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

Unofficial table of contents

BPolHfV

Date of completion: 22.05.2014

Full quote:

" Federal Police Health Care Ordinance of 22 May 2014 (BGBl. 586), which are provided by Article 12 of the Law of 17 July 2015 (BGBl. I p. 1368).

Status: Amended by Art. 12 G v. 17.7.2015 I 1368

For more details, please refer to the menu under Notes

Footnote

(+ + + Text evidence from: 1.7.2014 + + +) 

Unofficial table of contents

Input formula

Pursuant to Section 70 (2) sentence 3 of the Bundesbesoldungsgesetz (Bundesbesoldungsgesetz), 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: Unofficial table of contents

Content Summary

Chapter 1General provisions
§ 1 Purpose, personal responsibility, obligation to participate
§ 2 Objective principle
§ 3 Curative care card
§ 4 Benefits
Chapter 2Benefits
§ 5 Medical treatment of persons entitled to health care who have a general health care card
§ 6 Medical treatment of those who are entitled to health care 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
§ 8 Dental treatment
§ 9 Medicine and bandage
§ 10 Remedies
§ 11 Aids
§ 12 Hospital treatment
§ 13 Organ transplants
§ 14 Benefits for rehabilitation
§ 15 Travel expenses
§ 16 Benefits in the case of need for care
§ 17 Treatment during an official stay abroad
§ 18 Treatment during a private stay in another Member State of the European Union, in another Contracting State of the Agreement on the European Economic Area or in Switzerland
§ 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
Chapter 3Final provisions
§ 20 Administrative provision
Section 21 Entry into force, external force

Chapter 1
General provisions

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§ 1 Purpose, personal responsibility, obligation to participate

(1) The purpose of health care is to restore, restore or improve the health of the health-care workers. (2) The health-care workers are jointly responsible for their health. They are intended to contribute to the onset of illness, disability, through a health-conscious lifestyle, early involvement in preventive health care, and active participation in medical treatment and rehabilitation. (3) The treatment also includes the examination of the person who is entitled to health care. (4) The persons entitled to health care are obliged to provide the medical service of the Federal Police to the Require medical certificates, doctor's and findings reports . 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. Unofficial table of contents

§ 2 Principals of benefits

Health care is generally granted in kind. The regulations of the Fifth Book of Social Code apply accordingly for payments and charges. Unofficial table of contents

§ 3 Heilfürsorgekarte

(1) Health-care workers who work in a service without their own police service receive 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 remaining health-care persons receive a health care card, which is only for dental treatments (3) The health care authorities shall submit the health care card to the treating physician or contract dentist, or to the attending physician or contract dentist, before the treatment. Unofficial table of contents

§ 4 Benefits

(1) Health care includes the following services:
1.
Services for the prevention and early detection of diseases, medical care and medical care for mothers and fathers in accordance with § § 20, 20i, 23 to 24b and 25 of the Fifth Book of the Social Code,
2.
Benefits in the event of pregnancy, birth and motherhood in accordance with § § 24c to 24i of the Fifth Book of the 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 (1) in conjunction with § § 28, 55 and 56 of the Fifth Book of the Social Code,
5.
Provision of medical and association funds in accordance with § 27 (1) in conjunction with Section 31 of the Fifth Book of the Social Code,
6.
Provision of a cure in accordance with § 27 (1) in conjunction with § § 32 and 92 of the Fifth Book of Social Code,
7.
Provision of assistance in accordance with § 27 (1) in conjunction with § § 33, 36 and 92 of the Fifth Book of the 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 of Social Code,
9.
Budgetary assistance in accordance with § 27 (1) in conjunction with Section 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 (1) in conjunction with § § 39 and 39a of the Fifth Book of the Social Code,
11.
Medical rehabilitation services, 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 Social Code,
12.
Travel expenses in accordance with § 60 of the Fifth Book of the Social Code,
13.
Benefits in the case of need for care in accordance with the Eleventh Book of Social Code.
(2) Unless otherwise provided in this Regulation, the benefits of medical care shall be in accordance with the benefits of
1.
statutory health insurance in accordance with the Fifth Book of the Social Code and the subsequent regulations based on this, as well as the following regulations:
2.
of social care insurance in accordance with the Eleventh Book of Social Security.
The benefits must be sufficient, practical and economic; they must not exceed the level of the necessary. (3) In principle, the costs of the benefits shall be based on the agreements concluded by the replacement funds with the (4) The provisions of the Fifth Book of Social Code shall apply to contract medical and contract dental services in the context of the order for the protection of the contract pursuant to Section 75 (3) of the Fifth Book of Social Code. the rules based on this Regulation, in so far as this Regulation is not (5) In duly 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 to ensure the provision of a derogation.

Chapter 2
Benefits

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§ 5 Medical treatment of persons entitled to health care who have a general health care card

(1) Health-care workers who have a general health care card, have a medical specialist for general medical practice or a specialist in internal medicine or one of the contract medical care provided by the contract physician. (2) In so far as the treatment requires special knowledge and experience, it is necessary to take care of the general practitioner or the specialist in internal medicine who is responsible for the function of the general practitioner or the family doctor. on the initiative of the family doctor or the family doctor, by means of a contract medical care participating doctor or a doctor attending the contract medical care, usually a medical specialist or a specialist. Unofficial table of contents

§ 6 Medical treatment of persons entitled to health care who do not have a general health care card

(1) Health-care persons who do not have a general health care card shall be treated by the responsible police doctor or the competent police doctor. (2) No medical doctor from the Federal Police or a doctor of the Federal Police shall be temporarily at the place of employment. Federal police, a contract doctor or a contract doctor can be used. The person entitled to health care has the right to inform the doctor or 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/she is a member of the federal police. 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 medical doctor of the Federal Police or the competent medical doctor of the Federal Police immediately of the illness or accident. (3) Insofar as the treatment has special knowledge and experience , on the initiative of the doctor of the Federal Police or of the physician of the Federal Police, she shall, as a rule, be a doctor attending the contract medical care or a physician participating in the contract medical care. Medical specialist or a specialist doctor.

Footnote

§ 6 para. 2 sentence 3 italic pressure: Due to obvious incorrectness, the word "medical care entitled" has been replaced by "health-care entitled" Unofficial table of contents

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

In the event of a sudden serious illness or accident, if a police doctor or a police doctor is not or not to be reached in time, health-care authorised persons who do not have a general health care card may provide other medical assistance in Take the right until a police doctor or a police doctor can take over or arrange for further medical care. Section 4 (3) shall apply accordingly. Unofficial table of contents

§ 8 Dental treatment

(1) Heilfuerbeneficiaries shall be entitled to take over the actual costs of a regular supply of dental prosthetics, including dental crowns and supraconstructions, in accordance with Section 56 (1) of the Fifth Book of Social Code. If the person entitled to health care elects a similar or other type of payment which goes beyond the provision of the regular pension, the amount of the fixed grant shall not exceed twice the amount of the fixed grant pursuant to section 55, paragraph 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 shall require the prior approval of the Department of the Federal Police Presidium responsible for health care matters. 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 and the expert and expert review procedure, including the forms to be used, shall be based on the replacement of the contract dentist on 1 January 2005, in the latest on the website of the Top Association of the Health Insurance Funds (www.gkv-spitzenverband.de). (3) The costs of a professional dental cleaning carried out once a year according to number 1040 of the system of fees regulations for dentists are taken over. Unofficial table of contents

§ 9 Medicine and association means

(1) The arrangements for the supply of medicinal products for health care with medicinal products and other means of association shall be laid down in the contract for the supply of medicinal products 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 German Federal Gazette (Bundesanzeiger). (2) The supply of medical and bandage means in closed use remains unaffected. Unofficial table of contents

§ 10 remedies

The costs of remedies shall be reimbursed in accordance with the agreements concluded by the replacement funds in accordance with the Fifth Book of the Social Code, provided that a medical prescription is provided for in accordance with the medicinal product directive of the Joint Federal Committee, in its latest version published on the website of the Joint Federal Committee (www.g-ba.de), and authorised service providers according to the Fifth Book of the Social Code . Unofficial table of contents

§ 11 Aids

(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 be provided with the service providers Miet, Leasing or similar Close contracts. The supply of aid by pharmacies shall be governed by the contract referred to in Article 9 (1). (2) The costs shall be taken over in accordance with the agreements concluded by the replacement funds in accordance with the Fifth Book of Social Code. Performers. 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 tools that continue to be required shall pass into 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. Unofficial table of contents

§ 12 Hospital treatment

(1) The hospital treatment is usually to be used at the place of service or residence or in the vicinity of it. (2) Health care entitled persons are entitled to the general hospital benefits according to the hospital pay law and the hospital Federal maintenance regulations and the following services, which are to be calculated separately and separately:
1.
Accommodation, the costs of which may not exceed the cost of a two-bed room; in so doing, health-care persons have to pay an equity of 14.50 euros per day, and
2.
Real-life services.
(3) In the case of particularly serious diseases and in the case of hospitalised treatment which is likely to be prolonged for a longer period of time, health-care persons may, with the consent of the competent doctor of the Federal Police or the competent medical doctor of the Federal Police, into a authorized hospital (§ 108 of the Fifth Book of the Social Code) at the place of residence or close to the place of residence, if this serves the healing process or the improvement of the care. Unofficial table of contents

§ 13 Organ transplants

In the case of organ and tissue transplants, the necessary and economically reasonable expenses of the donor, including the donor, will also be provided in accordance with the provisions of the German Federal Aid Regulation. Insurance costs and the proven failure to pay for work income, provided that such expenses are not taken over by other sources. The proven loss of work income will also be assumed if the donor or donor provided is ultimately not eligible. Unofficial table of contents

§ 14 Benefits for Rehabilitation

(1) Services for medical rehabilitation are granted in accordance with § 40 of the Fifth Book of Social Code after medical examination. (2) Services for medical rehabilitation include outpatient and inpatient treatment in Rehabilitation centres or other medically managed institutions with which there is a supply contract in accordance with § § 111 and 111a of the Fifth Book of the Social Code. (3) Health-care entitled persons shall be entitled to benefits for the benefit of the Medical rehabilitation according to § 40 (1) of the Fifth Book Social code, if the immediate connection of rehabilitation to hospital treatment is necessary after medical determination. 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 of 1 January 2007, as published in the German Federal Gazette (Bundesanzeiger), must be applied accordingly. (4) The costs for family or family seminars in therapeutic institutions shall be taken over as far as these Costs are not already covered with the general care set. Travel expenses for relatives shall be borne by regular transport means up to the level of the cost of journeys in the lowest class of transport. (5) In the last twelve months before the end of the period of service on the basis of the achievement of the The age limit for retirement will not be granted to medical rehabilitation services which serve to maintain the service's capacity. (6) Rehabilitation benefits shall be provided before the start of the measure in the case of: Health-care affairs department of the Federal Police Bureau in writing to apply. Unofficial table of contents

§ 15 Driving costs

(1) The costs of transport for the sick are taken over in accordance with the health-transport guidelines 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. Deciding on the granting of the authorisation in accordance with § 9 of the Ambulance Transport Directives
1.
in the case of those who are entitled to health care, who have a general health care card, the department of the Federal Police Bureau responsible for medical care matters,
2.
for those who are entitled to health care, who do not have a general health care card, the competent doctor of the Federal Police or the competent doctor of the Federal Police.
(2) The members of the Association of Replacement Banks shall be covered by local or local law or in the contracts of the members of the Association of Replacement Funds. V. the charges laid down with the carriers of the rescue and ambulance services. Unofficial table of contents

§ 16 Benefits in the case of need for care

(1) Healing persons receive half of the benefits referred to in the Eleventh Book of Social Code. (2) The services are to be submitted in writing to the department of the Federal Police Presidium responsible for health care matters. The application shall be accompanied by the caregivers 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. Unofficial table of contents

§ 17 Treatment during a service stay abroad

(1) In the case of illness during an official stay abroad, the necessary and economically appropriate expenses incurred by illness are taken over. In the event that there are no compelling reasons, only service providers may be used to calculate the usual remuneration. (2) Health care entitled persons shall have the reimbursement of the costs of the health care matters. Department of the Federal Police Bureau to request in writing; a bank connection is to be disclosed. The application shall be accompanied by:
1.
Original receipts (invoice with diagnosis, regulation),
2.
where appropriate, copies of the medical reports with German translation and
3.
where appropriate, 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 paragraph 2 shall be taken over. Unofficial table of contents

§ 18 Treatment during a private stay in another Member State of the European Union, in another Contracting State of 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 or in Switzerland, only such service providers may be entitled to: shall be taken,
1.
where the conditions of access and the pursuit of the profession are the subject of a European Union directive, or
2.
which are entitled to the health insurance scheme of the country of residence for the provision of care for 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 treatment or of one of the patients receiving the treatment. (3) Stationary treatment requires prior approval. (3) Stationary treatment requires prior approval. by the department of the Federal Police Bureau responsible for health care matters. The authorisation shall be granted only if a treatment corresponding to the state of the medical findings is not possible in Germany. (4) § 17 (2) shall apply with the proviso that translation costs shall not be accepted. . Unofficial table of contents

§ 19 Treatment 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

(1) The costs of a treatment immediately required during a private stay outside the Member States of the European Union, of the other States Parties to the Agreement on the European Economic Area and Switzerland shall be: up to the level in which it is taken up in the event of illness at the place of service or residence in the country and the use of a doctor who is attending the contract medical care or a doctor who is attending the contract medical care or of an approved hospital, taking into account the (2) Stationary treatment requires the prior approval of the Federal Ministry of the Interior. § 18 (3) sentence 2 shall apply mutah. (3) § 17 (2) shall apply with the proviso that translation costs shall not be accepted.

Chapter 3
Final provisions

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Section 20 Administrative provision

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

Section 21 Entry into force, external force

(1) This Regulation shall enter into force on 1 July 2014. (2) At the same time, the health-care provisions for the Federal Police of 6 November 2005 (GMBl p. 1228) shall not apply.