Law on structural reform in the health sector (Health Reform Act-GRG)
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GRG
Date of completion: 20.12.1988
Full quote:
" Health Reform Act of 20 December 1988 (BGBl. 2477), as last amended by Article 105 of the Law of 27 April 1993 (BGBl I). 512) has been amended "
| Status: |
Last amended by Art. 105 G v. 27.4.1993 I 512 |
For more details, please refer to the menu under
Notes
Footnote
(+ + + Text evidence from: 1.1.1989 + + +)
Art. 1: SGB 5 860-5
Art. 8: KVLG 1989 8252-3
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Content Summary
| Part one |
Amendment and amendment of the Social Code |
| Article 1 |
Social Code (SGB) |
| |
Fifth Book (V) |
| |
Statutory health insurance |
| Article 2 |
Amendment of the First Book of the Social Code |
| Article 3 |
Amendment of the Fourth Book of Social Law |
| Article 4 |
Amendment of the Tenth Book of Social Law |
| Part two |
Amendment of other laws |
| Article 5 |
Reichsversicherungsordnung |
| Article 6 |
Law on the health insurance of farmers |
| Article 7 |
Employee Insurance Act |
| Article 8 |
Second Law on the Health Insurance of Farmers (KVLG 1989) |
| Article 9 |
Reichsknappschaftsgesetz |
| Article 10 |
Law on the Social Security of Disabled Persons |
| Article 11 |
Artistic Social Insurance Act |
| Article 12 |
Artisanal Insurance Act |
| Article 13 |
Law on the management of funds of sickness insurance institutions |
| Article 14 |
Workers ' Pension Insurance New Law |
| Article 15 |
Employee Insurance New Regulation Act |
| Article 16 |
New Law on the Scarce Pension Insurance |
| Article 17 |
Law on health insurance law |
| Article 18 |
Admission regulations for treasury doctors |
| Article 19 |
Admission regulations for treasury dentists |
| Article 20 |
Arbitration Rules |
| Article 21 |
KV-Flat-rate contribution regulation |
| Article 22 |
Hospital Finance Act |
| Article 23 |
Federal Pflegesatzverordnung |
| Article 24 |
Pharmacy Operating Regulations |
| Article 25 |
Law on the development of social security |
| Article 26 |
Third Regulation on social security (Community tasks) |
| Article 27 |
Self-Management and Health Insurance Act Berlin |
| Article 28 |
Social Insurance Act Saar |
| Article 29 |
Self-Management Act |
| Article 30 |
Seventh Act amending the Self-Government Act |
| Article 31 |
Social security agreements |
| Article 32 |
Social justice law |
| Article 33 |
Federal Education Promotion Act |
| Article 34 |
Labour Promotion Law |
| Article 35 |
Early retirement law |
| Article 36 |
Employment Insurance Act |
| Article 37 |
Federal Supply Act |
| Article 38 |
Bundesvertriebenengesetz |
| Article 39 |
Home sweeping law |
| Article 40 |
Prisoner Assistance Act |
| Article 41 |
Law on the approximation of benefits for rehabilitation |
| Article 42 |
Federal Social Assistance Act |
| Article 43 |
Soldata supply law |
| Article 44 |
Civil Service Law |
| Article 45 |
Federal Medical Regulations |
| Article 46 |
Fourth Act amending the Federal Medical Regulations |
| Article 47 |
Approbational Order for Doctors |
| Article 48 |
Fifth Regulation amending the Doctors Approbationsordnung |
| Article 49 |
Law on the admission of persons entitled pursuant to § 19 of the Dentistry Act to the treatment of insured persons in statutory health insurance |
| Article 50 |
Second Law on Unification and Reregulation of the Law on Remuneration in the Federal Government and the Länder |
| Article 51 |
Penal law |
| Article 52 |
Maternity Protection Act |
| Article 53 |
Seemannsgesetz |
| Article 54 |
Wage Fortzahlungsgesetz |
| Article 55 |
Return to the Single Regulation |
| Part Three |
Transfer and final provisions |
| First section Overline rules |
| Article 56 |
Sickness insurance for pensioners and students |
| Article 57 |
Exemption from the insurance obligation for doctors in the internship |
| Article 58 |
Consideration of sickness benefits in the financial compensation of the health insurance of pensioners |
| Article 59 |
Voluntary insurance |
| Article 60 |
Orthodontic treatment and treatment with dental prosthetics |
| Article 61 |
Reimbursement of expenses |
| Article 62 |
Performance exclusion for family insured persons |
| Article 63 |
Reimbursement of expenses by the institutions of the statutory accident insurance |
| Article 64 |
Participating physicians and dentists as members of the health insurance associations |
| Article 65 |
Conversion of participations in appropriations |
| Article 66 |
Contract doctors |
| Article 67 |
Large-scale medical devices |
| Article 68 |
Order |
| Article 69 |
National associations of health insurance companies |
| Article 70 |
Regional treasury associations |
| Article 71 |
Contribution rate for students and interns |
| Article 72 |
Back-sheet education at the Federal Cnapphood |
| Article 73 |
Trusting medical services at the national insurance institutions |
| Article 74 |
Transfer of audit services to the countries of the national insurance institutions |
| Article 75 |
Operation of pension or rehabilitation facilities of statutory health insurance by national insurance institutions |
| Article 76 |
Continuation of the Institutional Label |
| Article 77 |
References and designations in other regulations |
| Second section Final provisions |
| Article 78 |
Berlin clause |
| Article 79 |
Entry into force, external force |
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Input formula
With the approval of the Federal Council, the Bundestag has adopted the following law:
Part one
Amendment and amendment of the Social Code
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Art 1 Social Code (SGB)
Fifth book (V) Social health insurance
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Type 2 to 4 (omitted)
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Part two
Amendment of other laws
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Species 5 to 7 ----
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Art 8 Second Law on the Health Insurance of Farmers (KVLG 1989)
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Art 9 to 54 ----
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Type 55 Return to the uniform regulation
The parts of the Regulations, which are based on Articles 18 to 21, 23, 24, 26, 47 and 48, may be amended or repealed by means of a regulation on the basis of the relevant authorization in connection with this Article.
Part Three
Transfer and final provisions
First section
Transfer rules
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Type 56 Health insurance of pensioners and students
(1) Persons who, until 31 December 1993, apply for a pension from the statutory pension insurance scheme and the conditions for the receipt of the pension, but not the conditions for the insurance obligation pursuant to § 5 (1) No. 11 of the Fifth The Book of Social Code will be insured if it or the person from whose insurance they derive their entitlement to a pension has been insured since the initial start of an employment, but at the earliest since 1 January 1950, until the position of the person in question has been taken into account. Pension contribution at least half of the time Member of a health insurance fund or with a Member married and no more than only marginally employed or slightly self-employed. If they do not fulfil the conditions for the receipt of a pension, they shall be deemed to be members until the date on which the application for a pension is withdrawn or the rejection of the pension application becomes unquestionable. (2) Who on 31 December 1988, due to the reference to the pension scheme, A pension from the statutory pension insurance is subject to insurance or if the application for a pension is deemed to be a member, the pension shall remain for the period of the date of the pension or until the date on which the pension application is withdrawn or the refusal to grant the pension the application becomes unchallenged, even if the application is subject to the application Requirements for compulsory insurance pursuant to § 5 (1) No. 11 or 12 of the Fifth Book of the Social Code are not fulfilled. (3) For the insured persons referred to in paragraph 1 or 2, the conditions pursuant to § 5 (1) No. 11 of the Fifth Book apply. Social Code as fulfilled if the periods of insurance referred to in paragraph 1 have been concluded on the basis of compulsory insurance; § 6 (3) sentence 1 of the Fifth Book of the Social Code shall not apply to those referred to in paragraph 2. (4) Who on 31. December 1988 due to the payment of a pension from the statutory pension insurance scheme In the case of the sickness fund, the exemption from the insurance obligation as a pensioner may apply to the sickness insurance fund until 30 June 1989. The exemption is effective from 1 July 1989 and cannot be revoked. (5) Paragraph 4 applies to the insurance subject to insurance obligations under § 2 (1) (4) of the Law on the Health Insurance of Farmers in the version valid until 31 December 1988. (6) Those who are subject to insurance on 31 December 1988 as a student pursuant to Section 165 (1) (5) of the Reich Insurance Code shall remain in force for the duration of the 1988/89 winter semester, up to 31 March 1989, even then Subject to insurance obligations, if the conditions for the insurance obligation pursuant to Section 5 (1) (9) of the (7) Persons who, under the legislation of a Contracting State of the European Economic Area, immediately before the entry into force of the Agreement, persons who are due to receive a German pension under the legislation of a Contracting State on the European Economic Area of health insurance as a pensioner who, as a result of the application of Council Regulation (EEC) No 1408/71 of 14 June 1971 on the application of social security schemes to employed persons, Self-employed persons and their families moving within the Community (OJ L 327, 31.12.2002, p. . EC No 2) (Regulation), shall apply for the further duration of the application procedure or Uninterrupted German pension cover and the continued uninterrupted residence in that State Party as insured within the meaning of German legislation on the health insurance of pensioners, to the extent that health insurance cover is subject to other Legislation of a Contracting State of the European Economic Area shall not exist. These persons, who only receive a German pension and who are subject to German health insurance through the application of the Regulation or the first sentence of the compulsory insurance scheme, will find the German legislation on the contribution payment for Pensioner with the proviso that a contribution shall be made only in so far as the previous amount of the pension is not undershot by this means. (8) Paragraph 7, second sentence, shall apply mutah. to persons to which the entry into force of the Agreement on the European Economic Area (EEA) Article 28a of the Regulation, for which: Duration of uninterrupted residence in the other Contracting State of the European Economic Area concerned.
Footnote
Article 56 (3) Half-sentence 1: In accordance with the decision-making formula, the GG is incompatible with Article 2 (1) of the GG and void. BVerfGE v. 15.3.2000 I 1300,-1 BvL 16/96-,-1 BvL 17/96-,-1 BvL 18/96-,-1 BvL 19/96-,-1 BvL 20/96-,-1 BvL 18/97-
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Art 57 exemption from insurance obligation for doctors in the internship
Persons who are subject to insurance as a doctor during an internship on 31 December 1988 will be exempted from the obligation to take out insurance upon application. The application shall be made to the sickness insurance fund until 31 March 1989. § 8 (2) sentences 2 and 3 of the Fifth Book of the Social Code shall apply accordingly.
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Type 58 Taking into account sickness benefits in the financial compensation of the health insurance of pensioners
(1) In the case of compensable performance expenses in accordance with Section 393b (1) of the Reich Insurance Code in the version valid until 31 December 1988, the sickness benefit for reference periods shall not be heard before 1 January 1984, unless the sickness benefit is payable. (2) Insofar as the calculation of the Vomhundertsatz in accordance with § 393 (2) sentence 4 of the Reich Insurance Code (Reichsversicherungsordnung) of the Reich Insurance Code (Reichsversicherungsordnung) is valid until 31 December 1988. (2) Wealth insurance policy in the version valid up to 31 December 1988 for the past In the case of a reference period of a calendar year before 1 January 1984, which was not provided for failure to obtain an income from work, it shall be included in the determination of the set of percentages in accordance with Article 272 (1) of the Fifth Book Social Code for the year 1989.
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Art 59 Volunteer Insurance
(1) The insurance may accede
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1.
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Persons whose insurance obligation is not required under this Act of 1 January 1989;
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2.
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persons for which the right to family assistance pursuant to this Act of 1 January 1989 is deleted and which are not insured under Section 10 of the Fifth Book of the Social Code,
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3.
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Employees of the health insurance companies and their associations, for which a service order (§ 351 of the Reich Insurance Code) applies, as well as civil servants who are active in an occupational health insurance fund or in the health insurance company.
(2) Accession shall be notified in writing to the sickness insurance fund in the cases referred to in paragraph 1 (1) and (2) at the latest by 31 March 1989; membership shall begin on 1 January 1989. In the cases referred to in paragraph 1 (3), the sickness insurance fund shall be notified in writing by 30 June 1989 at the latest; membership shall begin on the date of accession in these cases.
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Art 60 orthodontic treatment and treatment with dental prosthetics
Insured persons whose dental treatment has commenced before 1 January 1989 for the treatment of dental prosthetics or dental crowns or their orthodontic treatment shall be entitled to the legislation in force on 31 December 1988, where the Health insurance has already made a written decision on the claim before 27 April 1988.
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Art 61
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Type 62 Performance exclusion for family insured persons
Until 31 December 1990, according to § 10 of the Fifth Book of the Social Code, insured persons from this insurance have no entitlement to benefits arising as a result of an accident at work or an occupational disease in the sense of the legal provisions of the law. Accident insurance is to be provided.
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Type 63 reimbursement of expenses by the institutions of the statutory accident insurance
(1) The institutions of the statutory accident insurance shall reimburse the health insurance funds for the costs which, beyond 31 December 1988, are incurred for diseases resulting from an accident at work or an occupational disease. (2) Top-class associations of statutory accident insurance may, individually or jointly, conclude agreements with the top associations of the health insurance companies that the costs referred to in paragraph 1
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1.
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by means of a case flat rate to be determined by them; or
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2.
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by a total annual flat rate to be determined by them, or by a total flat rate for the entire period of repayment of Section 565 (1) of the Reich Insurance Order until 31 December 1990
be golted. In so far as a total flat rate is agreed in accordance with the first sentence of the first sentence of the first sentence, the compensatory parts to be provided by the institutions of the statutory accident insurance shall be the flat rate according to the ratio of the number of persons insured under the relevant accident insurance institution to the number of accidents at work to be displayed on all the institutions concerned, to be calculated in the years in question; accidents at work pursuant to Article 539 (1) (14) (a), (b) or (d) of the Reich Insurance Order and occupational diseases shall not be taken into consideration. The top associations of the sickness funds shall distribute the total flat rate among the health insurance funds on the basis of the number of members for which the costs referred to in paragraph 1 have been incurred.
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Type 64 Participants physicians and dentists as members of the health insurance associations
The membership of doctors and dentists in the health insurance associations and the national associations of the health insurance sector, which took part in the legislation applicable until 31 December 1988, remains open until 31 December 1988. the following term of office, no later than 31 December 1992.
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Art 65 Conversion of participations in appropriations
Shareholdings in accordance with Section 368a (8) of the Reich Insurance Code in the version in force on 31 December 1988 shall apply from 1 January 1989 in the form of authorisations within the meaning of the Fifth Book of the Social Code. The secondary provisions connected with the participation in accordance with § 29 of the admission regulations for treasury doctors and in accordance with section 29 of the admission regulations for treasury dentists in the version in force on 31 December 1988 shall apply until the express conversion of the participations in appropriations carried out by the Admissions Committee.
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Art 66 Contract doctors
§ 95 (8) sentence 1 of the Fifth Book of the Social Code does not apply to doctors and dentists who were the contract doctors of the replacement funds on 1 January 1977 or who had applied for participation in the contract medical care up to that date.
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Art 67 Medical and technical equipment
§ 368n (8) (3) and (4) of the Reichsversicherungsordnung, as amended on 31 December 1988, shall apply to large-scale medical-technical equipment purchased, used or co-used before 1 January 1989, as amended on 31 December 1988, as well as those on the basis of: § 368 (1) and (3), § 368n (8) and § 368p (1) of the Reich Insurance Code (Reichsversicherungsordnung) for the needs-based and economic use of large-scale medical devices of 10 December 1985 (BAnz. (OJ No 60a of 27 March 1986, p. 3).
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Art 68
§ § 349 to 357, § 360, § 413 para. 2 sentence 1 and § 414b of the Reichsversicherungsordnung continue not to apply to health insurance companies or their associations which do not belong to the health insurance funds pursuant to § 225 (1) or the associations pursuant to § 406 or § 414 of the Reichsversicherungsordnung (Reich Insurance Code).
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Art 69 Landesfederations of the health insurance companies
National associations whose tasks in accordance with Section 207 (4) of the Fifth Book of the Social Code will in future be carried out by the sickness insurance fund shall be entitled to insist on the expiry of 31 December 1988. The sickness insurance fund shall enter into its rights and obligations on 1 January 1989.
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Art 70 Regional treasury associations
§ § 407, 409 and 411 to 413 of the Reichsversicherungsordnung apply to treasury associations, which were formed on December 31, 1988, in accordance with § 406 of the Reich Insurance Code, as well as for treasury associations in accordance with § 218 of the Fifth Book of Social Code. Moreover, these associations are subject to the provisions of the Fifth Book of Social Law.
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Art 71 Contribution rate for students and interns
The one on the basis of section 381a of the Reich Insurance Order on 1. The average contribution rate determined by the Federal Minister for Labour and Social Affairs in October 1988 is valid for students until the beginning of the 1989/90 winter semester, up to the 31. October 1989, and for interns until 30 September 1989.
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Art 72 Backsheet formation at the Federal Cnapphood
The Bundesknappschaft as the institution of the health insurance company has its reserve on the return duty prescribed in section 261 (2) of the Fifth Book of the Social Code by 31 December 1998 by means of partial payments of equal amount per year. to be filled.
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Type 73 Medical services at national insurance institutions
(1) The rights and obligations of the national insurance institutions shall apply to the medical services established in the respective districts of the national insurance institutions, in so far as they are concerned with the performance of the duties of the medical certificate of trust. (2) The assets (property and all other property rights) and the liabilities of the national insurance institutions, which are in legal or economic context with the duties of the trust service, go to the medical services. Due to the transfer of liabilities, the national insurance companies are exempted from the previous debtor. (3) The medical services assume the majority of the national insurance institutions with the performance of the tasks of the Persons employed in the field of trust (civil servants, employees of civil servants, employees and workers). The medical services may, in agreement with the national insurance institutions and the persons concerned, also take over persons who are not primarily concerned with the performance of the duties of the trust-based service. The medical services shall enter into the rights and obligations arising out of the service or employment relationships of the persons taken over. (4) Medical services shall be awarded for the officials and officials of the civil servants referred to in paragraph 3. Dienthernability (§ 121 of the Civil Service Law). The right to have officials shall be limited to officials and officials who have been accepted in accordance with paragraph 3. If there is no longer any need for the dientability, the dientability and the status of the medical service as a legal entity of public law are no longer necessary. The supreme administrative authority of the country responsible for social security shall establish the date on which the status as a legal entity of public law is deleted and shall make it known. (5) The provisions of paragraphs 3 and 4 shall apply to the (6) The working conditions of the workers taken over must not be worsened as a result of the adoption of the takeover. Medical services may terminate, until 30 June 1990, an employment relationship only from an important reason in the person or in the conduct of the worker. Until the conclusion of new collective agreements, the collective agreements which have been applied to them at the relevant national insurance institution shall apply to the employment relationships of the employees and workers who have been transferred. (7) National insurance institutions for the performance of the duties of the confidential service have concluded leases or other agreements, the medical services shall enter into the rights and obligations arising out of these contracts, or other agreements. The same shall apply to agreements which govern the sharing of buildings and medical equipment provided by the national insurance institutions for the purposes of pension insurance and the service of trust. (8) The provisions of paragraphs 1 to 3, 6 and 7 shall apply mutagenic to the Allgemeine Ortskrankenkasse Berlin (Allgemeine Ortskrankenkasse Berlin), insofar as it was the institution of the service of trust The second sentence of the second sentence of paragraph 4 and paragraph 5 shall apply in accordance with the persons employed by the Allgemeine Ortskrankenkasse Berlin (Allgemeine Ortskrankenkasse Berlin), who are employed on the basis of employment contracts, in accordance with the rules of civil service law. (9) The transition the rights and obligations and the acquisition of the persons referred to in paragraphs 3 and 5 shall take place at the end of the month in which the authorisation of the Statute of the Medical Service shall be issued by the competent supervisory authority of the country. Until that date, the Service of Trust continues and assumes the tasks of the Medical Service in accordance with the Fifth Book of Social Law. Up to 1. In October 1989, the Board of Directors decided to adopt the Articles of Association, to determine the budget and to elect the Managing Director (Section 280 (1) (1), (2) and (6) of the Fifth Book of the Social Code).
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Type 74 Transition of audit services to countries in the national insurance institutions
(1) The rights and obligations of the national insurance institutions shall, in so far as it relates to the performance of the tasks of the examination of the business, accounting and management of the health insurance funds, go to the competent authorities responsible for social security insurance. (2) The assets (property and all other property rights) and the liabilities of the national insurance institutions, which are responsible for the audit of the business, accounting and operational management of the Sickness funds in a legal or economic context, go to the top administrative authorities of the countries responsible for social security. As a result of the transfer of liabilities, the national insurance companies will be exempted from the previous debtors. (3) The top administrative authorities of the Länder responsible for social security shall take over those in the national insurance institutions. mostly with the performance of the tasks of the audit of the business, invoicing and management of the health insurance companies (civil servants, civil servants, employees and workers). The supreme administrative authorities of the Länder responsible for social security enter into the rights and obligations arising out of the service or employment relationships of the persons taken over. (4) Paragraph 3 applies accordingly to the recipients of the care. (5) The working conditions of the workers taken over must not be worsened as a result of the takeover. Until 30 June 1990, the supreme administrative authorities of the Länder responsible for social security can only terminate an employment relationship from an important reason in the person or in the behaviour of the worker. Until the conclusion of new collective agreements, the collective agreements which have been applied to them at the relevant national insurance institution shall apply to the employment relationships of the employees and the workers who have been acquired. (6) Insofar as the National insurance companies for the performance of the tasks of the examination of the business, invoicing and management of the health insurance companies have concluded leases or other agreements, enter the relevant social insurance the supreme administrative authorities of the countries in the rights and obligations arising out of these contracts; or other agreements. The same shall apply to agreements relating to the sharing of buildings and technical equipment of national insurance institutions for the tasks of the pension insurance scheme and the examination of the management, accounting and management of health insurance funds. rules. The countries and the national insurance institutions can agree with each other.
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Type 75 Operation of pension or rehabilitation facilities of statutory health insurance by national insurance institutions
National insurance institutions operating on 1 January 1989 under the rules on Community tasks of the sickness insurance scheme for the provision of health insurance or rehabilitation facilities or similar bodies shall be allowed to take place on 1 January 1989. as statutory health insurance institutions, continue until 31 December 1989. (2) The supreme administrative authorities of the countries responsible for social security shall determine that the sponsorship of such institutions shall be limited to: Health insurance companies or their associations, and regulate the transition 1 January 1990, insofar as the national insurance institutions do not enter into force by 30 September 1989
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the transfer of facilities to health insurance funds or their associations, or
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any other use of the facilities, in particular their continued operation as institutions of statutory pension insurance;
at the latest by 1 January 1990. The contract requires the consent of the health insurance funds, to which in each case the average of the years 1986 to 1988 is more than 10 of the hundred of the calculation days of the institution, insofar as it is not concluded with these health insurance funds. (3) The In accordance with § 140 (1) of the Fifth Book of the Social Code, health insurance companies or their associations shall be deemed to be the institutions of their own.
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Art 76 Continuation of the Institutional Label
Instead of an agreement in accordance with Section 293 (2) of the Fifth Book of the Social Code, the parties may also agree to continue to use the existing institutional code.
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Type 77 referrals and names in other provisions
(1) Where reference is made in other provisions to provisions or are used in terms which are amended or repealed by this Act, their place shall be replaced by the corresponding provisions and designations of this Act. (2) The Federal Minister of Health shall, in agreement with the Federal Ministers concerned, make known the text of the provisions and designations which, in accordance with paragraph 1, replace the previous provisions and designations.
Second section
Final provisions
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Art 78 Berlin-clause
This law shall also apply in the Land of Berlin in accordance with the provisions of Section 13 (1) of the Third Transfer Act. Legal orders issued pursuant to this Act shall apply in the Land of Berlin pursuant to Section 14 of the Third Transfer Act.
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Art 79 Entry into force, external force
(1) This Act shall enter into force on 1 January 1989, unless otherwise specified in paragraphs 2 to 5. (2) (3) (4) (5) (6) 1. up to 10. (7)
