Regulation Concerning The Granting Of Medical Care For Male And Female Police Officers In The Federal Police

Original Language Title: Verordnung über die Gewährung von Heilfürsorge für Polizeivollzugsbeamtinnen und Polizeivollzugsbeamte in der Bundespolizei

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Regulation on the granting of curative care for law enforcement officers and police officers in the Federal Police (Bundespolice-Heilfürcustody Ordinance-BPolHfV)

Non-official Table of Contents

BPolHfV

Date of delivery: 22.05.2014

Full quote:

" Federal Police Health Care Ordinance of 22 April 2014. May 2014 (BGBl. 586), as defined by Article 12 of the Law of 17. July 2015 (BGBl. I p. 1368) has been amended "

:Modified by Art. 12 G v. 17.7.2015 I 1368

See Notes

Footnote

(+ + + Text Evidence: 1.7.2014 + + +)

Non-Official Table of Contents

Inbox Formula

Based on Section 70 (2) sentence 3 of the Federal Law on Bespoking, which is defined by Article 1 (31) of the Law of 11. June 2013 (BGBl. I p. 1514), the Federal Ministry of the Interior, in agreement with the Federal Ministry of Finance, is ordering: Table of Contents

Content Overview

Chapter 1General
§ 1Purpose, Responsibility, Compaction obligation
§ 2Performance principle
§ 3 Health care card
§ 4Benefits
2Services
§ 5Medical treatment of health care authorized persons who have a general health care card
§ 6 Medical treatment of health-care persons who do not have a general health care card
§ 7 Emergency treatment of health-care workers who do not have a general health care card
§ 8Dental health care Treatment
§ 9Arznei-und Verbandmittel
§ 10 Heilmittel
§ 11Tools
§ 12 Hospital Treatment
§ 13Organ transplants
§ 14 Benefits for rehabilitation
§ 15Driving costs
§ 16 Services in need of care
§ 17Treatment during a service stay in the Abroad
§ 18Treatment during a private stay in another Member State of the European Union, in another Contracting State of the European Union Agreement on the European Economic Area or in Switzerland
§ 19Treatment during a private stay outside of the Member States of the European Union, of the other States Parties to the Agreement on the European Economic Area and Switzerland
3Final provisions
§ 20administrative rule
§ 21Entry into force,

Chapter 1
General Rules

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§ 1 Purpose, Personal responsibility, duty of participation

(1) Health care has the purpose of maintaining, restoring, or improving the health of the health-care beneficiaries.(2) The persons entitled to health care shall be responsible for their health. They are intended to contribute to the onset of illness, disability or disability by means of a health-conscious lifestyle, early involvement in preventive health care measures and active participation in medical treatment and rehabilitation. To avoid the need for care or to overcome its consequences.(3) The treatment shall include the examination of the person entitled to health care or the person entitled to health care.(4) The persons entitled to health care are obliged to submit to the Medical Service of the Federal Police, upon request, medical certificates, medical reports and reports of medical findings. The medical service of the Federal Police can arrange for diagnostic measures if these are necessary for the determination of the state of health and are reasonable for those who are entitled to health care or health care. The costs are borne by the federal government. Non-official table of contents

§ 2 Principality of benefits

The health care is generally granted as a material benefit. The regulations of the Fifth Book of Social Code apply accordingly for payments and charges. Non-official table of contents

§ 3 Health care card

(1) Health-care workers who work in a service without their own police medical service , are granted a health care card, which applies to all health care services in accordance with § 4 (1) (general health care card). With the approval of the Federal Ministry of the Interior, other health-care persons can also receive a general health care card.(2) The other persons entitled to health care receive a health care card, which applies only to dental treatments.(3) The persons entitled to health care shall submit the health care card to the treating physician or contract dentist or to the attending physician or contract dentist before the treatment. Non-official table of contents

§ 4 Services

(1) Health care includes the following benefits:
1.
Services for the prevention and early detection of diseases, medical care and medical care for mothers and fathers according to § § 20, 20i, 23 to 24b and 25 of the Fifth Book of the Social Code,
2.
Services in pregnancy, birth and maternity, in accordance with § § 24c to 24i of the Fifth Book Social Code,
3.
Benefits for artificial insemination in accordance with § 27a of the Fifth Book of the Social Code,
4.
Medical and dental treatment in accordance with § 27, paragraph 1, in conjunction with § § 28, 55 and 56 of the Fifth Book of Social Code,
5.
Supply of medical and association funds in accordance with § 27, paragraph 1, in conjunction with § 31 of the Fifth Book of Social Code,
6.
Supply of remedies in accordance with § 27, paragraph 1, in conjunction with § § 32 and 92 of the Fifth Book of Social Code,
7.
Supply of aid in accordance with § 27, paragraph 1, in conjunction with § § 33, 36 and 92 of the Fifth Book of Social Code,
8.
Home nursing, sociotherapy and specialized outpatient palliative care in accordance with § 27 paragraph 1 in conjunction with § § 37 to 37b of the Fifth Book Social Code,
9.
Household aid in accordance with § 27, paragraph 1, in conjunction with § 38 of the Fifth Book of the Social Code,
10.
Hospital treatment as well as in-patient and outpatient hospice services in accordance with § 27 paragraph 1 in conjunction with § § 39 and 39a of the Fifth Book Social Code,
11.
Services for medical rehabilitation, medical rehabilitation for mothers and fathers, as well as supplementary benefits for rehabilitation In accordance with § 27 (1) in conjunction with § § 40, 41 and 43 of the Fifth Book of the Social Code,
12.
Travel expenses in accordance with § 60 of the Fifth Book Social Code,
13.
Benefits in the case of need for care in accordance with the Eleventh Book of Social Code.
(2) Unless otherwise specified in this Regulation , the benefits of health care are equivalent to the benefits
1.
of the statutory health insurance according to the Fifth Book of Social Code and the following based on the in the ranking regulations as well as
2.
of the social care insurance according to the Eleventh Book of Social Code.
The benefits must be sufficient, appropriate and They shall not exceed the level of the necessary.(3) In principle, the costs of the services shall be borne on the basis of the agreements concluded with the service providers by the replacement funds.(4) The provisions of the Fifth Book of Social Code as well as the provisions of the Fifth Book of the Social Code shall apply to contractual and contractual dental services within the scope of the order for the protection of the contract in accordance with Section 75 (3) of the Fifth Book of Social Code. Rules to the extent that this Regulation does not specify otherwise and shall not be subject to different agreements.(5) In substantiated individual cases, the Federal Ministry of the Interior may agree to a derogation from the guidelines of the Joint Federal Committee within the framework of its duty of care.

Chapter 2
Services

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§ 5 Medical treatment of health-care workers, who have a general health care card

(1) Health care entitled persons who have a general health care card, have a medical specialist for general medicine or a medical specialist for internal medicine or one at the To take care of a general practitioner or a specialist in internal medicine who is responsible for the function of the general practitioner or the general practitioner.(2) In so far as the treatment requires special knowledge and experience, it shall be carried out on the initiative of the general practising physician or the family doctor by a physician participating in the contract medical care or by a physician in the contract medical care. a doctor, usually a specialist, or a specialist. Non-official table of contents

§ 6 Medical treatment of health-care workers who do not have a general health care card

(1) Persons entitled to health care who do not have a general health care card shall be treated by the responsible police doctor or by the appropriate police doctor.(2) If a doctor of the Federal Police is temporarily not available at the place of employment or a doctor of the Federal Police, a contract doctor or a contract doctor may be used. The person entitled to health care has the right to inform the doctor or the physician that he or she is a member of the federal police, and that he or she is a member of the federal police, who is entitled to health care, and that he or she is entitled to health care. will submit a transfer note or a statement of costs within four weeks after the treatment of the competent doctor of the Federal Police or of the competent medical doctor of the Federal Police. The person responsible for health care has to inform the competent doctor of the Federal Police or the competent medical officer of the Federal Police immediately of the illness or the accident.(3) In so far as the treatment requires special knowledge and experience, it shall be provided by the doctor of the Federal Police or the physician of the Federal Police by a physician who is participating in the contract medical care or by a doctor who is responsible for the treatment.

6 para.

sentence 3 italic pressure: Due to obvious inaccuracy, the word "health care calculator" has been given by a doctor or a specialist doctor. "Health-care entitled" replaces unofficial table of contents

§ 7 Emergency treatment of health-care workers, who do not have a general health care card

a police doctor or a police doctor is not or not to be reached in due time in case of a sudden serious illness or in the event of an accident, persons entitled to health care who do not have a general health care card may not be able to reach a doctor or a police doctor in good time. medical assistance, until a police doctor or a police officer can take over or arrange for further medical care. Section 4 (3) shall apply accordingly. Non-official table of contents

§ 8 Dental treatment

(1) Health-care workers are entitled to take over the actual costs of a Regular supply of dental prosserts, including dental crowns and supraconstructions, in accordance with § 56 (1) of the Fifth Book of Social Code. If the person entitled to health care elects a similar or other type of dental prosthesis beyond the provision of a regular service, the amount of the fixed grant shall not exceed twice the amount of the fixed grant in accordance with the second sentence of § 55 (1) sentence 2 of the Fifth Book of Social Code.(2) The preparation of dental prosthetics (including dental crowns and supraconstructions), the systematic treatment of periodontopathies and orthodontic treatments require the prior approval of the treatment of medicinal products for the treatment of medicinal products. Responsible unit of the Federal Police Bureau. In case of doubt as to the necessity, appropriateness or economic appropriateness, the department of the Federal Police Bureau responsible for health care matters can have the marriage and cost plan verified by a reviewer. If an approved salvation and cost plan is changed, the change of approval is also required. The approval procedure as well as the expert and expert review procedure, including the forms to be used, shall be based on the replacement of the contract dentist of 1. January 2005, in the latest version published on the website of the Association of the Federal Government of the Health Insurance Funds (www.gkv-spitzenverband.de).(3) The costs of a professional dental cleaning carried out once a year in accordance with point 1040 of the Appendix to the Fees Regulations for Dentists shall be taken over. Non-official table of contents

§ 9 Medicine and association equipment

(1) Details of the health care of the health-care workers with a doctor's and The pharmaceutical supply contract between the Federal Republic of Germany and the German Pharmacists ' Association (Deutsches Apothekerverband e. V. of 1. October 2011, in the latest version published in the Federal Gazette.(2) The supply of medical and bandage means in closed use shall remain unaffected. A non-official table of contents

§ 10 remedies

The cost of medicines will be reimbursed according to the costs of the replacement funds according to the Fifth Book Social Code adopted with the service providers, provided that a medical prescription according to the Remedies Directive of the Joint Federal Committee in its latest on the Internet site of the Joint Committee The Federal Committee of the European Union (www.g-ba.de) has published a published version of the Fifth Book of Social Code and has been approved by the Federal Committee of the European Union (www.g-ba.de). Non-official table of contents

§ 11 Tools

(1) For the provision of assistance in accordance with § § 33 and 36 of the Fifth Book of the Social Code The department of the Federal Police Bureau responsible for health care matters can conclude leasing, leasing or similar contracts with the service providers. The supply of aid by pharmacies shall be governed by the contract referred to in Article 9 (1).(2) The assumption of costs shall take place in accordance with the agreements concluded with the service providers in accordance with the Fifth Book of Social Law. In the case of the procurement of auxiliary funds, the fixed amount schemes for the acquisition of costs shall apply in accordance with § 36 of the Fifth Book of Social Code. Existing supply contracts are to be used.(3) If the right to health care is to be taken away, the resources that continue to be required shall be covered by the property of the former health-care agent or the former health-care-authorized person. Aid from contracts referred to in the first sentence of paragraph 1 shall be returned to the service provider if the right to health care has been taken away. Non-official table of contents

§ 12 Hospital treatment

(1) The hospital treatment is usually at the service or place of residence or in the vicinity of the hospital. Claim to be taken.(2) Health-care beneficiaries shall be entitled to the general hospital benefits under the Hospital Charges Act and the Federal Order of Care Ordinance, as well as to the following benefits to be calculated separately and separately:
1.
Accommodation, the cost of which must not exceed the cost of a two-bed room; in this case, health-care persons have to pay an own share of 14,50 euros per day, and
2.
True performance.
(3) In the case of particularly serious diseases and in the case of a steady-state treatment that is likely to be prolonged for a longer period of time, Persons entitled to health care with the consent of the competent doctor of the Federal Police or the competent doctor of the Federal Police to an approved hospital (§ 108 of the Fifth Book of Social Code) in the place of residence or close to the place of residence or be transferred if this serves the healing process or the improvement of the care. Non-official table of contents

§ 13 Organ transplants

In case of organ and tissue transplants, the rules of the Federal aid regulation also takes over the necessary and economically reasonable expenses of the donor or the donor, including the insurance costs and the proven failure to work income, insofar as these expenses are will not be taken over by the other side. The proven loss of work income will also be assumed if the donor or donor provided is ultimately not eligible. Non-official table of contents

§ 14 Benefits for Rehabilitation

(1) Medical rehabilitation benefits will be provided in accordance with § 40 of the Fifth The Book of Social Code is granted after medical examination.(2) Services for medical rehabilitation include outpatient and inpatient treatment in rehabilitation facilities or in other medically-led facilities with which a supply contract is made in accordance with § § 111 and 111a of the Fifth Book Social Code.(3) Health-care beneficiaries shall be entitled to medical rehabilitation services in accordance with § 40 (1) of the Fifth Book of Social Code, if the immediate connection of rehabilitation to hospital treatment according to medical Determination is necessary. The agreement of the Federal Ministry of the Interior with the German Pension Insurance Association for the implementation of follow-up treatment for police officers of the police officers of the Federal Police in AHB-facilities of the German Federal Republic of Germany Pension insurance from 1. January 2007 in its current version published in the Federal Gazette (Bundesanzeiger) is to be applied accordingly.(4) The costs of family or family seminars in therapeutic institutions shall be borne in so far as these costs are not already covered by the general care set. Travel expenses for the family members shall be borne by regular transport means up to the level of the cost of journeys in the lowest transport class.(5) In the last twelve months before the end of the period of service on account of reaching the retirement age limit for retirement, medical rehabilitation services which serve to maintain the service capacity are not granted.(6) Services for rehabilitation are to be requested in writing before the beginning of the measure at the department of the Federal Police Presidium responsible for health care matters. Non-official table of contents

§ 15 Driving costs

(1) Travel costs for health care services will be provided in accordance with the health insurance policies of the Joint Federal Committee in the latest version published on the website of the Joint Federal Committee (www.g-ba.de). This also applies to ambulances with vehicles of the Federal Police.
1.
in the case of health-care authorised persons who have a general health care card shall decide on the granting of the authorisation in accordance with § 9 of the German Health Insurance Directives. the Office of the Federal Police Presidium responsible for health care matters,
2.
in the case of health-care authorised persons who do not have a general health care card, which The competent doctor of the Federal Police or the competent doctor of the Federal Police.
(2) The members of the Association of Replacement Banks are taken over by national or local law or in the contracts of the members of the Association of Replacement Banks. V. the charges laid down with the carriers of the rescue and ambulance services. Non-official table of contents

§ 16 Benefits in the case of need for care

(1) Health care entitled to receive the Social Code Book of the Eleventh Book of Social Security Services half-way.(2) The services are to be submitted in writing to the department of the Federal Police Bureau responsible for health care matters. The application shall be accompanied by the foes of the caregivers or the private insurance undertaking concerning the level of care established, as well as the extent and amount of the benefits provided by the nursing care insurance. Non-official table of contents

§ 17 Treatment during a service stay abroad

(1) In case of illness during a service The necessary and economically appropriate expenditure on sickness is taken over in foreign countries. If there are no compelling reasons, only service providers may be used to calculate the usual remuneration.(2) In the case of the Office of the Federal Police Presidium responsible for health care matters, health-care persons have to apply for reimbursement in writing; a bank connection must be provided. The application must be accompanied by the following:
1.
Original receipts (invoice with diagnosis, regulation),
2.
If necessary, copies of the doctor's reports with German translation and
3.
if necessary, proof of the Exchange rate of the foreign currency on the day of payment.
The cost of translations in accordance with the second sentence of the second paragraph shall be taken over. Non-official table of contents

§ 18 Treatment during a private stay in another Member State of the European Union, in another Member State State Party to the Agreement on the European Economic Area or in Switzerland

(1) During a private stay in another Member State of the European Union, in another State Party to the Agreement on the European Economic Area Only such service providers may be used in the economic area or in Switzerland,
1.
in which the conditions of access and exercise of the -are the subject of a European Union directive or
2.
which are covered by the health insurance scheme of the country of residence for the purpose of supplying the insured persons
(2) The costs of a treatment shall be taken up to the extent to which they are incurred in the event of illness at the place of service or residence in the country and the use of a doctor who is participating in the contract medical care, or a doctor or hospital approved at the contract medical service, having regard to the accounting procedures applicable to the Federal Police.(3) Stationary treatment is subject to prior approval by the Office of the Federal Police Bureau responsible for health care matters. The authorisation shall be granted only if it is not possible to treat it at home in the recognised state of medical knowledge.(4) Paragraph 17 (2) shall apply with the proviso that translation costs shall not be taken over. Non-official table of contents

§ 19 Treatment during a private stay outside of the Member States of the European Union, the other States Parties to the Agreement on the European Economic Area and Switzerland

(1) The costs of a private stay outside the Member States of the European Union, the other States Parties to the Convention on the The European Economic Area and Switzerland shall be treated without delay up to the level in which they are treated in the event of illness at the place of service or residence in the territory of the country and the use of one of the services provided for in the contract medical service A participating doctor or a physician or an approved hospital participating in the contract medical care would have been created, taking into account the accounting procedures applicable to the Federal Police.(2) Stationary treatment requires the prior consent of the Federal Ministry of the Interior. The second sentence of Article 18 (3) shall apply accordingly.(3) Paragraph 17 (2) shall apply with the proviso that translation costs shall not be taken over.

Chapter 3
Final provisions

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§ 20 Administrative Regulation

The Federal Ministry of the Interior shall adopt an administrative provision for the implementation of this Regulation. Non-official table of contents

§ 21 Entry into force, expiry

(1) This Regulation occurs on the 1. July 2014 will be in force.(2) At the same time, the provisions on health care for the Federal Police of 6. November 2005 (GMBl p. 1228).