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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Read the untranslated law here: http://www.gesetze-im-internet.de/bpolhfv/BJNR058600014.html

Regulation concerning the granting of medical care for male and female police officers in the Federal Police (Bundespolizei medical care regulation BPolHfV) BPolHfV Ausfertigung date: 22.05.2014 full quotation: "federal police medical care regulation of 22 may 2014 (BGBl. I S. 586), by article 12 of the Act of July 17, 2015 (BGBl. I S. 1368) has been changed" stand: amended by art. 12 G v. 17.7.2015 I in 1368 for more information on the stand number you see in the menu see remarks footnote (+++ text detection from) : 1.7.2014 +++) input formula on the basis of article 70 paragraph 2 sentence 3 of the federal pay law, by article 1, paragraph 31 of the law of 11 June 2013 (BGBl. I p. 1514) is been inserted, prescribed the Federal Ministry of the Interior in consultation with the Federal Ministry of Finance: table of contents chapter 1 General provisions § 1 purpose, responsibility, duty section 2 kind principle § 3 medical care card section 4 services chapter 2 services section 5 medical treatment of legitimate medical care , § 6 have the a general medical care card medical treatment of legitimate medical care, which have no general medical care card section 7 emergency treatment of legitimate medical care, that no general medical care card have section 8 dental § 9 medicaments and dressings § 10 remedies section 11 tools § 12 hospital treatment § 13 organ transplants § 14 article 15 rehabilitation benefits expenses section 16 long-term care article 17 benefits during treatment an official stay abroad article 18 treatment during a private stay in another Member State of the European Union , in another Contracting State to the agreement on the European economic area or Switzerland article 19 treatment during a private stay outside the Member States of the European Union, the other parties to the agreement on the European economic area and Switzerland Chapter 3 final provisions § 20 administrative provisions article 21 entry into force, expiry of Chapter 1 General provisions article 1 purpose, responsibility, obligation to cooperate (1) which has medical care the purpose of the health of the medical care authorized to receive , to restore or improve their health.
(2) the medical care beneficiaries are responsible for their health. You contribute through a health-conscious lifestyle, through early involvement on health precautions, as well as through active participation in treatment and rehabilitation to avoid the entry of illness, disability or infirmity or overcome their consequences.
(3) the treatment includes also the study of or the medical care authorized.
(4) the medical care beneficiaries are obliged to submit medical certificates, medical and diagnostic reports to the medical service of the Federal Police at the request. The medical service of the federal police can cause diagnostic measures, if they are necessary and reasonable for the or the medical care authorized for determining the State of health. The costs are borne by the Federal Government.

§ 2 principle of the kind the medical care is basically as benefits in kind granted. The provisions of the fifth book of the social code shall apply mutatis mutandis for co-payments and limits.

§ 3 medical care card (1) medical care beneficiaries, who are working in an Office without own polizeiärztlichen service, get a medical care card, which is valid for all medical care services according to § 4 paragraph 1 (General medical care card). With the approval of the Federal Ministry of the Interior, other legitimate medical care can receive a general medical care card.
(2) the remaining medical care beneficiaries receive a medical care card, which is valid only for dental treatments.
(3) the medical care beneficiaries have to submit the medical care card prior to treatment to treating contract physician contract dentist or the contract physician or dentist.

§ 4 (1) the medical care includes the following services: 1. Services for the prevention and early detection of diseases, medical benefits and medical care for mothers and fathers according to §§ 20, 20i, 23 to 24 b and 25 of the fifth book of the social code, 2. pregnancy, childbirth and maternity benefits according to the § § 24 c to 24i of the fifth book of social code, 3. services to the artificial insemination according to § 27a of the fifth book of the social code , 4. medical and dental treatment according to article 27 paragraph 1 in connection with the sections 28, 55 and 56 of the fifth book of the social code, 5. supply of medicines and means of association according to § 27 para 1 in conjunction with § 31 of the fifth book of social code, 6 supply of medicines according to § 27 para 1 in conjunction with § 32 and 92 of the fifth book of social code, 7 supply of AIDS according to § 27 para 1 in conjunction with the articles 33 , 36 and 92 of the fifth book of the social code, 8 nursing home care, social therapy, and specialized outpatient palliative care according to § 27 para 1 in conjunction with the §§ 37 to 37 b of the fifth book of social code, 9th home help according to article 27 paragraph 1 in conjunction with § 38 of the fifth book of the social code, 10 hospital treatment as well as inpatient and outpatient hospice services according to article 27 paragraph 1 in connection with the articles 39 and 39a of the fifth book of the social code , 11 benefits for medical rehabilitation, medical rehabilitation for mothers and fathers, as well as complementary services of rehabilitation according to § 27 para 1 in conjunction with the sections 40, 41 and 43 of the fifth book of social code, 12 travel costs according to section 60 of the fifth book of social code, 13 long-term care benefits according to the eleventh book of the social code.
(2) insofar as nothing else is determined in this regulation, the services of medical care comply with the services 1 statutory health insurance after the fifth book of the social code and regulations based on this, rising to the rank and 2 the social long-term care insurance under the eleventh book of the social code.
The services must be adequate, appropriate, and cost-effective; they must not exceed the level of necessary.
(3) in principle, the costs of the services on the basis of the agreements concluded by the spare funds are applied with providers.
(4) the provisions of the fifth book of the social code as well as the limitation-based regulations apply to contract medical and contract dental services within the framework of the freezing order according to section 75, paragraph 3, of the fifth book of the social code, unless this regulation otherwise and no different agreements.
(5) in justified individual cases, the Federal Ministry of the Interior can agree within the framework of its duty of care of a deviation from the guidelines of the German Federal Joint Committee.
Chapter 2 § 5 (1) medical care beneficiaries, which have a general medical care card, have benefits medical treatment by medical care beneficiaries who have a general medical care card to a participating contract medical supply specialist in general practice or specialist in internal medicine or a participating contract medical supply specialist for general practitioner or specialist in internal medicine in claim, or takes over the function of the family doctor or the doctor.
(2) if the treatment requires special knowledge and experience, is it at the behest of the family doctor or the doctor by a doctor participating in the contract-medical care or a participating in the contract-medical care physician, usually a specialist or a specialist.

§ 6 medical treatment by medical care beneficiaries who do not have general medical care card be (1) medical care beneficiaries, who do not have general medical care card, by the competent Polizeiärztin or the competent police doctor.
(2) temporarily not a doctor the police or no doctor of the Federal Police at the disposal is at the place of employment a contract physician or a doctor claims can be taken. That or the party entitled to medical care has the unused doctor or the doctor claimed to know that he or she is nationals who are medical care or medical care authorized member of the federal police and four weeks after the treatment will be enough for a transfer ticket or a cost transfer Declaration of the competent doctor of the federal police or the competent doctor of the Federal Police. That or the party entitled to medical care has to inform the competent doctor of the federal police or the competent doctor of the Federal Police immediately about the illness or the accident.
(3) if the treatment requires special knowledge and experience, she is granted by a doctor participating in the contract-medical care or a participating in the contract-medical care physician, usually a doctor or a specialist, at the instigation of the doctor of the federal police or the physician's federal police.
Footnote § 6, paragraph 2, sentence 3 italics: due to obvious mistake the word "Heilfürsorgeberechtige" was replaced by "Medical care entitled" § 7 emergency treatment of medical care beneficiaries who do not have general medical care card
A Polizeiärztin or a police doctor is not or not timely to reach, sudden serious illness or accidents medical care beneficiaries who do not have general medical care card, can take other seek medical help, until a Polizeiärztin or a police doctor may take more medical support or encourage. Section 4, paragraph 3 shall apply mutatis mutandis.

Article 8 dental care (1) medical care beneficiaries have claim to the actual cost of a rule providing for tooth replacement, dental crowns and prostheses, after article 56, paragraph 1, of the fifth book of the social code. Which or the medical care authorized chooses a beyond primary care equal or different tooth replacement, the double amount of the fixed subsidy will be granted a maximum according to § 55 paragraph 1 sentence 2 of the fifth book of the social code.
(2) the fabrication of Dental restorations (including dental crowns and prostheses), the systematic treatment of periodontal disease and orthodontic treatments require the prior approval of the competent medical care Affairs Unit of the federal police regional headquarters. In case of doubt on the necessity, expediency or economic appropriateness for medical care Affairs Unit of the federal police regional headquarters can by an expert examine the treatment and cost plan. Modifying a licensed medical and cost plan requires also the change of the approval. The approval procedure as well as the expertise and top expert determination, including the forms to be used, follow up spare cash contract dentists by January 1, 2005, in the most recent which the Internet site of the Association of top federal of health insurance fund (www.gkv-spitzenverband.de) version published.
(3) the costs of an once a year carried out by professional tooth cleaning after number 1040 of the plant to the fee schedule for dentists are covered.

§ 9 medicaments and dressings (1) the details of the supply of the medical care beneficiaries with medication and Association resources regulates the pharmaceutical supply agreement between the Federal Republic of Germany and the Deutsche Apothekerverband E.v. by October 1, 2011, in the most recent version published in the Federal Gazette.
(2) the supply of medicines and Association resources in closed use remain unaffected.

§ 10 cure the cost of cure are according to the of the spare funds after the fifth book social law adopted agreements with providers, unless you have a doctor's prescription after the remedies directive of the joint Federal Committee in its most recent version published on the Internet site of the German Federal Joint Committee (www.g-ba.de) and approved providers under the fifth book of social law claim made.

§ 11 means (1) to the supply of AIDS according to the articles 33 and 36 of the fifth book of the social code can close for medical care Affairs Unit of the federal police regional headquarters with the rental, leasing providers or similar contracts. The contract referred to in article 9 paragraph 1 regulates the supply of AIDS through pharmacies.
(2) the assumption of costs is made according to the agreements reached by the spare funds after the fifth book of the social code with care providers. In the procurement of equipment, the fixed amount regulations existing for the assumption of costs apply pursuant to section 36 of the fifth book of the social code. Existing supply contracts are to take.
(3) the entitlement to medical care falls away, the still needed aid in the property go over which or the former medical care entitled. AIDS from contracts are referred to in paragraph 1 sentence 1 to return the service provider, if the entitlement to medical care.

§ To take 12 hospital treatment (1) that hospital treatment is generally on the service or the place of residence or close to complete.
(2) medical care beneficiaries are entitled to the General Hospital services the hospital fee Act and of the Federal care rate regulation, as well as on services above and beyond and to be charged separately: 1. accommodation, which costs; not more than the cost of a twin room yet have a deductible amounting to 14.50 euros per day and 2nd choice medical services to pay legitimate medical care.
(3) in especially serious diseases as well as expected prolonged inpatient treatment medical care authorized with the consent of the competent doctor of the federal police or the competent doctor of the Federal Police in an approved hospital (section 108 of the fifth book of the social code) of the place of residence or in the vicinity of the place of residence can be admitted or moved, if this serves the healing process or improving the service.

§ 13 organ transplants with organ and tissue transplants are applied also the necessary and economically reasonable expenses of the donor or the donor, including insurance costs and the proven failure of labour income, in appropriate application of the provisions of the Federal aid regulation, insofar as these costs are not covered by the other side. The proven failure of work income is applied even if the intended donor or the intended donor ultimately not taken into consideration.

§ 14 (1) rehabilitation benefits medical rehabilitation benefits are granted according to § 40 of the fifth book of the social code after medical assessment.
(2) medical rehabilitation benefits cover outpatient and inpatient treatment in rehabilitation centres or other medically managed facilities, with which a supply contract is § 111 and 111a of the fifth book of the social code under the section.
(3) medical care authorized are entitled to benefits for medical rehabilitation according to article 40, paragraph 1, of the fifth book of the social code, if the direct connection of rehabilitation at a hospital treatment is necessary after medical assessment. The agreement of the Federal Ministry of the Interior with the German pension insurance is Covenant to carry out following medical treatment for police Landespolizei / police officers of the Federal Police in AHB facilities of the German pension insurance from 1 January 2007 in their currently valid version published in the Federal Gazette apply mutatis mutandis.
(4) the costs for family or relatives seminars in therapeutic facilities be applied insofar as these costs are not already satisfied with the overall care rate. Travel costs for members are applied up to the amount of the cost of trips in the lowest class of carriage scheduled transport.
(5) in the last twelve months prior to the termination of the period of service due to reaching the age limit for entry into the retirement benefits for medical rehabilitation, which are used to maintain the service of, not be granted.
(6) the rehabilitation benefits are to apply in writing before the start of the action in the competent medical care Affairs Unit of the federal police regional headquarters.

§ 15 travel costs (1) travel costs for medical transportation are applied according to the medical guidelines of the German Federal Joint Committee in the recent version published on the Internet site of the German Federal Joint Committee (www.g-ba.de). This also applies ambulance services with vehicles of the Federal Police. 1 medical care for beneficiaries decides on grant approval pursuant to § 9 of ambulance guidelines, have the a general medical care card, for medical care Affairs Unit of the Federal Police Headquarters, 2. medical care for beneficiaries, who do not have general medical care card, the competent doctor of the federal police or the doctor of the Federal Police.
(2) you are by provincial or municipal law or the treaties of Association's members the replacement Fund e. V. with the makers of rescue and ambulance services laid charges.

§ 16 long-term care benefits (1) medical care beneficiaries receive the benefits referred to in the eleventh book of the social code in half.
(2) the services are to apply in writing the competent medical care Affairs Unit of the federal police regional headquarters. The decisions of the maintenance fund or of the private insurance company about the detected level of care, as well as the scope and the level of benefits of long-term care insurance to be attached are the application.

§ 17 treatment during an official stay abroad (1) diseases during an official stay abroad the necessary and economically reasonable disease-related expenses are applied. If not compelling reasons for oppose, only providers claim are allowed, which charge local payments.
(2) medical care authorized have in writing to apply for the reimbursement of costs at the unit of the federal police regional headquarters for medical care matters; Bank details must be given. The application shall be accompanied by: 1. original documents (invoice with diagnosis, regulation), 2. where appropriate, copies of the medical reports with German translation and 3, if necessary, proof of the conversion rate of the foreign currency on the day of payment.
The cost of translations pursuant to sentence be applied 2 number 2.

§ 18 treatment during a private stay in another Member State of the European Union, in another Contracting State to the agreement on the European economic area or of Switzerland (1) during a private stay in another Member State of the European Union, in another Contracting State to the agreement on the European economic area or in the Switzerland only such providers claim may be carried , 1 where the conditions of access and the exercise of the profession are subject of a directive of the European Union or 2 who are authorized in the health insurance of of country of residence for the supply of insured system.
(2) the costs of treatment are up to the height where they were taken, when a disease on the service or the place of residence in Germany and the use of a participating contract medical supply medical or a physician participating in the contract-medical care or a licensed hospital, taking into account created for the Federal Police of force invoicing.
(3) a stationary treatment requires the prior approval of the competent medical care Affairs Unit of the federal police regional headquarters. The approval shall only be granted if a recognised State of medical knowledge treatment at home is not possible.
(4) § 17 paragraph 2 applies subject to the proviso, that translation costs are not covered.

§ 19 treatment during a private stay outside the Member States of the European Union, the other parties to the agreement on the European economic area and Switzerland (1) the cost of treatment immediately necessary during a private stay outside the Member States of the European Union, the other parties to the agreement on the European economic area and of Switzerland are applied up to the amount of them when a disease on the service or the place of residence in Germany and the use of a participating contract medical supply Doctor or a physician participating in the contract-medical care or a licensed hospital would have been created taking into account the invoicing for the federal police force.
(2) a stationary treatment requires the prior approval of the Federal Ministry of the Interior. Article 18, paragraph 3, sentence 2 shall apply accordingly.
(3) § 17 paragraph 2 applies subject to the proviso, that translation costs are not covered.
Chapter 3 final provisions § 20 regulations the Federal Ministry of the Interior shall issue an administrative action for the application of this regulation.

Article 21 entry into force, termination (1) this regulation enters into force on 1 July 2014.
(2) at the same time the medical care provisions for the federal police force of the 6th November 2005 (GMBl p. 1228) override enter.