Law on the safeguarding and structural improvement of statutory health insurance (Health Structure Act)

Unofficial table of contents

GSG

Date of completion: 21.12.1992

Full quote:

" Health Structure Act of 21 December 1992 (BGBl. 2266), as last amended by Article 205 of the Regulation of 25 November 2003 (BGBl I). I p. 2304).

Status:

Last amended by Art. 205 V v. 25.11.2003 I 2304

For more details, please refer to the menu under Notes

Footnote

(+ + + Text evidence from: 1.1.1993 + + +) 

  

Art. 13: PflPersRgL 2126-9-12 Unofficial table of contents

Content Summary

Article 1	Amendment of the Fifth Book of Social Law
Article 2	Second Amendment of the Fifth Book of Social Law
Article 3	Amendment of the Fourth Book of Social Law
Article 4	Amendment of the Sixth Book of Social Law
Article 5	Amendment of the Reich Insurance Order
Article 6	Amendment of the Law on the Health Insurance of Farmers
Article 7	Amendment of the Second Law on the Health Insurance of Farmers
Article 8	Amendment of the Artists ' Social Insurance Act
Article 9	Amendment of the Authorisation Regulation for Contract Physicians
Article 10	Amendment of the Authorisation Regulation for Contractual Dentists
Article 11	Amendment of the Hospital Finance Act
Article 12	Amendment of the German Federal Government Regulations
Article 13	Regulation on standards and principles for human resource requirements in inpatient nursing care (nursing staff regulations)
Article 14	Hospital investment programme for the territory referred to in Article 3 of the Unification Treaty
Article 15	Amendment of the Social Court Act
Article 16	Amendment of the Federal Education and Training Promotion Act
Article 17	Amendment of the Employment Promotion Act
Article 18	Amendment of the Medicines Act
Article 19	Amendment of the law on pharmacy
Article 20	Amendment of the Rules relating to Fees for
Article 21	Amendment of the fees regulations for dentists
Article 22	Amendment of the law on the exercise of dentistry
Article 23	Budgeting of administrative expenditure
Article 24	Return to the Single Regulation
Article 25	Amendment of the Health Reform Act
Article 26	Unenforceability of unlawful agreements
Article 27	Legal regulations for the fulfilment of the legal obligations of self-government
Article 28	Extension of the insurance obligation
Article 29	Medical and medicinal products budget for 1993
Article 30	Price Oratorio for Medicinal Products
Article 31	(dropped)
Article 32	Special right of dismissal for insurance-free persons
Article 33	Transfer rules
Article 34	Transitional provisions on risk structure compensation
Article 35	Entry into force, external force

Unofficial table of contents

Input formula

With the approval of the Federal Council, the Bundestag has adopted the following law:

Species 1 to 11

Species 12
Amendment of the German Federal Government Regulations

(1) (2) For hospitals which, on 1 January 1995, account for the flat-rate and special charges determined on the basis of Article 17 (2a) of the Hospital Finance Act, paragraph 1, with the exception of point 6 and point 7 (b), shall apply only to: the period of the calendar years 1993 and 1994. (3)

Art 13
Regulation on standards and principles for human resource requirements in stationary nursing care (PflPersRgl)

Species 14
Hospital investment programme for the territory referred to in Article 3 of the Unification Treaty

(1) For the rapid and sustainable improvement of the level of inpatient care of the population in the area referred to in Article 3 of the agreement and for the adjustment to the level in the rest of the territory of the Federal Republic of Germany, the of the agreement referred to in § 9 (1) and (2) of the Hospital Finance Act in the years 2002 to 2014 by an investment surcharge of 5.62. Euro for each calculation day of a daily allowance, in case of a case-flat rate for the corresponding occupancy days. The contract shall be used to finance the interest cost of loans or the corresponding costs of other forms of private sector financing or direct investment financing. The countries agree on the details of the procedure and the use of the funds with the parties referred to in § 18 (1) sentence 2 of the Hospital Finance Act. (2) The obligation of the countries to finance investment after the Hospital finance law and its responsibility for hospital planning remain unaffected. In order to achieve the objectives referred to in paragraph 1, the countries shall, in agreement with the parties referred to in Article 18 (1), second sentence, of the Hospital Financing Act, provide annual jointly financed investment programmes up to 31 December 2008. December 2004. Section 18b of the Hospital Finance Act shall not apply until 31 December 2004 in the area referred to in Article 3 of the Agreement. (3) Additional funds of the countries within the meaning of Article 14 (2) sentence 2 in the until 31 December 2004 Until 31 December 2000, until 31 December 2000, the funds provided by hospitals for the implementation of eligible hospital investments are also available from a loan, provided that the country is responsible for debt servicing in the context of the promotion according to § 9 (1) and (2) of the Hospital Finance Act has taken full effect; the However, repayment services for this loan may not be included in the accounting for the Federal Government for the year 2001. Countries may, in accordance with the second sentence of Article 14 (2), take account of their additional appropriations in the version in force until 31 December 2001, for the years 1995 to 2000 inclusive. The federal financial aid granted to them on the basis of the first and second sentences can be taken into account by the Länder until 31 December 2002.

Species 15 to 22

Art 23
Budgeting of administrative expenditure

(1) In 1993, 1994 and 1995, the annual administrative expenditure of the sickness fund for each member of the Federal Republic of Germany outside the territory of the Federal Republic of Germany may not exceed the administrative cost allowance of the care fund (Section 46 (3) of the Eleventh Book). Social code) per member and by the amount which is changed by multiplying the average administrative expenditure of all health insurance funds in the Federal territory outside the accession area by member with the rate of change of the according to the § § 270 and 270a of the Fifth Book of Social Code Contributory income of members of all health insurance funds in the Federal Republic of Germany outside the accession territory of each Member. The starting point shall be the annual administrative expenditure of the sickness fund per member in 1991, which shall be increased by the amount resulting from the calculation procedure as set out in the first sentence for the calendar year 1992. The calculations referred to in sentences 1 and 2 shall, in so far as they relate to the average administrative expenditure of the sickness funds per member, be carried out separately according to the occupational health insurance funds and to other sickness funds. The budget for the following year shall be subject to an unavoidable overrun of the budget for legal reasons. (2) Paragraph 1 shall apply to sickness funds in the accession area, subject to the proviso that the members of all the members of the sickness insurance fund shall be responsible for the revenue. health insurance funds in the accession area. In the case of the occupational health insurance funds in the accession area, only the administrative expenditure reduced by personnel costs in accordance with Article 147 (2) of the Fifth Book of the Social Code is to be used as the starting basis for 1991. (3) Paragraphs 1 and 2 apply. (4) Administrative expenditure within the meaning of paragraphs 1 and 2 shall be all expenditure referred to in Annex 1 to Section 25 of the General Administrative Regulation on the Accounting of Social Security of 3. August 1981 in account class 7-Administrative and procedural costs. It does not take into account administrative expenditure for services which only individual cash points are created by the implementation of legislation and are not replaced by a third party. (5) The supervisory authority may, in the presence of exceptional circumstances, be able to permit, in particular, an exception to the limitation of administrative expenditure referred to in paragraphs 1 to 3.

Species 24
Return to the Single Regulation

The parts of the legal ordinances referred to in Articles 9, 10, 12, 20 and 21 may be amended or repealed by means of a regulation on the basis of the relevant authorization in connection with this Article. Article 13 may be based on § 16 sentence 1 in conjunction with Section 19 (2) of the Hospital Finance Act as amended by the Notice of 10 April 1991 (BGBl. 886), as amended by Article 10 of the Law of 20 December 1991 (BGBl I). 2325), as well as in conjunction with this Article, are amended or repealed by means of a regulation.

Species 25

Species 26
Unenforceability of unlawful agreements

Contractual agreements are ineffective in the parts in which they are not compatible with the provisions of this law. This shall also apply to agreements which have been concluded before 1 January 1993. The Contracting Parties shall adapt the agreements to the statutory provisions by 31 March 1993. Section 71 (2) of the Fifth Book of the Social Code applies accordingly.

Species 27
Legal regulations for the fulfilment of the legal obligations of self-government

§ 106 (3) and (4), § 135 (3) and (4), § 136 (1), § 296 (4), § 300 (3), § 301 (3), § 302 (2) of the Fifth Book of Social Code (Sozialgesetzbuch) cannot be reached by 31 December 1994, the Federal Ministry for Economic Cooperation and Development (Bundesgesetz) Health and Social Security with the approval of the Federal Council, taking into account the provisions applicable to the self-administration, in each case corresponding regulations shall be made by means of a regulation.

Species 28
Extension of the insurance obligation

(1) From 1 January 1997, persons receiving ongoing assistance for subsisting under the Federal Social Assistance Act, with the exception of asylum seekers and similar groups of persons, shall be included in the obligation to insure against insurance pursuant to Article 5 (1) of the Fifth Act. (2) The details of the delimitation of the person liable to pay, the measurement of contributions and the reporting obligations are regulated in a special law.

Species 29
Medical and medicinal products budget for 1993

(1) As a budget in accordance with Section 84 (1) of the Fifth Book of the Social Code for the year 1993, the expenditure of the participating sickness funds for medical, association and remedy funds in 1991 shall apply within the scope of the budget in accordance with the rates 2 to 7. The expenditure on medicinal products shall be reduced by

1.

4.25 of the hundred on the basis of the repayment of the surcharge in accordance with § 31 of the Fifth Book of Social Code,

2.

2.45 of the hundred on the basis of the reduction in the price of medicinal products referred to in Article 30;

3.

1.51 of the hundred on the basis of the fixing of further fixed amounts in accordance with § 35 of the Fifth Book of the Social Code in 1992 and 1993.

On this basis, the expenditure on medicines will be increased by

1.

1.74 of the hundred on the basis of the increase in the prices of medicinal products from 1 January to 30 April 1992;

2.

0.9 of the hundred on the basis of the increase in the value added tax for medicinal products on 1 January 1993,

3.

3.5 of the hundred due to a one-off consideration of the increased number of contract doctors,

4.

0.9 of the hundred on the basis of the obligation to benefit the health insurance funds for contraceptive funds in accordance with § 24a (2) of the Fifth Book of Social Code.

The percentages referred to in the second sentence shall be in each case at the 1991 expenditure, the percentages referred to in the third sentence in each case shall be based on the expenditure level adjusted in accordance with the second sentence. The expenditure on remedies is increased by the percentage of the contributions of the members of all health insurance funds to be given in the years 1992 and 1993 according to § § 270 and 270a of the Fifth Book of the Social Code. Seat in the federal territory outside the accession area for each member. Sentence 3 No 3 also applies to medicinal products. In the case of sickness funds, the expenditure referred to in the first sentence of paragraph 1 shall be based on the results of the year's accounts for sickness funds, the division of which does not exceed the scope of the budget. In 1991 on the basis of types 430 and 450 to 453 in accordance with Appendix 1 to § 25 of the General Administrative Regulation on the accounting of social security of 3 August 1981. In the case of health insurance companies whose business unit exceeds the scope of the budget, the expenditure is based on expenditure resulting from the multiplication of expenditure on medicinal products, association and cures per treatment case of the respective sickness insurance fund. In 1991, the number of treatment cases covered by the sickness fund in question with the Association of Sickness Funds in the scope of the budget for the year 1991 is the result of the treatment. The expenditure in accordance with Section 84 (1) sentence 4 of the Fifth Book of Social Code for the year 1993 shall be determined accordingly. Where sufficient statistical data on expenditure within the scope of the budget are not available, estimates shall be made on the basis of appropriate reference quantities. (3) In the event of an overrun of the data referred to in the second sentence of the first paragraph of paragraph 1, the estimates shall be The Federal Association of Health Insurance Physicians ensures that the Federal Association of Sickness Insurance Funds ensures that the excess amount is offset by appropriate measures up to a total of 280 million Deutsche Mark in relation to the health insurance funds. The distribution of the compensatory amount to the terminal medical associations shall take place in accordance with their shares in the excess amount. If compensation is not guaranteed by the Federal Association of Statesmen and Health (Bundesvereinigung), a settlement will be carried out within the framework of the total remuneration in 1994. § 84 (1) sentence 7 of the Fifth Book of the Social Code applies accordingly. (4) Exceeding the expenditure on medicinal products determined in accordance with the second sentence of the first sentence of paragraph 1 by more than 280 million Deutsche Mark up to an amount of 560 million. Deutsche Mark was balanced by the pharmaceutical companies in relation to the health insurance companies. The compensation shall be provided by a corresponding extension of the period of validity of the price oratorio referred to in Article 30. The pharmaceutical companies are the same as those of the wholesale pharmaceutical trade and pharmacies resulting from the prolongation of the price oratorio by corresponding discounts. (5) In the event of exceeding those referred to in paragraph 1, The Federal Minister of Health shall, with the consent of the Federal Council, determine the expenditure for the medicinal products referred to in paragraph 4 of the Social Code in accordance with Article 84 (1) sentences 4 to 7 of the Fifth Book of Social Law. , extension of the period of validity of the price oratorio pursuant to Article 30 and the amount of the rebates referred to in the third sentence of paragraph 4. (7) The budget referred to in paragraph 1 shall continue until the entry into force of agreements pursuant to Section 84 (1) of the Fifth Book of the Social Code; Section 84 (4) of the Fifth Book of the Social Code remains (8) For the first time, budgets for the accession area shall apply for the year 1994. The 1994 budget is the doubled expenditure of the first half of 1992, adjusted for the clearance of the accounts in accordance with Article 311a of the Fifth Book of the Social Code, taking into account the provisions of paragraph 1 and Section 84 (1) of the Fifth Book of the Fifth Book of the Fifth Book of the Fifth Book of the Fifth Book of the Fifth Book of the Fifth The Book of Social Code has to be based on the principles set out above Paragraph 7 shall apply accordingly.

Art 30
Price Oratorio for Medicinal Products

(1) The manufacturer's release prices of ready-to-use pharmaceutical products for which § § 2 and 3 of the Pharmaceutical Price Regulation of 14 November 1980 (BGBl. 2147) and for which no fixed amount is fixed on 1 January 1993 in accordance with Article 35 of the Fifth Book of the Social Code, the years 1993 and 1994 shall be:

1.

a maximum of 95 per hundred of the prices in force on 1 May 1992 for finished medicinal products subject to the obligation to presenter,

2.

a maximum of 98 per cent of the prices for finished medicinal products which are not subject to the obligation to prescend on 1 May 1992.

The pharmaceutical manufacturers have to reduce prices accordingly and to announce them in good time. Where a manufacturer does not disclose the prices or does not disclose the prices in good time, the maximum permitted prices shall be those specified in the first sentence of the first sentence of 1 and 2 as the manufacturer's prices. The prices referred to in the first and second sentences of 1 and 2 shall be based on the wholesale surcharges in accordance with § 2 and in accordance with the pharmacies surcharges referred to in § 3 of the Regulation on the price of medicinal products. The remuneration to be paid to pharmacies by the sickness insurance funds shall be calculated on this basis. In the case of medicinal products for the first time introduced into the market in the period from 2 May to 31 December 1992, the rates 1 to 5 shall apply with the proviso that the market entry prices shall be the reference quantity for the price reduction referred to in the first sentence of the first sentence of 1 and 2. The prices of medicinal products for the first time being introduced into the market after 31 December 1992 must not be increased in 1993 and 1994. For medicinal products for which fixed amounts are fixed after 31 December 1992 according to § 35 of the Fifth Book of the Social Code, the rates 1 to 7 shall not apply from the date of entry into force of these fixed amounts. (2) The Federal Minister for Health may following a review of the need for the price reductions referred to in paragraph 1 in accordance with the Directive of the Council of the European Communities of 21 December 1988 on the transparency of measures to regulate the pricing of prices Medicinal products for human use and their inclusion in the public sector Health insurance systems (89/105/EEC), with the consent of the Federal Council, repeal or reduce the markdowns by means of a regulation with the consent of the Federal Council. (3) Paragraph 1 does not apply to medicinal products which, according to Article 34 (3) of the Fifth Book of the Social Code, have been published by the Supply according to § 31 of the Fifth Book of the Social Code are excluded.

Art 31
Institut "Arzneimittel in der Krankenversicherung"

Species 32
Special right of dismissal for insurance-free persons

Non-insurance persons who are not entitled to a contribution grant under Article 257 of the Fifth Book of the Social Code and are insured with a private insurance undertaking may, as from 1 July 1994, be entitled to a contribution from that insurance undertaking request a certificate attesting that the insurance cover complies with the conditions laid down in Article 257 (2a), first sentence, no. 1 to 4 of the Fifth Book of Social Code. If the insurance undertaking does not issue this attestation within two months of receipt of the application, the policyholder may terminate the insurance contract with immediate effect within two further months. The insurance undertaking may only issue the certificate if the competent supervisory authority has confirmed that it operates the insurance contract, which is the basis of the insurance contract, in accordance with the conditions set out in the first sentence.

Type 33 transfer rules

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§ 1 Age limit for contract physicians and contract dentists

In the case of contract doctors and contract dentists, who took the 68 on 1 January 1999. The date of the authorisation shall end on 1 January 1999. Was the contract doctor or contract dentist at that time

1.

Less than 20 years as a contract doctor or a contractual dentist, and

2.

before 1 January 1993, as a contracting doctor or a contractual dentist, the authorisation committee shall extend the authorisation at the latest by the end of this period. The first sentence shall apply to employed physicians and dentists.

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§ 2 Registration in the doctor's register

Entries in the doctor's register remain unaffected until 31 December 1993. Without prejudice to the first sentence, if an application for admission as a contracting doctor is submitted after 31 December 1994, the doctor shall comply with the requirements of Section 95a of the Fifth Book of Social Code. Unofficial table of contents

Section 3 Decision on admission

(1) A request for admission as a contract doctor, which shall be filed until 31 January 1993, shall also be in accordance with the restrictions on admission after 1 January 1993 pursuant to Section 103 (1) of the Fifth Book of the Social Code. The authorisation shall end in accordance with the first sentence if the contract medical activity is not at the latest by 1. It will be held in October 1993. By way of derogation from the first sentence of Article 95 (2) of the Fifth Book of the Social Code, an application for the first sentence may be filed even if the preparatory period has commenced before 5 November 1992 in accordance with Article 95 (2) sentence 3 of the Fifth Book of the Social Code and before 1 April 1993. (2) The admissions committee may decide on applications for applications submitted after 31 January 1993 only if the Land Committee of Physicians and Health Insurance Funds is to determine the determination according to § 103 Paragraph 1, first sentence, of the Fifth Book of the Social Code has been taken. Applications for the first sentence are to be rejected due to restrictions on admission, even if they have not yet been ordered at the time of application. (3) The Admissions Committee may grant authorisations for the appointment of a physician pursuant to section 32b (2) of the Admission Regulation for contract doctors only if the Land Committee of Doctors and Health Insurance Funds has made the determination in accordance with Section 103 (1) sentence 1 of the Fifth Book of the Social Code. (4) The provisions of paragraphs 1 to 3 shall apply mutagens to contract dentists. Unofficial table of contents

§ 3a Conversion of the treasury doctors into contract doctors

(1) The doctors and dentists who, on 31 December 1992, were admitted as cash doctors or treasury dentists, as well as contract doctors or contract dentists of the replacement funds, are authorised contract doctors or contract dentists. (2) The The legal status of the contract doctors and contract dentists of the replacement funds who are only participating in the medical and dental care on 31 December 1992 shall remain unaffected. Unofficial table of contents

§ 4 Volunteer Insurance

§ 9 (1) (1) of the Fifth Book of the Social Code and Article 6 (1) (1) of the Second Law on the Health Insurance of Farmers in each case apply to persons who leave the insurance obligation up to 31 December 1992 from the obligation to insurance insurance. the current version shall be valid even if the accession to the sickness insurance fund is indicated after 31 December 1992. Unofficial table of contents

§ 5 Supply of orthodontic services in adults

Insured persons who have completed the eighteenth year of life and whose orthodontic treatment has commenced before 1 January 1993 shall be entitled to take over the costs of orthodontic treatment including dental services at the level of the law applicable on 31 December 1992, when the sickness insurance fund has already made a written decision on the claim before 5 November 1992. Unofficial table of contents

§ 6 Supply of dentures

Insured persons whose dental treatment for the supply of dentures or dental crowns commenced before 1 January 1993 shall be entitled to take over the costs of dental treatment and the costs of dental services at the level of the dental treatment. as provided for in the law applicable on 31 December 1992, when the sickness insurance fund has already made a written decision on the claim before 5 November 1992. Unofficial table of contents

§ 7 Continuation of existing contracts

(1) Contracts for the regulation of the contract medical and contractual dental care which expire on 31 December 1992 shall continue to apply until the contracting parties meet new regulations or the arbitration offices in accordance with § 89 of the Fifth Book (2) If from 1 January 1993 the Federal Association of Statesmen, the Federal Association of Statesmen and the Federal Association of Sickness Funds, or the top associations of the health insurance companies do not have a final authority, replace the German Federal Association for Social Insurance. Federal Association of Statesmen, the Association of Statesary Medical Associations, in place of the Federal Association of Sickness Insurance Associations of the Federal Association of Sickness Insurance Funds, in place of the top associations of the health insurance companies, the national associations of the health insurance companies or the associations of the replacement funds, which in this respect the rights and obligations of a National Association, enter into the Treaties. Unofficial table of contents

§ 8 Effects of the complaint of remuneration agreements

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§ 9 Effects of the application of decisions of the Arbitration Offices

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Section 10 Election of members of the Administrative Board

(1) The representative assembly of the health insurance company referred to in § 35a of the Fourth Book of the Book of Social Code in the version in force as of 1 January 1996 shall elect the members of the Board of Directors by 30 June 1995 in accordance with section 31 (3a) of the Fourth Book of the Fourth Book of the German Social Code. The Book of the Social Code in the version in force as from 1 January 1996. In this connection, Section 43 (1) sentence 2 of the Fourth Book of the Social Code is to be observed in the version in force as from 1 January 1996. The members of the Executive Board shall be deemed to be members of the representative assembly for this election. In addition, the provisions of the Fourth Book of Social Code shall apply in accordance with the election of the Board of Directors. (2) The Board of Directors shall elect the Chairman and his deputy from among its members. (3) The first term of office of the members of the The Administrative Board shall end with the expiry of the eighth term of office of the self-governing bodies. Unofficial table of contents

§ 11 Election of the Executive Board of the sickness insurance fund

The Board of Directors, in accordance with § 10, shall elect the Management Board and the Chairman of the Board of Management and its alternates until 31 December 1995. § 35a of the Fourth Book of the Social Code shall be applied in the version in force as from 1 January 1996. Unofficial table of contents

§ 12 General rules for the associations of health insurance companies

§ § 10 and 11 apply to the federal states and federal associations accordingly. Unofficial table of contents

Section 13 Overline provision for the association of replacement cash registers

(1) (2) In the case of replacement cash registers prior to 1 January 1996, the resulting replacement fund may only take up persons who could have been accepted by the replacement funds participating in the association on 31 December 1994. Unofficial table of contents

§ 14 Insurance obligation of pensioners

Those who were liable to insurance on 31 December 1992 on the basis of a pension from the statutory pension insurance scheme or who were considered to be a member for applying for a pension, shall remain in respect of the period of the retirement of that pension or until the date on which the pension is paid. the pension application is withdrawn or the rejection of the application becomes undisputed, even if it is subject to the conditions for the insurance obligation pursuant to Article 5 (1) (11) of the Fifth Book of Social Code or Article 56 1 to 3 of the Health Reform Act is not complied with.

Species 34
Transitional provisions on risk structure compensation

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§ 1

(1) For the financial year 1994, the following shall be considered:

1.

Performance expenditure, insofar as it is attributable to persons referred to in Article 5 (1) (11) and (12) of the Fifth Book of the Social Code and to the members of the family insured pursuant to Section 10 of the Fifth Book of the Social Code, in the determination of performance expenditure pursuant to Section 266 (2) of the Fifth Book of the Social Code and the demand rate in accordance with Section 145 (3) of the Fifth Book of the Social Code,

2.

Contribution income of compulsory insured persons referred to in § 5 (1) of the Fifth Book of the Social Code, who receive a pension from the statutory pension insurance scheme, in so far as these contributions are based on pensions, pensions, pensions, and labour income In the determination of the contribution requirement and the financial power in accordance with § 266 of the Fifth Book of Social Code and the demand rate in accordance with § 145 (3) of the Fifth Book of the Social Code.

(2) The expenditure for the 1994 financial year according to § 145 (3) of the Fifth Book of the Social Code also includes the share of funding to be financed by each sickness fund in accordance with § 270, sentence 1 of the Fifth Book of the Social Code. Unofficial table of contents

§ 2

§ § 268 to 273 of the Fifth Book of the Social Code shall be repeal if the claims and obligations of the sickness funds arising from the results of the 1994 business and the results of the accounts are balanced. The Federal Minister of Health shall determine the date of the expiry date in accordance with Section 266 (7) of the Fifth Book of the Social Code. For business and billing results in the health insurance of the pensioners, the risk structure compensation shall apply from 1 January 1995 in accordance with § 266 of the Fifth Book of Social Code. Unofficial table of contents

§ 3

(1) The statutes of the leading associations may provide for financial aid provisions for the financial year 1993 in special emergency situations of a sickness insurance fund of their cash-in-cash type. The condition is that the requirement of this sickness insurance fund exceeds the national average demand rate of the cash register by more than 12.5% and that a financial equalisation procedure is carried out in accordance with § 266 of the Fifth Book of Social Code has been made. More information on the conditions, scope, financing and implementation of the financial aid rules are laid down in the statutes. The statutes require the approval of two-thirds of the members of the top association. A health insurance company can only receive the aid once within 60 calendar months. § 266 (2) sentences 3 and 4 and § 313 (10) (a) of the Fifth Book of the Social Code apply accordingly. (2) The Board of Management of the Leading Association shall decide on the assistance at the request of the Executive Board of the sickness insurance fund after hearing the members of the Top association. Before deciding on the aid, the leading association shall examine the causes of the above-average requirement in accordance with paragraph 1 together with the sickness fund and, if the sickness fund is a member of a national association, with the national association. and measures likely to improve the financial situation of the health insurance fund. § 266 (3) sentences 4 to 6 of the Fifth Book of the Social Code shall apply accordingly. Unofficial table of contents

§ 4

According to § 145 (3) of the Fifth Book of the Social Code, the ratio of expenditure on benefits for the financial year 1993 is the sum of the expenses incurred by the Social Code in accordance with Section 269 of the Fifth Book of Social Code. of the members ' income without the amounts referred to in § 270, sentence 4, points 1 and 2 of the Fifth Book of the Social Code. The expenditure shall be reduced by the expenditure incurred by third parties in respect of benefits, the expenditure relating to the provision of additional and trial services and the expenditure on which there is no legal claim. The expenditure also includes the share of funding pursuant to § 270 sentence 1 of the Fifth Book of Social Code.

Art 35
Entry into force, external force

(1) This Act shall enter into force on 1 January 1993, unless otherwise specified in the following paragraphs. (2)-(6) (7) (omitted) (8). (9)