes in performance, in so far as they are not a consequence of a changed coding of the diagnoses and procedures, in the amount of the estimated share of the variable costs in the benefits assessed in accordance with section 7, first sentence, point 1,
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4.
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the overall expenditure performance in the performance areas which are not remunerated by charges assessed by valuation ratios, to the extent that they exceed the value of change in accordance with Article 9 (1) (5), where the surcharges in accordance with § 7 sentence 1 (3),
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5.
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The sum of the proceeds, which is expected to be non-budget-reducing for hospitals in the country as a whole due to the capping limit pursuant to § 4 (5) sentence 5, as well as the sum of the other surcharges in accordance with § 7 sentence 1 Point 3, in so far as the benefits have so far been financed by the basic credit value,
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6.
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Increasing the sum of the other deductions in accordance with section 7, first sentence, point 3, in so far as the benefits have so far been financed by the basic payment value,
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7.
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Agreements pursuant to Section 9 (1).
For the purposes of the application of the first sentence of paragraph 3, it shall be ensured that additional benefits are taken into account in the agreement of the national base rate value. Where expenditure increases arise as a result of changes in the coding of the diagnoses and procedures, they shall be fully compensated for by a corresponding reduction in the national base rate. (3) The agreement agreed in accordance with paragraph 2 of this Article shall be The national base pay value shall not exceed the national base pay value of the previous year, which has been changed and corrected by the change value in accordance with section 9 (1) (5). This shall not apply in so far as an increase in the national base pay value is only technically conditional and does not lead to an increase in the total expenditure on hospital services or to the extent that a correction of misestimates as referred to in paragraph 1 is to be carried out is. Only due to technical reasons is an increase in the state base value value, in particular if it is due to the further development of the compensation system in accordance with § 17d of the Hospital Finance Act or the settlement provisions. (4) The agreement of the Land Basic Value is to be concluded by 30 November of each year. The Contracting Parties at the country level shall immediately enter into negotiations after a party has called for a written request. The agreement shall be concluded by agreement between the parties which took part in the hearing; it shall be concluded in writing. If an agreement is not reached by 30 November of the year in question, the arbitral body shall, in accordance with Section 13, immediately determine the national base value at the request of one of the Contracting Parties.
Unofficial table of contents
§ 11 Agreement for the individual hospital
(1) In accordance with § § 3 to 6 and in compliance with the hospital supply order (§ 8 (1) sentence 3 and 4), the Contracting Parties shall govern the agreement in accordance with Section 18 (2) of the Hospital Finance Act (Contracting Parties) in the agreement. The total amount, the revenue budget, the sum of the valuation ratios, the basic health value of the hospital, the proceeds, the other charges, the surcharges and the more and the reduction of the earnings. The agreement is to be made for a future period of time (agreement period). The agreement must also contain provisions ensuring a timely payment of the charges to the hospital, in particular by means of appropriate monthly instalments and interest on late payment in arrears shall be taken. The agreement is reached by agreement between the contracting parties who took part in the negotiation; it must be concluded in writing. (2) The agreement period is one calendar year when the hospital operates all year round . A period of time, which includes several calendar years, may be agreed. (3) The Contracting Parties shall immediately take up the hearing after a Contracting Party has called for it in writing. The trial is to be concluded in time, taking into account the six-week period of Section 18 (4) of the Hospital Finance Act, in such a way that the new budget and the new charges will expire at the end of the current agreement period. (4) In order to prepare the hearing, the hospital carrier shall transmit to the other Contracting Parties, the parties referred to in § 18 (1) sentence 2 of the Hospital Finance Act and the competent State authority
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1.
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for the years from 2013, 2014, 2015, 2016 or 2017, sections E1 to E3 and B1 after the installation of this Regulation in the respectively valid version of the agreement in accordance with § 9 (1) sentence 1, point 6, as well as the performance and calculation of the calculation according to Annex 1 to the Federal Government Regulations on the Provisions of the Federal Government of Germany, as amended on 31 December 2012, with the exception of Sections V1, V4, L4 and K4,
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2.
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for the years from 2019 the sections E1 to E3 and B2 after the installation of this Regulation or in the respectively valid version of the agreement in accordance with Article 9 (1), first sentence, point 6.
The data shall be presented on machine-readable data carriers. The hospital shall, at the joint request of the other Contracting Parties, submit additional documents and provide further information in accordance with section 18 (2) (1) and (2) of the Hospital Finance Act, insofar as this is necessary for the assessment of the benefits of the hospital. Hospital as part of its supply contract is required on a case-by-case basis and if the benefits to be expected significantly exceed the expenditure incurred. (5) The Contracting Parties are obliged to ask essential questions on the supply contract and the the structure of the hospital as well as the amount of the surcharges and surcharges after § 5 so early together to clarify that the negotiation can be carried out expeditiously.
Unofficial table of contents
§ 12 Preliminary Agreement
In particular, the Contracting Parties may not agree on the amount of the total amount, the revenue budget, the individual basic pay value or on the level of other charges, and shall therefore be called upon to call the arbitration body in accordance with § 13 , the Contracting Parties shall conclude an agreement in so far as the amount is undisputed. The charges based on this agreement shall be levied until such time as the definitive charges become binding. Any more or less of the hospital ' s earnings as a result of the provisional charges levied shall be offset by any increase or fall on the charges of the current or subsequent agreement period.
Unofficial table of contents
Section 13 Arbitration
(1) If an agreement in accordance with § 10 or § 11 does not come into effect in whole or in part, the arbitration body shall decide in accordance with Section 18a (1) of the Hospital Financing Act at the request of one of the contracting parties referred to in § 10 or § 11. It is bound by the legislation in force for the Contracting Parties. (2) The arbitral body shall decide within six weeks on the items on which no agreement could be reached. (3) (omitted)
Unofficial table of contents
§ 14 Approval
(1) The approval of the agreed upon or by the arbitral body in accordance with § 13 of the national base fee value according to § 10 and the individual basic pay values, the revenue budget, the proceeds, the other fees and the increase in the income and the supply and the supply and the Any surcharges pursuant to § 5 shall be applied for by one of the Contracting Parties to the competent authority of the State. The competent State authority shall grant the authorisation if the agreement or the fixing complies with the provisions of this Regulation and other law. It shall decide on the approval of the Land base value within four weeks of receipt of the application. (2) The Contracting Parties and the Arbitration authorities shall submit the documents to the competent national authority and provide the information on , which are necessary for the verification of legality. In addition, the legislation applicable to the parties to the agreement must be applied accordingly. The authorisation may be accompanied by secondary provisions to the extent that this is necessary to remove legal obstacles to full authorisation. (3) If the authorisation of an arbitral award is failed, the In order to obtain the approval of the Land base value, the administrative right shall be limited to the Contracting Parties only. (4) In view of the approval of the Land base value, the administrative right shall be limited to the Contracting Parties only. Country level. A pre-trial procedure shall not take place. The action does not have suspensive effect.
Unofficial table of contents
§ 15 Duration
(1) The charges and other charges assessed by valuation ratios shall be levied in the hospital-individual level agreed for the calendar year from the start of the new agreement period. If the agreement is not approved until after that date, the charges shall be levied from the first day of the month following the authorisation, unless otherwise specified in the agreement or arbitration decision. is determined. Until then, the charges currently in force must be further collected; this also applies to the introduction of the compensation system in accordance with § 17d of the Hospital Finance Act in 2013, 2014, 2015, 2016 or 2017. However, they shall be subject to the correction of the compensatory amounts contained therein, if and to the extent that this has been determined in the previous agreement or setting. (2) More or less proceeds will be made as a result of the further collection of the previous charges. the new charges to be levied during the remainder of the agreement period are offset by surcharges and surcharges. If the amount of the compensatory amount is exceeded or fallen below the revenue from these allowances and surcharges in the remainder of the agreement period, the difference shall be offset by the charges for the next agreement period; it shall be: to agree simple compensation procedures. If the charges were increased by more than 30 percent as a result of this compensation and an amount pursuant to § 3 (7) or § 4 (10) as a whole, exceeding amounts up to this limit are to be equated in subsequent budgets. There is no compensation for any reduction in the number of minors, in so far as the late approval of the agreement is to be represented by the hospital.
Fifth Section
Other provisions
Unofficial table of contents
Section 16 separately calculable medical and other services
The calculation of the employee benefits is based on § 18 of the hospital pay law. The agreement and the calculation of elective services are based on § § 17 and 19 of the Hospital Pay Law.
Unofficial table of contents
§ 17 Competence of the health insurance funds at the country level
The tasks assigned to the national associations of the health insurance companies in this Regulation shall take into account the authorized representatives designated pursuant to Section 212 (5) of the Fifth Book of the Social Code, for the health insurance of the health insurance companies. Deutsche Rentenversicherung Knappschaft-Bahn-See and for the health insurance of farmers the social insurance for agriculture, forestry and horticulture is true.
Unofficial table of contents
Section 18 Transitional provisions
(1) Hospitals that do not introduce the remuneration system in accordance with § 3 (1) sentence 2 in the years 2013, 2014, 2015 or 2016 under § 17d of the Hospital Financing Act, have in these years the Federal Order of Pflegesatzverordnung in der am 31. December 2012, with the proviso that:
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1.
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in place of the rate of change pursuant to § 6 (1), third sentence, as from 2013, the rate of change in accordance with section 9 (1) (5) of the Federal Government Regulations in the version in force as from 1 January 2013 as the relevant rate for the increase of the The total amount shall be:
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2.
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Section 6 (2) is repealed as of 31 December 2012; and
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3.
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Article 15, paragraph 1, first sentence, shall last for the year 2012.
For the year 2013, the budget agreed by the contracting parties shall be adjusted by 40 per cent of the rate agreed in accordance with section 9 (1), first sentence, point 5 of the hospital pay law, with the correction amount over the budget of the following § 3 (2) sentence 5, second half-sentence must be taken into account. (2) For the years 2013 to 2018, the hospitals have an agreement in accordance with § 6 (4) of the German Federal Order of Care (Bundespflegesatzverordnung) in the period of 31 December 2012. , the other Contracting Parties shall, in accordance with Article 11, confirm the to present annual financial statements on the actual annual average number of vacancies as at 31 December and the appropriate use of funds; appropriations not used for the purpose are to be repaid.
Unofficial table of contents
Annex List of charges and budgeting (AEB-Psych)
(Fundstelle: BGBl I 2012, 1623;
with regard to of the individual amendments. Footnote)
Establishment of charges and budgeting
(AEB-Psych)
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E
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Fees according to § 17d KHG
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E1
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Establishment of the charges assessed by valuation ratios
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E2
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Establishment of additional charges
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E3
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Establishment of the charges negotiated according to § 6 of the hospital-individually negotiated procedure
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B
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Budgeting
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B1
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Total and basic payment value according to § 3 for the calendar years 2013 to 2018
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B2
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Redemption budget and base pay according to § 4 from the calendar year 2019
E1 List of the charges for the hospital evaluated with valuation ratios
1) 2) 3)
Charge Nr.Calculation Days (only day-based charges) related case number case number (only case-and time-space-related charges) related occupancy rate evaluation relation according to remuneration catalogue sum of the valuation ratios without intakes and disburses (Sp. 2 x 4 and 3 x 4) of which cases with patients- Related cases of suspected cases with patients- the sum of the effective valuation ratios (Sp. 5-Sp. 9 + Sp. 13)
Number of cases with number of days of slumber of days with a drop-out ratio of the total number of abatchings (Sp. 7 x 8) Number of cases with random number of days with rate-of-allowance ratio for each aggregate of the surcharges (Sp. 11 x 12)
122a33a4567891011121314
| Annual cases and all cases with day-related charges 4) |
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E2 Establishment of additional charges for hospital
1)
ZE-Nr.Number of ZEEntgelthöhe lt. ZE catalog revenue total
1234
Annual cases and all cases with day-related charges 2)
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Supersede (only case-and time-related charges) 2)
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E3 erection of the charges which are negotiated according to § 6 of the sickness insurance
1) 2) E3.1 The establishment of the case-related charges
3)
Charges according to § 6 BPflVFallzahl (daily, case-or period-related charges) salary level (in €) gross proceeds without fees and surcharges (in €) (Sp. 2 x 4) of which cases with patient-related offshoot cases with patient-related income net proceeds-total incl. Surcharges and surcharges (in €) (Sp. 4-Sp. 8 + Sp. 12)
Number of cases with number of days of abatation, with abatation rate per day (in €) total of abatses (Sp. 7 x 8) Number of cases with random number of days with supplement per day (in €) Total amount of surcharges (Sp. 11 x 12)
12345678910111213
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| E3.2 Establishment of additional charges 3) |
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E3.3 Establishment of daily charges 3) |
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Additional fee in accordance with § 6 BPflVAnpayable Remuneration Fee (Sp. 2 x 3) Discharge after § 6 Paragraph 1 BPflVFallPayTageöheErlössum (Sp. 3 x 4)
1234 12345
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Total: |
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Total: |
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B1 Total amount and basic payment value according to § 3 for the calendar years 2013 to 2018
lfd. Nr.Calculation step agreement for the current calendar year agreement period
123
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Adjustment of the total amount (Section 3 (2)): |
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Total amount for the current year |
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| 2 |
./. Power displacements (No. 1a) |
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./. Outsourcing of foreign patients (No. 1b) |
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+/-Cleanup for included matching (No. 2) |
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+/-Off/reintegration of surcharges and surcharges (no. 3a) |
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+/-Models, integrated supply (No. 3b) |
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= Baseline amount for agreement according to § 3 |
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here: Negotiation of the total amount for the agreement period
| 8 |
Total amount for the agreement period |
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+/-new comparisons and corrections for previous years 1) |
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= Changed total amount (§ 3, paragraph 2, sentence 5) |
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Of which: changed revenue budget (§ 3, paragraph 2, sentence 5) 2) |
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thereof: charges pursuant to § 6 paragraph 1 BPflV |
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Determination of base rate value: |
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Redemption budget from lfd. No. 11 2) |
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./. Proceeds from additional duties |
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./. Proceeds for overseers at the beginning of the year 3) |
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= Sum with valuation ratios assessed charges included. lfd. No. 9 |
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: sum of the effective valuation ratios (Annex E1) 4) |
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= Sick-individual base pay |
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Message:
Base pay value without exception and corrections |
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B2 Redemption budget and base pay according to § 4 from the calendar year 2019
lfd. Nr.Calculation step agreement for the current calendar year agreement period
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Determination of the initial value (paragraph 2): |
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Revenue budget for the current year |
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| 2 |
./. Power displacements (No. 1a) |
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| 3 |
./. Outsourcing of foreign patients (No. 1b) |
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| 4 |
+/-Cleanup for included matching (No. 2) |
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| 5 |
+ inclusion of innovations (No 3) |
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+/-Off/reintegration of surcharges and surcharges (no. 4a) |
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| 7 |
+/-The reintegration/reintegration of services pursuant to § 6 (1) (no. 4b) |
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| 8 |
+/-Models, integrated supply (No. 4c) |
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| 9 |
= initial value of the previous year |
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| 10 |
+/-likely performance changes (paragraph 3, first sentence, no. 1) |
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| 11 |
+/-Change value according to § 9, paragraph 1, point 5 (paragraph 3, first sentence, no. 2) |
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| 12 |
(repealed) |
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| 13 |
= modified initial value (paragraph 3) |
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Determination of the target value (paragraph 4):
| 14 |
Proceeds from charges assessed with valuation ratios |
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| 15 |
+ Estimated revenue from additional duties |
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= target value (paragraph 4) |
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Determination of the amount of the accoration: |
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| 17 |
Target value from lfd. No. 16 |
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| 18 |
./. changed initial value from lfd. No. 13 |
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= intermediate result |
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...% of lfd. No 19 (second sentence of paragraph 5) or cap |
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= amount of equalisation (paragraph 5, second sentence) |
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Determination of revenue budget: |
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| 22 |
modified starting value from lfd. No. 13 |
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+/-Equal Amount from lfd. No. 21 |
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= revenue budget (paragraph 5, sentence 3) |
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lfd. Nr.Calculation step agreement for the current calendar year agreement period
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Determination of the underlying asset value (paragraph 6): |
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| 25 |
Redemption budget from lfd. N ° 24 |
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| 26 |
./. anticipated proceeds from additional costs (lfd. No. 15) |
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| 27 |
./. Proceeds for overseers at the beginning of the year 1) |
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| 28 |
+/-new comparisons for previous years 2) |
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| 29 |
= Change of revenue budget (paragraph 6, first sentence) 3) |
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| 30 |
: sum of the effective valuation ratios (Annex E1) 4) |
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| 31 |
= Sick-individual base pay |
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Message:
Base pay value without exception and corrections |
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Unofficial table of contents
Annex 1 (to Appendix 1) for performance and calculation
Source of the original text: BGBl. I 2002, 1421
lfd. Nr.BettenLeading Specialist Departments *)
| 1 |
Psychiatry and Psychotherapy |
| 2 |
Child and adolescent psychiatry and psychotherapy |
| 3 |
Psychosomatics |
| 4 |
Psychotherapeutic medicine |
| 5 |
Other |
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*)
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Only departments which are led by a doctor who is not subject to instructions and who are subject to a specific area designation and which are mainly used for this area of expertise.
Unofficial table of contents
Annex 2 (to Appendix 1) for performance and calculation
(Content: uncovered table,
Fundstelle: Investment country for BGBl. I 1994 No 67, p. 45-46;
with regard to of the individual amendments. Footnote)
Unofficial table of contents
Annex 3 on the performance and calculation of the calculation
Separate ID card for foreign patients according to § 3 (4)
Source of the original text: BGBl. I 1997, 2880;
with regard to of the individual amendments. Footnote The services of the hospital and its departments for foreign patients pursuant to § 3 (4) are to be shown in separate sections "L1" and "L3", limited to the following contents:
| -lfd. No. 4 |
BT with daily care rates 4), |
| -lfd. No. 8 |
Occupancy days FP-Area 9), |
| -lfd. No. 13 |
Full-time cases with daily care records 11), |
| -lfd. No. 18 |
Partial inpatient cases with daily care kits 11a), |
| -lfd. No. 19 |
Cases with case flat rates. |
