Structure Reform In Health Care Bill

Original Language Title: Gesetz zur Strukturreform im Gesundheitswesen

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Law on structural reform in the health sector (health reform bill GRG) GRG Ausfertigung date: 20.12.1988 full quotation: "health reform law of 20 December 1988 (BGBl. I S. 2477), most recently by article 105 of the law of 27 April 1993 (BGBl. I S. 512) has been changed" stand: last amended by article 105 G v. 27.4.1993 I 512 for more information on the stand number you see in the menu see remarks footnote (+++ text detection from) : 1.1.1989 +++) article 1: SGB 5 860 5 article 8: KVLG 1989 8252-3 table of contents part one amending the social security code article 1 social security code (SGB) fifth book (V) statutory health insurance article 2 change of the first book of the social code article 3 amendment of the fourth book of the social code article 4 amendment of the tenth book of social code second part change other laws article 5 Reichsversicherungsordnung article 6 law on health insurance of farmers article 7 Angestelltenversicherungsgesetz article 8 second law on health insurance of farmers (KVLG 1989) article 9 Reich associations law article 10 Law on the social security of disabled article 11 artists social security law article 12 craftsmen insurance law article 13 law on the management of funds of the health insurance carrier article 14 Arbeiterrentenversicherungs new regulatory law article 15 Angestelltenversicherungs new regulatory law article 16 Knappschaftsrentenversicherungs new regulation law article 17 Act on cash medical law article 18 admission regulations for doctors article 19 admission regulations for cash dentist article 20 Schiedsamtsordnung article 21 KV lump-sum contribution regulation article 22 hospital financing law article 23 Federal care rate regulation article 24 pharmacy regulations article 25 law on the establishment of the social security article 26 third regulation establishing social security (community tasks) article 27 management and health insurance approximation law Berlin article 28 social harmonisation law Saar article 29 self-government law article 30 seventh law amending the local Government Act article 31 social security agreements article 32 social courts act article 33 federal education assistance Act article 34 labour promotion Act article 35 retirement law article 36 working backup Act article 37 Federal article 38 Federal expellees Act article 39 returnees Act article 40 prisoner Assistance Act article 41 law concerning the reconciliation of the rehabilitation benefits article 42 federal social assistance Act article 43 soldier supply Act article 44 civil service law article 45 Federal physician order article 46 fourth law amending the Federal physician procedure article 47 licensure for physicians article 48 fifth Ordinance amending the licensure for physicians article 49 registration according to § 19 of the dentistry Act legislation legitimate people to treat of the insured persons in the statutory health insurance article 50 second law to unify and revision of salary law in federal and State article 51 penal law article 52 maternity protection act article 53 sailor law article 54 salary law article 55 return to single third part Überleitungs-regulation rank and final provisions of first section have management governing
Article 56 sickness insurance of pensioners and the students article 57 exemption from compulsory insurance for doctors in the internship article 58 taking into account sickness benefits in the sickness insurance of pensioners compensation article 59 voluntary insurance article 60 orthodontic treatment and dental supply article 61 reimbursement article 62 exclusion for family insurance article 63 reimbursement by the statutory accident insurance institutions article 64 participating doctors and dentists as members of statutory health insurance physicians associations article 65 conversion of shareholdings in appropriations article 66 contract doctors article 67 medical-technical large-scale article 68 regulations article 69 national associations of sickness funds article 70 regional fund associations article 71 contribution rate for students and interns article 72 reserves at the Federal associations article 73 Vertrauensärztliche services at the State Insurance Institute article 74 transition of the inspection services at the State Insurance Institute on the countries article 75 operation of preventive or rehabilitation facilities of the statutory health insurance by State Insurance Institute article 76 continuation of institution identification article 77 references and names in other legislation second section final provisions article 78 Berlin clause Article 79 entry into force , Force input formula the Bundestag has passed the following law with the consent of the Federal Council: first part amending the social security code type 1 social security code (SGB) fifth book (V) statutory health insurance - type 2-4 (dropped out) - second unit change other laws type 5-7 - type 8 second act on the health insurance of farmers (KVLG 1989) - type 9 to 54-55 species return to the single rank of regulation on articles 18 to 21 , 23, 24, 26, 47 and 48-based parts of there changes to the regulations can be changed by Decree on the basis of the applicable authorization in connection with this article or repealed.
Part Überleitungs-and final provisions first section line rules type 56 sickness insurance of pensioners and students (1) persons who apply for a pension under the statutory pension insurance and fulfil the conditions for the purchase of the pension, but not the conditions for the insurance obligation according to § 5 para 1 No. 11 of the fifth book of the social code, until 31 December 1993 are insured if they or the person , whose insurance they their pension rights derived from, since the first time you take of up employment, but at the earliest since January 1, 1950, to the position of the pension claim at least half of the time member of a health insurance company or were married to a member and employed not more than only slightly or marginally self-employed. Does not meet the requirements for the receipt of a pension, they apply to day as members, at which the pension request withdrawn or the refusal of the pension will be final.
(2) a person who on December 31, 1988, due to the cover of a pension from the statutory pension insurance is resident or is due to apply for a pension as a member, is withdrawn for the duration of the cover of this pension or up to the date on which the pension or the rejection of the application final will, also then insurance, if he does not meet the requirements for the insurance no. 11 or 12 of the fifth book of the social code according to § 5 para 1.
(3) for the after paragraph the requirements shall be deemed 1 or 2 insured persons according to § 5 para 1 No. 11 of the fifth book of the social code if the periods of insurance referred to in paragraph 1 on the basis of compulsory insurance are established; § 6 para 3 sentence 1 of the fifth book of the social code not applies to the insured persons referred to in paragraph 2.
(4) a person who is resident on December 31, 1988, on the basis of the cover of a pension under the statutory pension insurance, may apply for exemption from compulsory insurance as a retiree to June 30, 1989, the health insurance fund. The exemption acts by July 1, 1989 and can't be undone.
(5) paragraph 4 applies to the according to § 2 para 1 No. 4 of the law on health insurance of farmers in force until December 31, 1988 amended persons subject to compulsory according to.
(6) a person who is resident on December 31, 1988, as a student pursuant to section 165 paragraph 1 No. 5 of the Reichsversicherungsordnung, remains even resident for the duration of the winter semester in 1988/89, maximum up to March 31, 1989, if he does not meet the requirements for compulsory coverage according to § 5 para 1 No. 9 of the fifth book of the social code.
(7) persons who directly have on the basis of the application or the cover of a German pension under the legislation of a Contracting State of the European economic area before entry into force of the agreement on the European economic area health insurance coverage as a retiree, as a result of the application of Regulation (EEC) No 1408/71 of the Council of 14 June 1971 on the application of the social security schemes to workers and self-employed persons, as well as their families , the to - within the community and moving (OJ EC No. L 149, p. 2) (Regulation) is omitted, shall apply to the further duration of the application process or continuous German retirement and also continuous residence in that Contracting State as insured within the meaning of the German legislation on health insurance of the pensioners, as far as health insurance coverage under other legislation of a Contracting State of the European economic area does not exist. These people, only a German pension and which are subject to the compulsory insurance of the German health insurance through application of the regulation or of sentence 1, the German legislation on the payment of contributions for pensioners with the proviso apply, that a contribution holdback occurs only in so far as the previous pension payment this is not less than.
(8) paragraph 7 sentence 2 accordingly applies to persons, on which at the entry into force of the agreement on the European economic area article 28a of the regulation to apply is for a period of continuous residence in the respective other Contracting State of the European economic area.
Footnote art. 56 para 3 half-sentence 1: in accordance with the decision formula with article 2 para 1 of the GG incompatible and invalid gem. 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 - type 57 exemption from compulsory insurance for doctors in the internship people , by employment as internship on 31 December 1988 insurance are, be exempted from compulsory insurance upon request. The application is up to March 31, 1989, the health insurance fund. § 8 para 2 sentence 2 and 3 of the fifth book of the social code shall apply mutatis mutandis.

Art 58 consideration of sick leave benefits in financial compensation of health insurance of retirees (1) to the compensation eligible expenses to § 393 b para 1 of the Reichsversicherungsordnung in the version applicable up to 31 December 1988 is not the sickness benefit for periods prior to January 1, 1984, unless the sickness benefit has been made due to failure of labor income in the sense of § 180 5 No. 3 of the Reichsversicherungsordnung in the version applicable up to 31 December 1988.
(2) where, in determining the reduced according to § 393 paragraph 2 sentence 4 of the Reichsversicherungsordnung in force until December 31, 1988 amended for past calendar years also sick leave for periods was included prior to January 1, 1984, which was not paid due to failure of labor income, this is when determining the reduced according to article 272, paragraph 1 of the fifth book of social law book for the year 1989 to depose.

Type 59 voluntary insurance (1) the insurance can join 1 people, whose insurance under this Act from January 1, 1989 the entitlement to family benefits on the basis of this Act is eliminated, 2 people, for that is eliminated by January 1, 1989 and not according to § 10 of the fifth book of the social code are insured, 3. employees of the health insurance companies and their associations, for a service order (§ 351 of the Reichsversicherungsordnung) , as well as officers who are working in a company health insurance plan or the miners health insurance.
(2) the candidate's writing display 1 and 2 no later than March 31, 1989 to the health insurance fund in the cases of paragraph 1; Membership begins on January 1, 1989. In the cases of paragraph 1 No. 3 is the health insurance membership no later than June 30, 1989 in writing to show; in these cases, the membership begins with the date of accession.

Type 60 orthodontic treatment and dental supply policyholders, whose dental treatment to the supply of dentures or dental crowns or orthodontic treatment has commenced before January 1, 1989, are entitled under the legislation in force on 31 December 1988, if the sickness fund has decided already in writing before April 27, 1988 about the claim.

Type 61 - type 62 exclusion for family insured until 31 December 1990 which have pursuant to § 10 of the fifth book of the social code insured under this insurance are not entitled to benefits, to provide as a result of an accident at work or an occupational disease within the meaning of the statutory accident insurance.

Type 63 reimbursement by the carrier of the statutory accident insurance (1) the statutory accident insurance institutions have to reimburse the costs of the health insurance funds on December 31, 1988, used up for diseases that are the result of an accident at work or an occupational disease.
(2) the umbrella organisations of statutory accident insurance agreements about meet individually or jointly with the Central associations of sickness funds, paid for the costs referred to in paragraph 1 1 through a case fee set of them to or 2. through an annual total package set of them to or a total package for the entire period of the continuing applicability of section 565, paragraph 1 of the Reichsversicherungsordnung until December 31, 1990. As far as a total fee pursuant to sentence 1 No. is agreed 2 to be applied by the statutory accident insurance institutions compensation units in the package according to the ratio of the number of to be displayed at the respective accident insurer accidents to display when all concerned agencies to work accidents in the relevant years shall be calculated; Accidents at work the to section 539 para 1 No. 14 insured persons, as well as occupational diseases remain letter a, b, or d of the Reichsversicherungsordnung this not taken into consideration. The leading associations of sickness funds distribute the total allowance under the health insurance companies according to the number of members for which costs have been used pursuant to paragraph 1.

64 participating doctors and dentists as members of statutory health insurance physicians associations remains membership of doctors and dentists at the associations of statutory health insurance physicians and physicians Federal associations, those involved in force until December 31, 1988 law until the expiry of the 31 December 1988 following term, maximum up to 31 December 1992, will receive.

Type 65 conversion of shareholdings in appropriations under section 368a para 8 of the Reichsversicherungsordnung in force on 31 December 1988 deemed investments from January 1, 1989 appropriations within the meaning of the fifth book of the social code. The incidental provisions linked to the participation according to § 29 of the admission regulations for doctors, and according to section 29 of the admission regulations for cash dentist in force on 31 December 1988 to the explicit conversion of participations in appropriations by the admission Committee shall continue to apply.

Type 66 contract doctors for doctors and dentists who were contract doctors of spare funds on January 1, 1977 or had applied up to this point to participate in the contract-medical supply, § 95 paragraph 8, sentence 1 of the fifth book of the social code shall not apply.

Have been type 67 medical major equipment for medical-technical large-scale, which purchased before January 1, 1989, used or used with section 368n, subsection 8, sentence 3 and 4 of the Reichsversicherungsordnung in force on 31 December 1988, as well as the 368 para 1 and 3, article 368n, paragraph 8, and 368p para 1 of the Reichsversicherungsordnung adopted guidelines on the basis of § apply for need-based and economic use of large-scale medical research equipment of 10 December 1985 (BAnz. No. 60a by March 27, 1986, p. 3) further.

Type 68 regulations §§ 349-357, § 360, Section 413, paragraph 2, sentence 1 and § 414 b of the Reichsversicherungsordnung still do not apply to health insurance companies or their associations which were part of the Reichsversicherungsordnung on December 31, 1988, not to the health insurance companies according to article 225, paragraph 1, or the organisations referred to in article 406 or section 414.

Type 69 national associations of sickness funds regional associations, whose Aufgaben perceived according to § 207, par. 4 of the fifth book of the social code in the future by the health insurance fund at the end of 31 December 1988 cease to exist. In their rights and duties, the health insurance fund occurs on January 1, 1989.

Type 70 regional fund associations apply the §§ 407, 409 and 411 to 413 of the Reichsversicherungsordnung to fund associations, which were made on December 31, 1988, according to section 406 of the Reichsversicherungsordnung, and to fund associations according to § 218 of the fifth book of the social code. In addition, the provisions of the fifth book of the social code apply to these associations.

Type 71 contribution rate for students and interns who determined average contribution rate applies on the basis of section 381a of the Reichsversicherungsordnung to October 1, 1988, the Federal Minister for labour and Social Affairs for students until the beginning of the winter semester 1989/90, at the latest until October 31, 1989, and for interns continue up to September 30, 1989.

Type 72 reserves at the Federal associations the Federal associations as a carrier of miners health insurance has to replenish their reserves on this in section 261, paragraph 2, of the fifth book of the social code prescribed reserve set up to December 31, 1998, by equal annual instalments.

73 Vertrauensärztliche services at the State Insurance Institute (1) of the rights and obligations of the Landesversicherungsanstalt go to type on the in the respective districts of the Landesversicherungsanstalt built medical services, as far as is the implementation of tasks of the Vertrauensärztlichen service.
(2) the assets (property and all other property rights) and the liabilities of the Landesversicherungsanstalt, related to the tasks of the Vertrauensärztlichen service in legal or economic context, are transferred to the medical services. The Landesversicherungsanstalt as previous debtor be freed by the transfer of the liabilities.
(3) the medical services do (officials, official candidates, employees and workers) persons employed in the insurance institution of the country mainly with the implementation of the tasks of the Vertrauensärztlichen service. Medical services can apply in agreement with the State Insurance Institute and the affected people, not predominantly involved in carrying out the tasks of the Vertrauensärztlichen service. The medical services occur in the rights and obligations arising from the service or employment relationships of adopted persons.
(4) the medical services for the acquired civil servants and officers candidate service Mr ability (§ 121 of the civil service law framework law) pursuant to paragraph 3. The right to have civil servants, is confined to the officials adopted pursuant to paragraph 3 and officer candidates. If the need for the service Mr ability no longer exists, the service Mr ability and the status of the medical service as a legal body of governed by public law are eliminated. The country Supreme Administrative authority responsible for social security determines the time which eliminates the status as a legal entity of public law, and makes him known.
(5) paragraphs 3 and 4 shall apply mutatis mutandis for the care recipient.
(6) the working conditions of the acquired workers must not be worsened on the occasion of the takeover. The medical services may terminate an employment contract only from one in the person or in the major reason the behaviour of the employee until June 30, 1990. The working conditions of the acquired employees and workers collective agreements are decisive for until new collective agreements, which have been regarded in the respective country insurance for them.
(7) as far as the State Insurance Institute for the implementation of the tasks of the Vertrauensärztlichen service have completed leases or other agreements, enter the medical services in the rights and obligations arising from these treaties or other agreements. The same applies to agreements which regulate the joint use of buildings and medical equipment of the Landesversicherungsanstalt for tasks of the pension insurance and the Vertrauensärztlichen service.
(8) paragraphs 1 to 3, 6 and 7 shall apply for the Allgemeine Ortskrankenkasse Berlin, where she was a carrier of the Vertrauensärztlichen service. Paragraph 4 shall apply mutatis mutandis for persons taken over from the General local health insurance Berlin, who are employed on the basis of employment contracts, according to the bibliographical rules set 2 to 4 and paragraph 5.
(9) the transfer of rights and obligations and the adoption of persons by paragraph 3 and 5 take place at the end of the month in which the approval of the Statute of the medical service is granted by the competent authority of the country. Up to this point, the Vertrauensärztliche service continues and performs the duties of the medical service after the fifth book of the social code. Up to October 1, 1989, the Board of Directors has to adopt the Statute, to determine the budget and to choose the Managing Director (§ 280 para 1 No. 1, 2 and 6 of the fifth book of the social code).

Type 74 transition of the inspection services at the Landesversicherungsanstalt countries (1) the rights and obligations of the Landesversicherungsanstalt, insofar as it was to carry out tasks of assessing the business, accounting, and management of health insurance funds, social security Supreme Administrative authorities of countries skip to.
(2) the assets (property and all other property rights) and the liabilities of the Landesversicherungsanstalt, related to the tasks of assessing the business, accounting, and management of health insurance companies in legal or economic context, to the competent for Social Security Supreme Administrative authorities of countries over. The Landesversicherungsanstalt as previous debtor be freed by the transfer of the liabilities.
(3) social security top management authorities of the countries which take in the Landesversicherungsanstalt predominantly with the carrying out of the tasks of assessing the business, accounting and management of health insurance funds employed persons (officials, official candidates, employees and workers). Social security top management authorities of the countries entering into the rights and duties arising from the service or employment relationships of adopted persons.
(4) paragraph 3 shall apply accordingly for the care recipient.
(5) the working conditions of the acquired workers must not be worsened on the occasion of the takeover. Social security top management authorities of the countries may terminate an employment contract only from one in the person or in the major reason the behaviour of the employee until June 30, 1990. The working conditions of the acquired employees and workers collective agreements are decisive for until new collective agreements, which have been regarded in the respective country insurance for them.
(6) as far as the State Insurance Institute for the execution of tasks of assessing the business, accounting, and management of health insurance funds leases or other agreements have completed, enter social security top management authorities of the countries in the rights and obligations arising from these treaties or other agreements. The same applies to agreements which regulate the joint use of buildings and technical equipment of the Landesversicherungsanstalt for tasks of the pension insurance and the examination of business, accounting, and management of health insurance companies. The countries and the National Insurance Institute may agree with each other otherwise.

Type 75 and operation of preventive or rehabilitation facilities statutory health insurance through the State Insurance Institute (1) the State Insurance Institute, the force on January 1, 1989 the at that time relating to community tasks of health insurance retirement savings or rehabilitation facilities or similar institutions operate, must these institutions the statutory health insurance at the most until 31 December 1989 continue.
(2) social security top management authorities of the countries determine that transferred the ownership of these facilities on health insurance companies or their associations, and not regulate the transition to January 1, 1990, as far as the Landesversicherungsanstalt until September 30, 1989 by contract 1 the transition of facilities at health insurance companies or their associations or 2. repurposing of institutions, in particular their continued operation as the statutory pension insurance , rules to 1 January 1990 at the latest. The contract requires the approval of the health insurance funds, each alone in the average for the years 1986 and 1988 more than 10 per cent of the calculation day of the institution accounting for, if he does not complete with these health insurance companies.
(3) the facilities transferred to health insurance companies or their associations considered equity facilities after article 140, paragraph 1 of the fifth book social code.

Type 76 continuation of institution identification instead of an agreement pursuant to section 293, para 2 of the fifth book of the social code can be involved even to communicate, continue to use the previous institution flag.

Type 77 references and names in other legislation (1) referenced in other legislation provisions or be used in labels, which are amended or repealed by this Act be replaced by the corresponding terms and labels this law.
(2) the Federal Minister for health in consultation with the involved Federal Ministers will make known the wording of the provisions and terms that occur in accordance with paragraph 1 to replace the existing provisions and terms.
Second section final provisions art 78 Berlin clause this law applies in accordance with § 13 para 1 of the third of Reconciliation Act also in the Federal State of Berlin. Regulations, which are adopted on the basis of this Act, apply in the Federal State of Berlin according to § 14 of the third of transfer Act.

Type 79 entry into force, expiry (1) this law into force on January 1, 1989, unless determined otherwise in paragraphs 2 to 5.
(2) (3) (4) (5) (6) 1-10 (7)

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