Regulation On The Control Of Hospital Care Set

Original Language Title: Verordnung zur Regelung der Krankenhauspflegesätze

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Read the untranslated law here: http://www.gesetze-im-internet.de/bpflv_1994/BJNR275010994.html

Regulation establishing the hospital care set (Federal care rate regulation - BPflV) BPflV Ausfertigung date: 26.09.1994 full quotation: "Federal care rate regulation of 26 September 1994 (BGBl. I S. 2750), most recently by article 12 of the law of 16 July 2015 (BGBl. I S. 1211) is changed" stand: last amended by art. 12 G v. 16.7.2015 I 1211 for more information on the stand number you see in the menu see remarks footnote (+++ text detection from) : Units +++) the V v was adopted as article 1 V 26.9.1994 I 2750 (PflNV) by the Federal Government with the consent of the Federal Council. You occurs under article 10 para 4 sentence 1 of this V on the units in force (differing in strength treads fluke conditions see article 10 para 1 to 3).

Table of contents the first section general rules section 1 scope article 2 hospital services second section remuneration of hospital services § 3 agreement a total amount for the years 2013 to 2016 § 4 agreement a revenue budget for the years 2017 to 2021 § 5 agreement of increases and reductions § 6 agreement any other charges third section remuneration types and billing section 7 fees for General Hospital Services § 8 calculation of charges fourth agreement procedures section 9 section agreement at the national level article 10 agreement at national level article 11 agreement for the individual hospital § 12 preliminary agreement article 13 arbitration § 14 approval of § 15 run fifth section regulations § 16 separately predictable medical and other services section 17 competence of health insurance funds at national level article 18 transitional provisions installation: establishment of fees and budget determination (AEB-psych) Annex 1 of the LKA: beds run end departments Appendix 2 of the LKA: footnotes annex 3 to the LKA: card for foreign patients the first section general rules section 1 are separate scope (1) according to § 3 para 4 under this regulation the full inpatient and partial inpatient services of the hospitals , are included according to § 17 para 1 sentence 1 second half-sentence of the hospital financing act not in the DRG payment system. Hospital within the meaning of this regulation is also the entirety of the self-employed, area medical departments for the areas of Psychiatry and psychotherapy, child and adolescent psychiatry and psychotherapy (psychiatric facilities) and for Psychosomatic Medicine and psychotherapy (psychosomatic facilities) at a somatic hospital.
(2) this regulation does not apply to 1 the hospitals to the hospital financing law does not apply no. 1 to 4 according to its paragraph 3 sentence 1, 2 hospitals, not promoted according to § 5 para 1 No. 2, 4 or 7 of the hospital financing Act.
(3) before and after stationary treatment is paid uniformly for all users after section 115a of the fifth book of the social code.

§ 2 (1) hospital services are hospital services pursuant to section 1 para 1 in particular medical treatment, not permanently employed physicians and doctors, nursing, supplies of medicines, medicinal and tools which are necessary for the supply in the hospital, as well as accommodation and catering; They include general hospital services and optional services. Not the services of physicians (§ 18 of the hospital pay Act) belong to the hospital services.
(2) General Hospital services are the hospital services, which are necessary, taking into account the performance of the hospital in some cases according to type and severity of disease for the medically appropriate and sufficient supply of the patient. Under these conditions also include 1 the measures carried out during the hospitalization for the early detection of diseases within the meaning of the fifth book of social code, 2. that led from the hospital services of third parties, 3. medical reasons necessary inclusion of an attendant of the patient or the inclusion of a caregiver after section 11, paragraph 3, of the fifth book of social code, 4. dismissed management within the meaning of section 39 paragraph 1 sentence 4 of the fifth book of the social code.
Dialysis is not among the hospital services.
(3) in the provision of General Hospital services by doctors fixed not in the hospital, the hospital has to ensure that these meet the same requirements for their work in the hospital, as they also apply to doctors employed in the hospital.
Second section remuneration of hospital services § 3 agreement a total amount for the years 2013 to 2018 (1) that is compensation system in accordance with section 17 d of the hospital financing law for the years 2013 to 2018 budget-neutral for the hospital introduced. For the years 2013, 2014, 2015 or 2016 (option years), the introduction is done at the request of the hospital. But not before, the hospital has his desire at the time of the request for negotiation by the social security institutions, according to § 18 paragraph 2 writing number 1 or 2 of the hospital financing Act the other Contracting Parties as at 31 December of the previous year's. The application of the remuneration system for all hospitals is binding from 1 January 2017. The to be provided according to § 11 paragraph 4 evidence of kind and number of charges may be used for the years 2013 to 2018 number 1 and 2 only pursuant to § 7, sentence 1 to determine the hospital-specific underlying remuneration according to paragraph 3 and to discuss the transformation of the medical power structure.
(2) off hospital-specific introduction year up to the year 2018 total in analogous application of article 6(1) of the Federal care rate regulation in on December 31, 2012 is for a hospital to agree, with the proviso that instead of amended version applicable rate of change according to § 6 paragraph 1 sentence 3 of the Federal care rate regulation in on December 31, 2012 the change value according to § 9 para 1 number 5 in the years 2015 and 2016 in duplicate, and in 2017 and 2018 for the increase of the total deemed authoritative rate amounting to easier; the year 2013 is in addition to § 18 paragraph 1 sentence 2 according to use. Starting point of the agreement is the total amount agreed for the respective year. This is especially when the agreement pursuant to sentence 1 1 reduces to a) share of the costs for services that would be shifted in the agreement period in other coverage areas b) included costs of services for foreign patients, as far as them pursuant to paragraph 6 of the total amount will be spun off, 2. adjusted for settlements therein, as well as compensation payments due to adjustments for prior years, 3 changes to the merger or integration of a) other increases and reductions referred to in § 7 set 1 number 3 , b) costs for services, which for the first time will be reimbursed in the agreement period within the framework of pilot projects under section 63 of the fifth book of the social code or contracts for integrated care section 140a of the fifth book of the social code or for the first time within the framework of the hospital budget.
The agreed amount is appropriately allocate 1 revenues for fees pursuant to § 7, sentence 1 Nos. 1 and 2 (revenue budget), including still not outsourced any other surcharges and discounts according to § 7, sentence 1 number 3; the revenue budget includes the effective valuation ratios, 2. revenues for fees pursuant to § 7, sentence 1 No. 4 (sum of proceeds pursuant to section 6, paragraph 3).
The total amount and the revenue budget are number 1 to sentence 4 to adjust offsets and adjustments for previous years; When a correction, appropriate compensation is carried in addition to the correction of the previous budgets (basis adjustment).
(3) for the settlement of fees pursuant to § 7, sentence 1, individual hospital basis pay values to determine are number 1 for the years 2013 to 2018. To the amount of the additional fees and revenues for excess trailer will be deducted from the respective changed revenue budget referred to in paragraph 2 sentence 5 and the resulting amount will be divided by the agreed sum of the effective valuation ratios. The base fee value for each year is to consider the settlement of fees valued at valuation ratios.
(4) at the request of a hospital funded not by the hospital financing law, investment costs for new investments in the total referred to in paragraph 2 are in addition to take account of sentence 1, as far as the individual hospital basis fee value is lower than the estimated average base remuneration value of the hospitals in the country. The account shall be in accordance of § 17 paragraph 5 sentence 3 of the hospital financing Act in conjunction with section 8 of the Federal care rate regulation in force on 31 December 2012. Sentences 1 and 2 shall apply mutatis mutandis for hospitals, only partially funded through an agreement according to § 8 paragraph 1 sentence 2 of the hospital financing Act.
(5) the amount of attributable to the calendar year revenues of the hospital from charges differs from that for the years 2013 to 2018 pursuant to § 7, sentence 1 Nos. 1, 2 and 4 of the changed amount referred to in paragraph 2 sentence 5, which will lower revenues or higher - compensated as follows: lower revenues are 1 for the years 2013, 2014, 2015, and 2016 to 95 per cent and the year 2017 to 20 percent balanced , 2. profit, arising as a result of a changed coding of diagnoses and procedures, be fully compensated, 3.
other extra revenue compensates for 2013, 2014, 2015 and 2016 for the years to 65 percent, starting in 2017 other additional revenues compensated set 5 to 85 percent and 90 percent up to the amount of 5 per cent of the modified total referred to in paragraph 2.
The parties can agree in advance any countervailing rates if this better matches the assumed development of services and their costs. For the range of fees valued at valuation ratios other excess revenues pursuant to sentence be determined simplified 1 number 3 by following factors are multiplied with each other: 1. number of calculation and assignment days, which provided that in determining the hospital-specific underlying of remuneration pursuant to paragraph 3 sentence 3 are considered in addition to those calculation and assignment days, 2. average value of the agreed valuation ratios per calculation and allocation day. the mean value is determined by the sum of the effective valuation ratios set 2 by the agreed upon calculation and assignment days is divided pursuant to paragraph 3 and 3 individual hospital basis fee value after paragraph 3 sentence 3.
As far as the hospital or another contracting party proves that other more revenues as a result are too low or too high sized 1 number 3 pursuant to sentence by changes in the power structure with the simplified determination pursuant to sentence 3, the amount of other profit is to adjust accordingly. The extra revenues are determined pursuant to sentence 1 number 2 by of the total incurred more revenue for fees which are rated with valuation ratios, the profit will be deducted according to set of 3 or 4.
(6) upon request of the hospital services for foreign patients, who travel with the aim of hospital treatment in the Federal Republic of Germany, are not paid within the framework of the total.
(7) the parties are bound to the total amount. At the request of a Contracting Party the total amount for the current calendar year is when significant changes in the assumptions underlying the agreement of the total newly arrange. The parties can agree in advance that in certain cases the total amount is only partially newly agreed. The amount of the difference to the previous total is to settle the newly agreed amount; Article 15, paragraph 2, sentence 3 shall apply accordingly.

§ 4 each to January 1, 2019, 2020, 2021, 2022 and 2023 the individual hospital basis fee value and the revenue budget of the hospital be agreement a revenue budget for the year 2019 to 2023 (1) (section 3, paragraph 2, sentence 4 No. 1) gradually aligned with the land base remuneration value according to § 10 and the resulting revenue volume.
(2) if the output value is number 1 for the year 2018, the basis of which is corrected according to § 3, paragraph 2, set of 5 for the determination of the revenue budget for the year 2019 the agreed revenue budget according to § 3, paragraph 2, sentence 4. This is 1 minus a) share of the costs for services, which will be moved during the agreement period in other coverage areas, b) to resettling after paragraph 9 services for foreign patients and patients, are included in the total for the year 2018, 2. adjusted for settlements therein, as well as compensation payments due to adjustments for prior years, 3 increased the estimated proceeds of charges pursuant to § 7, sentence 1 number 1 and 2 , as far as so far according to § 6 paragraph 2 paid services be included in the remuneration system according to section 17 d of the hospital financing law, 4 changes the carve-out or reintegration of a) other increases and reductions referred to in § 7 set 1 number 3, b) revenues for services according to article 6 paragraph 1, c) which during the agreement period for the first time in the framework of pilot projects under section 63 of the fifth book of the social code or contracts for integrated care according to section 140a of the fifth book of the social code, or for the first time in the budget of the hospital costs of services, be remunerated.
Output value is for determining the revenue budget for the years 2020 and 2023 respectively the revenue budget of the previous year; the provisions of sentence 1 shall apply accordingly.
(3) if the output value is changed pursuant to paragraph 2, by taking account of following facts for a future period (the period of the agreement pursuant to article 11, paragraph 2): 1. 2. the change value of changes in the type and quantity of expected services to be provided full - and part-stationary, that number 1 and 2 are included by the nationwide pay catalogues according to § 9 para 1, after article 9 paragraph 1 number 5 additional services pursuant to sentence 1 number 1 are for the year 2019 to 45 percent , for the year 2020 to 55 percent for the year 2021 to 60 per cent for the year 2022 to 70 percent and for the year 2023 to 80 percent funded and therefore included in the initial value with the following percentage of the level of charges number 1 under application of the land underlying remuneration resulting in charges pursuant to § 7, sentence 1,: 1 38.9 percent for the year 2019 , 2. 46 per cent for the year 2020, 3. 50 per cent for the year 2021, 4. 55 per cent for the year 2022 and 5. 60 per cent for the year 2023.
the same shares falling away services take into account, as far as these services are not already to consider sentence 1 number 1 budget performance according to the requirements of paragraph 2. To facilitate the negotiations the Parties apply at a flat rate the specifications of the set of 2 on the corresponding change in the sum of the effective valuation ratios, as far as this is not attributable to changes of charge brochures, the settlement rules or the coding guidelines. As far as in some cases the costs for additional services with these percentages can are not covered the parties agree a consideration in a non-sentence 2 percent rate; by way of derogation from sentences 2 and 3 as far as larger organizational units will be closed and services are no longer provided, is the seed to reduce accordingly. Additional charges for medicines are considered 100 percent.
(4) as the target value for the approximation referred to in paragraph 1 a revenue volume for the hospital for the year 2019 to 2023 each, arranged by type and amount of charges expected to be number 1 with the respective country base remuneration value according to § 10 are valued according to § 7, sentence 1 and increases the calculated sum of the proceeds to the estimated amount of revenue from extra charges.
(5) the adjustment according to paragraph 1 for the year 2019 to 10 percent, for the year 2020 and 2021 to 15 percent each for the years 2022 and 2023 to 20 percent each. The decisive for the adjustment referred to in paragraph 1 approximation amount for the year 2019 to 2023 is determined by subtracting each of the modified output value pursuant to paragraph 3 of the destination value pursuant to paragraph 4 and following shares are calculated by this intermediate result: 1 10.0 per cent for the year 2019, 2. 16.7 per cent for the year 2020, 3. 20.0 percent for the year 2021 , 4 33.3 percent for the year 2022 and 5. 50.0 per cent for the year 2023.
For determining the revenue budget for the year 2019 to 2023, which is relevant for the respective year modified the output value pursuant to paragraph 3 and the adjustment amount calculated for the same year are added pursuant to sentence 2 in accordance with the sign. At previous special facilities according to § 6 para 1, which for the first time negotiate according to § 4, which is pursuant to sentence 2 percent rate known for the given year. For hospitals, whose revenue budget is reduced, the approximation is limited pursuant to sentences 2 and 3 on no more than following shares by the modified output value pursuant to paragraph 3 (capping limit): 1 1.0 percent for the year 2019, 2. 1.5 per cent for the year 2020, 3. 2.0 per cent for the year 2021, 4. 2.5 per cent for the year 2022 and 5 3.0 per cent for the year 2023.
(6) for the determination of the hospital-specific base fee values applicable for the year 2019 to 2023, the respective revenue budget is 3 under paragraph 5 set to reduce 1 to the expected proceeds from additional charges as well as prices for excess trailer and 2 to change order still to be implemented, prescribed compensation for previous years, even if this result a correction.
The modified revenue budget is divided by the agreed sum of the effective valuation ratios of the cases pursuant to sentence 1. The resulting base fee value is to use the invoicing of fees valued at valuation ratios.
(7) at the request of a hospital funded not by the hospital financing law investment costs for new investment measures in the revenue budget in addition to take into account, as far as the individual hospital basis fee value is lower than the land underlying remuneration according to § 10. The account shall be in accordance of § 17 paragraph 5 sentence 3 of the hospital financing Act in conjunction with section 8 of the Federal care rate regulation in force on 31 December 2012. Sentences 1 and 2 shall apply mutatis mutandis for hospitals, only partially funded through an agreement according to § 8 paragraph 1 sentence 2 of the hospital financing Act.
(8) the agreed set of 3 revenue budget referred to in paragraph 5 and agreed to paragraph 6(3) proceeds amount are summarized for the discovery of more or less revenue balancing to a total. The sum of relating to the calendar year revenues of the hospital from the charges differs from this total number 1, 2 and 4 after paragraph 7, sentence 1, which will be so compensated more or less proceeds as follows: 1 reduced revenues be compensated 20 percent, profit up to the amount of 5 per cent of the total are 2 pursuant to sentence 1 to 85 percent and compensated for in addition to 90 percent.
The parties can agree in advance any countervailing rates if this better matches the assumed development of services and their costs.
(9) upon request of the hospital services for foreign patients, who travel with the aim of hospital treatment in the Federal Republic of Germany, will not be refunded set 1 in the context of the total amount referred to in paragraph 8.
(10) the parties are bound by the revenue budget pursuant to section 11. At the request of a Contracting Party is in significant changes in the assumptions underlying the revenue budget agreement, renegotiated the revenue budget for the current calendar year. The parties can agree in advance that the revenue budget is only partly newly agreed in certain cases. The amount of the difference to the previous revenue budget is to settle on the newly agreed revenue budget; Article 15, paragraph 2, sentence 3 shall apply accordingly.
(11) if entered no other statutory provision into force for the period from the year 2024, are for the determination of the revenue budget of paragraph 4 and the taking into account of balance and adjustments for previous years (6) sentence 1 to apply accordingly. Paragraphs 8, 9 and 10 shall apply.

§ 5 agreement of increases and reductions (1) number are section 17 d paragraph 2 sentence 4 of the hospital financing law according to § 9 para 1 3 agreed rules for federal and discounts to the Contracting Parties according to § 11 binding. At the request of a Contracting Party is to check whether the requirements for a premium or discount are available at the hospital. A common premium or discount amount has been set for an offence, which must be converted for the purposes of billing against patients or patients or the cost bearers on a hospital-individual base so the Contracting Parties in accordance with the provisions of the agreements agree the resulting hospital-specific billing amount or percentage.
(2) section 17 d paragraph 2 sentence 5 of the hospital financing law applies to the agreement freezing rates.

§ 6 agreement any other charges (1) for services which can be paid for still not properly, and agree the year 2019 for special facilities according to § 17 d paragraph 2 sentence 4 of the hospital financing law with the applicable fees according to section 17 d of the hospital financing Act at the federal level the Contracting Parties according to § 11 tages-, case - or period-related fees, provided that the services or the special facilities from the identification of the Contracting Parties pursuant to article 9 or regulation according to § 17 d paragraph 6 sentence 1 No. 3 of the hospital financing law by the application the fees assessed at the federal level are excluded. In very limited exceptional cases the Contracting Parties additional charges agree. The charges are appropriate to calculate; the recommendations are according to § 9 para 1 No. 4.
(2) for the payment of new examination and treatment methods that can still not properly be remunerated with the applicable fees according to section 17 d of the hospital financing Act at the federal level and not c of the fifth book the social law from financing have been suspended in accordance with section 137, the parties should agree first 2019 temporary charges outside of the revenue budget pursuant to section 11 for the calendar year according to section 4 and the sum of proceeds pursuant to paragraph 3. For the details of the procedure is to apply article 6, paragraph 2, sentence 2 to 9 of the hospital charges act according to.
(3) be agreed individual hospital charges for services or special facilities referred to in paragraph 1 sentences 1 and 2, a revenue amount is for these charges in analogous application of article 6(1) of the Federal care rate regulation in force on 31 December 2012 to form, with the proviso that instead of change rate according to § 6 paragraph 1 sentence 3 of the Federal care rate regulation in on December 31, 2012 amended the value of changes to article 9, paragraph 1 number 5 as a significant rate increase the revenue amount applies. It includes not the fees referred to in paragraph 2. § 9(1) of spreadsheet documents are to present number 4 for the agreement of the charges and the revenue total. The actually occurring revenues deviate from the agreed amount of the proceeds, which are more or less revenue to determine according to article 4, paragraph 8, and to compensate for.
Third section remuneration types and billing section 7 are for general hospital services the General Hospital services compared with the patients and billed patients or their payers with the following charges: 1 with rating relations reviewed fees according to the remuneration catalogue (§ 9) agreed at the federal level, 2. additional charges after the federal pay catalog (§ 9) agreed 3. Education Supplement (§ 17a paragraph 6 of the hospital financing Act) and other surcharges and discounts, (section 17 d, paragraph 2, sentence 4 and 5 of the hospital financing law and quality assurance deductions pursuant to § 8, paragraph 4) , 4. fees for special facilities and services which are not yet covered by the fees agreed at the federal level (§ 6 paragraph 1), 5. charges for new examination and treatment methods that still do not have been recorded in the catalogues of the fee pursuant to § 9 (§ 6 paragraph 2).
With these charges, all for the care of patients and patients will be reimbursed necessary general hospital services. In addition following surcharges will be charged: 1 the DRG system charge according to § 17 b paragraph 5 of the hospital financing law, 2 the system contract for the joint Federal Committee and the Institute for quality and efficiency in health care after section 91 paragraph 3 sentence 1 in conjunction with § 139 c of the fifth book of the social code and 3. Telematikzuschlag after section 291a paragraph 7a sentences 1 and 2 of the fifth book of the social code.

Calculation of fees (1) which are charges for general hospital services for all patients of the hospital uniform to calculate 8; § 17 paragraph 5 of the hospital financing Act shall remain unaffected. Patients and patients who are treated in a clinical study for general hospital services are according to § 7 to calculate; This also applies to clinical trials with medicines. The fees must be calculated only in the context of the supply contract; This does not apply for treating emergency patients and patients. The public service mission of the hospital stems 1 to a plan hospital from the provisions of the hospital plan in connection with the decisions for its implementation pursuant to section 6 paragraph 1 in conjunction with § 8 paragraph 1 sentence 3 of the hospital financing act as well as a supplementary agreement according to § 109 paragraph 1 sentence 4 of the fifth book of social code, 2nd at a college clinic from the recognition according to the national regulations , from the hospital plan under section 6(1) of the hospital financing act as well as a supplementary agreement according to § 109 paragraph 1 sentence 4 of the fifth book of social code, 3. at other hospitals under the supply contract according to § 108 paragraph 3 of the fifth book of the social code.
(2) tag-related will be charged for the day and each subsequent day of hospitalization fees for full - or part-inpatient services (calculation date); the dismissal or transfer day, who is not also a day, is computed only when part of inpatient treatment. Set 1 first half-sentence shall apply mutatis mutandis when internal linings; is a patient or a patient several times internally relocated in one day, only the last record Department calculates the day-related remuneration. The provisions of § 8 paragraph 2 sentence 3 shall apply to the fees predictable in addition to day-related charges number 1, 2 and 4 of the hospital charge act according to. Insofar as case-related charges to calculate, the requirements of § 8 paragraph 2 sentence 3 shall apply paragraph 5 and 6 of the hospital charge act according to. For more information or otherwise agreed by the Contracting Parties according to § 17 paragraph 2 sentence 1 of the hospital financing law, or according to § 17 d, paragraph 6 of the hospital financing Act regulated in a legislative decree. Separate charges are calculated for the patients evidence physicians.
(3) hospitals in the area referred to in article 3 of the Unification Treaty calculate the investment contract until December 31, 2014 for each calculation day referred to in article 14 paragraph 3 of the law of health structure. Part of inpatient treatment will be charged the surcharge for the release day.
(4) the hospital reneges on its commitments to quality assurance, so 1 and 2 tee-offs are number of the charges pursuant to § 7, sentence 1 according to article 137 paragraph 1 sentence 2 of the fifth book of the social code.
(5) the hospital may demand a reasonable advance payment of patients as far as a health insurance coverage is not detected. From the eighth day of hospitalization, the hospital may demand a reasonable advance payment, the amount of which is based on the services previously provided in connection with the charges expected to be paid. The sentences 1 or 2 do not apply, so far as other arrangements on a timely remuneration of General Hospital services in binding regulations for the hospital be taken according to the sections 112 to 114 of the fifth book of the social code or in the agreement according to article 11, paragraph 1.
(6) the hospital has to give the expected relevant fees even paying patients and patients or their legal representative as soon as possible in writing, unless the patient or the patient is covered in full for the hospital treatment. In addition, each patient and each patient may require that the expected billable charges are communicated without obligation. When recording a self paying patient or a self paying patient charges not yet have been determined, is to point this out. This is to inform that the fee to be paid is increased when the new fee takes effect during the hospitalization of the patient or the patient. The expected increase is to specify.
Fourth agreement procedures section 9 section agreement at the federal level (1) the Association of top federal of health insurance fund and the Association of private health insurance together with the German Hospital Federation (parties at the federal level) with effect for the Contracting Parties pursuant to section 11 each specifically agree 1 a catalogue in accordance with article 17 d, paragraph 1, of the hospital financing law in particular day-related charges including the valuation ratios, as well as in appropriate cases schemes to premium or discount , are going to be after parent - or Undershoot disease typical treatment times, the settlement rules for the fees according to paragraphs 1 and 2, as well as the regulations regarding increases and reductions, 4. can recommendations for the calculation and the hospital-individual remuneration of services and new examination and treatment methods, which according to § 6 special charges agreed 2. a catalog of complementary additional fees according to section 17 d paragraph 2 sentence 2 of the hospital financing law including the compensation amount, 3. , 5 up to October 31 of each year, for the first time for the year 2013, the change value in accordance with § 10 paragraph 6 set 5 or 6 of the hospital charges Act to limit the development of the underlying charge according to § 10 paragraph 3, taking into account already funded cost increases are, as far as this rate of change to section 71, paragraph 3, of the fifth book of the social code is reached in the case of § 10 paragraph 6 set 6 of the hospital charges Act, the rate of change to section 71, paragraph 3, of the fifth book of the social code is to increase 40 percent of this difference, 6 the uniform structure of the records and the procedures for the transmission of data according to article 11, paragraph 4, sentence 1, as well as the further development of the sections E1 to E3 and B1 and B2 for the conditioning of this regulation.
By way of derogation from sentence 1 number 5 second half-sentence is for the years 2014-2015 the rate of change to section 71, paragraph 3, of the fifth book the social law in the case of § 10 paragraph 6 set 6 of the hospital charges Act, taking into account the guarantee of necessary medical care and staff and cause cost increases up to the full amount of this difference, but at least to increase 40 percent of this difference.
(2) an agreement to paragraph 1 is reached number 1 to 3 wholly or partially not, section 17 d, paragraph 6 of the hospital financing law applies. In other cases, the Board of arbitration decides at the request of a party pursuant to section 18a, paragraph 6 of the hospital financing law; a decision on paragraph 1 has number 5 until November 15th of each year to meet the Board of arbitration.

Section 10 agreement at national level (1) for determining the amount of the fees valued at valuation ratios according to § 9 para 1 No. 1 the (parties referred to in § 18 paragraph 1 sentence 2 of the hospital financing law at land level) agree with effect for the Contracting Parties pursuant to section 11 a year, for the first time for the year 2019, a nationally applicable base remuneration (value land base remuneration) for the following calendar year. Here they assume as the starting point of the agreement values of the hospitals in the country for the current calendar year according to the annex to this regulation, in particular by the sum of the effective valuation ratios and the sum of revenues for fees pursuant to § 7, sentence 1 number 1, and on this basis will appreciate the foreseeable development in the following calendar year; as far as values for individual hospitals still do not exist, they are appreciated. The contract parties at the country level, that error estimates in the facts, which are based on the agreement of the land underlying remuneration, be corrected with the agreement of the land base fee value for the following year. You have to set in the agreement to the facts and circumstances in which a correction is made in the following year. When a correction, appropriate compensation is carried in addition to the correction of the agreed revenue volume (basic adjustment). The correction is only carried out insofar as in the context of the change value pursuant to paragraph 3 in the agreement to be changed last year even without an error estimate a consideration of the amount of the basic allowance would have been allowed.
(2) in the case of the agreement are to take into account in particular: 1 estimated General cost developments, 2 ways to exploit efficiency reserves, as far as this not, stored 3. changes in performance, due to the development of the assessment ratios as far as these are not the consequence of a changed coding of diagnoses and procedures, the estimated share of variable costs in the charges pursuant to § 7, sentence 1 number 1 rated services , 4. the evolution of expenditure total at the service areas, which are, not paid fees review relations rated as far as they exceed the change value number 5 according to article 9, paragraph 1; While the charges pursuant to § 7, sentence 1 are not included number 3, 5. reducing is the sum of the revenue which is expected during the year due to the capping limit according to § 4 paragraph 5 sentence 5 in hospitals in the country as a whole not budget performance effectively, as well as the sum of the other supplements according to § 7, sentence 1 number 3, as far as the services so far through the underlying charges have been funded , 6 increasing the sum of other deductions pursuant to § 7, sentence 1 number 3, as far as the services so far have been funded through the underlying charge, 7 arrangements referred to in article 9, paragraph 1.
In the application of sentence 1 number 3 is to ensure that additional services are included in the agreement of the land underlying remuneration reduces. As far as spending increases arising as a result of a changed coding of diagnoses and procedures, these are fully expressed through a corresponding reduction of the land base fee value to compensate for.
(3) the land base remuneration agreed pursuant to paragraph 2 shall not exceed the change value according to § 9 para 1 number 5 modified and corrected land base pay last year not exceed. This does not apply if an increase of the land underlying charge is only technical reasons and does not lead to an increase in the total expenditure on hospital services or if the making is a correction of incorrect estimates referred to in paragraph 1. An increase of the land underlying charge is only technical reasons especially if it is due to the further development of the compensation system according to section 17 d of the hospital financing Act or the provisions of the settlement.
(4) the agreement of the land underlying remuneration is close to 30 November each year. The parties at the country level negotiations immediately, after a party in writing has prompted to do so. The agreement is reached through agreement between the parties, which took part in the negotiations; It is concluded in writing. An agreement is not concluded until 30 November of the year concerned, so the Arbitration Board sets immediately the land base remuneration value at the request of a Contracting Party according to § 13.

§ 11 agreement for individual hospitals
(1) in accordance with articles 3 to 6 and in accordance with the Mission of the Hospital (section 8, paragraph 1, sentence 3 and 4) the Parties shall regulate the total amount, the revenue budget, the sum of the valuation ratios, the hospital-specific value of base pay, the sum of proceeds, the other charges, the surcharges and discounts, and the more - according to § 18 paragraph 2 of the hospital financing Act (Contracting Parties) agreement and reduced revenue offsets. The agreement is to apply for a future period (Agreement). The agreement must include provisions that guarantee timely payment of charges at the hospital; for this purpose, regulations on reasonable monthly payments and interest for late payment should be made. The agreement is reached through agreement between the parties, which took part in the negotiations; It is concluded in writing.
(2) the agreement period is one calendar year if the hospital is operating all year round. A period that includes several calendar years, can be agreed upon.
(3) the Contracting Parties shall immediately record the hearing after a party in writing has prompted. The negotiations will be completed in time, taking into account the six-week period of § 18 paragraph 4 of the hospital financing Act that the new budget and the new fees upon expiration of the current agreement period can come into force.
(4) the hospital institution sections E1 forwarded to prepare the negotiation the other Contracting Parties, referred to in § 18 paragraph 1 sentence 2 of the hospital financing Act stakeholders and the competent land authority, 1 for the years after 2013, 2014, 2015, 2016 or 2017 until E3 and B1 the attachment hereto in the currently valid version of the agreement article 9, paragraph 1, sentence 1 number 6 as well as the performance and costing site after Appendix 1 of the Federal care rate regulation in the on December 31, 2012 Amended with the exception of sections V1, V4, L4, and K4, 2 for the years from 2019 the sections E1 to E3 and B2 according to the system of this regulation or in the current version of the agreement according to article 9, paragraph 1, sentence 1 No. 6.
The data shall be provided on machine-readable data carriers. The hospital has at the joint request of the other parties according to § 18 paragraph 2 additional documents to present number 1 and 2 of the hospital financing Act and to provide information, as far as this is necessary for assessing the benefits of hospital within the framework of his mission in each case, and if the expected benefit clearly outweighs the caused effort.
(5) the parties are obligated, essential to the supply contract and the power structure of the hospital and the amount of and charges according to § 5 so early together before to clarify questions, that the negotiations can be performed quickly.

§ 12 preliminary agreement can the parties in particular about the amount of the total of the revenue budget, hospital-specific underlying remuneration or any other of the amount of charges does not agree and will be called therefore the Arbitration Board according to section 13, the parties to sign an agreement, so far as the amount is not disputed. Charges based on this agreement are so long to raise until the final relevant fees are binding. More or less revenues of the hospital as a result of the levied preliminary charges be offset by premium or discounts on the fees of the current or a following period of the agreement.

§ 13 comes Arbitration Board (1) an agreement according to article 10 or article 11 entirely or partially didn't materialize, the Board of arbitration decides according to section 18a, paragraph 1, of the hospital financing Act on request of one of the Contracting Parties referred to in article 10 or article 11. It is bound by the legislation in force for the Contracting Parties.
(2) the Arbitration Board decides the items on which no agreement could be reached within six weeks.
(3) (dropped out) section 14 permit (1) which according to § 10 and the hospital-specific base fee values, of the revenue budget, the sum of revenue, of other charges- and discounts according to § 5 is approval of agreed upon or fixed by the Arbitration Board article 13 country pay underlying of one of the Contracting Parties to the competent authority of the country to apply for. The competent authority of the country granted approval if the agreement or determination complies with the requirements of this Regulation as well as any other law. It decides on the approval of the land base fee value within four weeks after receipt of the application.
(2) the parties and the arbitration boards have to submit the documents to the competent authority of the country and to provide the information that is required for the review of the legality. In addition, the law applicable to the parties with respect to the agreement are apply mutatis mutandis. The approval can be connected to auxiliary regulations, insofar as this is necessary to eliminate legal obstacles that hinder a full approval.
(3) is failing the approval of an arbitration award, the Arbitration Board at the request of is obliged to decide in accordance with the legal opinion of the approving authority.
(4) with regard to the approval of the land underlying remuneration is the way of administrative law only for those parties at the country level. A pre-litigation procedure does not take place. The complaint has no suspensive effect.

§ 15 maturity (1) the fees valued at valuation ratios and other fees are collected in the agreed for the calendar year of hospital-specific height of the commencement of the new agreement period to. Only approved the agreement after that date, the charges from the first day of the month are to rise, following the approval, unless there is no other future time specified in the agreement or Schiedsstellenentscheidung. Until then, the existing fees are to rise; This 2015, 2016 or 2017 also applies to the introduction of the compensation system according to section 17 d of the hospital financing law in 2013, 2014. You are to clean up, but the compensation amounts contained therein if and insofar as this has been so determined in the previous agreement or determination.
(2) excess or reduced revenues as a result of the continuing survey of previous charges are offset by surcharges and discounts on the new fees to be collected in the remaining period of the agreement. Is the compensation amount by the proceeds from these increases and reductions in the remainder of the agreement period exceeded or fallen below, so the different amount of the charges of the next agreement period is balanced; It is a simple procedure of compensation to agree. Would the fees increased as § 3 paragraph 7 or § 4 paragraph 10 as a whole by more than 30 percent by this balance and an amount, excess amounts are up respectively to this limit in subsequent budgets to compensate for. A balance by reducing revenue is eliminated, as far as the late approval of the agreement by the hospital is responsible.
Fifth section regulations § 16 separately predictable medical and the calculation of belegärztlicher services other services according to § 18 of the hospital fee Act. The agreement and calculation of optional services are based on the sections 17 and 19 of the law on hospital charges.

§ 17 jurisdiction the health insurance funds at the country level which take tasks assigned to the land associations of sickness funds in this regulation for the replacement cashboxes to § 212, subsection 5 of the fifth book of the social code named agent, for the miner health insurance the Deutsche Rentenversicherung Knappschaft-Bahn-see and for the health insurance of farmers social insurance for agriculture, forestry and horticulture.

Article 18 transitional provisions (1) hospitals, which have over the years 2013, 2014, 2015 or 2016 according to § 3, paragraph 1, sentence 2 which do not lead compensation system in accordance with section 17 d of the hospital financing law in these years the Federal care rate regulation in force on 31 December 2012 shall apply, that 1 instead of the rate of change after section 6, paragraph 1, sentence 3 from the year 2013 the change value according to § 9 para 1 number 5 of the Federal care rate regulation in the ab each applied as in force January 1, 2013 as a significant rate of the increase of the total amount, 2. § 6 paragraph 2 to 31 December 2012 will be repealed and 3. Article 15, paragraph 1, sentence 1 last time applies to the year 2012.
For 2013, the budget agreed by the Contracting Parties by 40 percent is the number 5 of the hospital fee agreed rate increasing to correct where the correction amount on the budget of the following period of set of maintenance to settle is according to section 9, paragraph 1, sentence 1; Article 3, paragraph 2, sentence 5 second half-sentence, be aware.
(2) for the years 2013 to 2018 have the hospitals, which conclude an agreement according to article 6 paragraph 4 of the Federal care rate regulation in force on December 31, 2012, to submit a confirmation of the year Auditors about the actual average staffing as at 31 December, as well as about the proper use of funds the other parties pursuant to section 11; not suitably used funds are to be paid back.
Plant establishment of fees and budget determination (AEB-psych) (site: BGBl I 2012, 1623; regarding the details of the changes see footnote) list of fees and budget determination (AEB-psych) E charges pursuant to § 17 d KHG E1 installation with rating relations charges E2 rated list of additional charges of E3 site the hospital individually negotiated according to § 6 charges B budget determination B1 total and underlying remuneration according to § 3 for the calendar years 2013 to 2018 B2 revenue budget and underlying charge under section 4 from the calendar year 2019 hospital : Page: Date: E1 statement of fees valued at valuation ratios for the hospital1) 2) fee No. Berechnungstage3) (only day-related charges) corresponding number of cases number of cases (only case and time space-related charges) associated occupancy days evaluation relation to pay catalog sum of rating relations without surcharges and discounts (SP 2 x 4 and 3 x 4) of cases with patienten--related reductions of cases with patienten--related surcharges sum of effective review relations (SP. 5 - SP. 9 + SP. 13) number of cases with tees number of days with tees evaluation relation Discount day sum of deductions (SP. 7 x 8) number of cases with surcharges number of days with surcharges assessment ratio per extra day sum of to blows (SP. 11 x 12) 1 2 2a 3 3a 4 5 6 7 8 9 10 11 12 13 14 year cases and all cases with day-related Entgelten4) Summe4) above trailer (only case - and period-related charges) 5) Summe5) hospital total total : Page: Date: E2 installation of additional charges for the hospital1) ZE No. number of ZE fee height according to the ZE catalog revenue total 1 2 3 4 year cases and all cases with day-related Entgelten2) sum of CR on trailer (only case - and period-related charges) 2) CR total sum ZE hospital overall: page: date: E3 installation of Entgelte1 hospital individually negotiated according to § 6) 2) E3. 1 list of case-related Entgelte3) pay according to § 6 BPflV case number (tages- , case - or period-related charges) level of charges (in €) gross proceeds amount without surcharges and discounts (in €) (SP. 2 x 4) of cases with patient-related reductions of total cases with patient-related surcharges Nettoerlös-including surcharges and discounts (in €) (SP. 4 - SP. 8 + SP. 12) number of cases with tees number of days with tees discount per day (in euros) total deductions (SP. 7 x 8) number of cases with overhead number of days with surcharges surcharge per day (in €) sum of surcharges (SP. 11 x 12) 1 2 3 4 5 6 7 8 9 10 11 12 13 total: E3. 2 installation of the Zusatzentgelte3) E3. 3 installation of the day-related Entgelte3) additional fee according to § 6 BPflV number fee revenue amount (SP. 2 x 3) pay according to § 6 paragraph 1 BPflV case number days fee revenue amount (SP. 3 x 4) 1 2 3 4 1 2 3 4 5 total: sum : Hospital: Page: date: B1 total and underlying charge under section 3 for the years 2013 to 2018 item No. No. calculation steps agreement for the current calendar year agreement period 1 2 3 adjustment of the total amount (section 3 paragraph 2): 1 total amount for the current year 2 /. Power shifts (No. 1a) 3 /. Carve-out foreign patients (No. 1 b) 4 + / - cleanup order included compensation (No. 2) 5 + / - / reintegration of increases and reductions (No. 3a) 6 + / - models, integrated care (No. 3 b) 7 starting amount = agreement according to § 3 here: negotiating the total amount of the agreement period 8 total for the agreement period 9 + / - new compensations and corrections for Vorjahre1) modified total (section 3 paragraph 2 sentence 5) = 10 11 of them : changed revenue budget (section 3 paragraph 2 sentence 5) 2) 12 of them: BPflV investigation of the underlying fee charges according to § 6 paragraph 1: 13 revenue budget in item No. No. 112) 14. /. Proceeds from additional charges 15. /. Revenue from excess trailer on the Jahresbeginn3) 16 = sum with rating relations reviewed fees incl. Item No. No. 9 17: sum of the effective valuation ratios (Appendix E1) 4) 18 = informed individual hospital basis fee value 19: base fee value without compensations and corrections hospital: page: date: B2 revenue budget and basic pay value according to § 4 No. 2019 calendar year Number of calculation steps agreement for the current calendar year agreement period 1 2 3 determination of the initial value (paragraph 2): 1 revenue budget for the current year 2 /. Power shifts (No. 1a) 3 /. Outsourcing foreign patients (No. 1 b) 4 + / - cleanup order included compensation (No. 2) 5 + integration of innovations (No. 3) 6 + / - / reintegration of increases and reductions (No. 4a) 7 + - / reintegration services after article 6, paragraph 1 (No. 4 b) 8 + / - models, integrated care (No. 4 c) 9 = output value of last year 10 + / - estimated performance changes (paragraph 3 set 1 No. 1) 11 + / - change value according to § 9 para 1 number 5 (paragraph 3 set 1 No. 2) 12 (repealed) = 13 modified output value (paragraph 3) discovery the target value (paragraph 4): 14 proceeds with rating relations assessed charges 15 + estimated revenue from extra charges 16 = target value (paragraph 4) determination of the approximate amount: 17 target value of item No. No. 16 18. /. modified output value from item No. No. 13 19 20 subtotal =... % by item No. No. 19 (paragraph 5 sentence 2) or approximate amount = Cap 21 (paragraph 5 sentence 2) determination of the revenue budget: 22 modified seed No. No. 13 23 + / - approximate amount in item No. No. 21 24 = revenue budget (paragraph 5 sentence 3) item No. Number of calculation steps agreement for the current calendar year agreement period 1 2 3 determination of the underlying charge (paragraph 6): 25 from indicated revenue budget No. 24 26. /. estimated proceeds from additional charges (item No. No. 15) 27. /. Revenue from excess trailer on the Jahresbeginn1) 28 + / - new offsets for Vorjahre2) = 29 modified revenue budget (paragraph 6 sentence 1) 3) 30: sum of effective review relations (Appendix E1) 4) 31 = informed individual hospital basis fee value 32: base fee value without compromises and adjustments 1) installation is to prepare each separately as follows in accordance with the requirements of footnote 2 for the following periods and to submit: - for the calendar year data according to the previous year (target charge catalog : among other things determine of the final revenue offsets), - for the current calendar year data after the charge catalog of the current year (goals: representation of the actual data, as well as determining the provisional revenue offsets), - for the current calendar year data according to the catalogue of remuneration for the period of the agreement (target: basis for agreement on budget and reduced services or higher -), - agreement covering the demand of hospital according to the catalogue of remuneration for the period of the agreement (target : Basis for the budget agreement).
A separate list to submit is for the services of document sections. An extrapolation is allowed for any outstanding data of the current calendar year.
(2) for the template of the actual data of the previous calendar year and the submission of the actual data of the current calendar year, all the columns are to be completed. For the requirement of the agreement period, the columns of 6-7 need not to be filled in 9-11 and 13; for this, only the respective grand totals are appreciated. An extrapolation is allowed for any outstanding data of the current calendar year.
(3) any calculation days during the budget period, regardless of the recording or dismissal.
(4) in the case of tag-related charges the case count according to the following formulaic mapping: (pictures + redundancies): 2. without internal linings. Cases with only for inpatient treatment are not included. Following performance histories in the treatment of patients or patients are counted only as a full stationary case: - interruption of treatment by leave of absence, - recovery of a patient or a patient is only a weekend between the recovery and the previous release, combination of full and partial in-patient treatment - combination of pre -, full -, and after stationary treatment.
An additional count as part of stationary case is not allowed.
For case - and period-related charges, the case count for all captured and sacked patients during the calendar year without excess trailer takes place at the beginning of the year.
(5) case - and period-related charges the assessment ratios of above trailer are assigned to the year in full, discharged the patient or the patient. You are to submit each according to the remuneration catalogue applicable in the respective previous year, i.e. template for the agreement period, the assessment ratios of charge catalogue of this year are for the above trailer to apply.
The representation and agreement of the above trailer does not apply in the year of change in the system.
1)
The establishment is to prepare each separately as follows for the following periods and to submit: - for the past calendar year data according to the ZE catalogue of the past year (target: including determination of final settlements of proceeds), - for the current calendar year extrapolated data according to ZE catalog of the current year (goals: representation of the actual data, as well as determining the provisional revenue offsets), - agreement covering the demand of hospital according to the ZE catalogue for the agreement period (objective : Presentation of the budget agreement).
(2) representation according to the footnotes 4 and 5 of section E1.
1) the installation is to prepare each separately as follows in accordance with the requirements of footnote 2 for the following periods and to submit: - for the past calendar year data according to the agreed fees of the past year (target: including determination of final settlements of proceeds), - for the current calendar year, the extrapolated data according to the agreed fees of the current year (goals: representation of the actual data, as well as determining the provisional revenue offsets) , - for the agreement period requiring the hospital to the required charges for the period of the agreement (target: presentation of the budget agreement).
A separate list to submit is for the services of document sections.
(2) for the template of the actual data of the previous calendar year and the submission of the actual data of the current calendar year, all columns must be completed. For the requirement of the agreement period, the columns 5-6 need not to be filled in 8-10 and 12; for this, only the respective grand totals are appreciated.
3) each separate installation and template for fee agreements under article 6, paragraph 1 or paragraph 2 BPflV. 1) the compensations and corrections shall be disclosed separately on a separate sheet.
(2) revenue budget including the proceeds for patient-related surcharges and discounts.
(3) separation of parent trailer proceeds for case - and period-related charges.
(4) sum of annual cases and all cases with day-related fees (columns 14 section E1).
(1) spin-off of the above trailer proceeds for case - and period-related charges.
(2) the compensations and corrections are having to apply out on a separate sheet.
(3) revenue budget including the proceeds for patient-related surcharges and discounts.
(4) sum of annual cases and all cases with day-related fees (columns 14 section E1).

Annex 1 (for Annex 1) for the performance and costing site site of the original text: Federal Law Gazette 2002 I, 1421 meters Nr beds run end departments *) 1 Psychiatry and psychotherapy 2 child and youth psychiatry and psychotherapy 3 Psychosomatics 4 psychotherapeutic medicine 5 other *) only departments are headed by a professional does not authorize physician with appropriate field name and mainly used for this field.

Appendix 2 (of annex 1) for the performance and costing site (content: not covered table, reference: System band to BGBl. I 1994 no. 67, pp. 45-46;)
regarding the details of the changes see footnote) Annex 3 to the performance and calculation setting up separate passport for foreign patients according to § 3 para 4 site of the original text: Federal Law Gazette I 1997, 2880;
regarding the details of the changes see the services of the hospital and its divisions for foreign patients according to § 3 para 4 footnote are in separate sections "L1" and "L3" to expel, limited to following contents: - item No. No. 4 BT with same-day care sets of 4), - item No. No. 8 occupancy days FP-9 range) - item No. No. 13 Vollstationäre cases with same-day care rates 11) - item No. No. 18 semi-stationary cases with same-day care sets 11a) - item No. No. 19 cases with case packages.