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Law (1993:1651) On Läkarvårds Replacement

Original Language Title: Lag (1993:1651) om läkarvårdsersättning

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Introductory provisions



section 1 of this Act provides for certain employee benefits

doctor in private activities in primary care and the open healthcare

health care in General and on patient fees in connection therewith

(läkarvårds replacement).



What the Act says about the county councils also applies to municipalities that do not

is part of a County. Law (1995:837).



section 2 of the provisions of this law apply in the care of the

lives in Sweden, unless something else is particularly

before written.



The provisions of this Act also apply in the care of the

which, without being a resident in Sweden, have the right to

benefits in kind for sickness and maternity in Sweden according to

the provisions of European Parliament and Council regulation

(EC) No 883/2004 of 29 april 2004 on the coordination of

social security systems. The same shall apply for the

referred to in Chapter 5. paragraph 7 of the first paragraph, the social security code

and covered by the said regulation. Law (2010:1318).



section 3 of this Act with the care provided for medically justifiable treatment,

treatment or examination given by a doctor or under

physician's supervision and advice provided by a physician in

birth control purpose or, in the case of abortion, or

sterilization.



A Regional Council may, as a condition for leaving

läkarvårds compensation under this Act, require referral for care

in a private working physicians with expertise in

prerequisite to the referral requirements for equivalent care of

a specialist in the County. Referral, however, may not be required

medical expenses in medical activities relating to children,

gynaecology or psychiatry. Law (2009:79).



section 4 unless otherwise provided under this law with the County Council it

County Councils in whose area the doctor carries on or intends to carry on

their activities. Law (1995:837).



Collaboration and care agreement



5 § Läkarvårds allowance under this Act is payable only to the

physician liaison agreements with the County Council regarding their

activity.



The provision of the partnership agreement does not apply for a substitute teacher that

referred to in section 10.



A doctor in a private business that provides care in accordance with agreements with the

the County Council, will receive compensation from the County Council on the

conditions and in accordance with the grounds of the County Council and the doctor

agreed. The health care agreement in lieu of

the provisions of this law.



At the conclusion of the partnership agreement and health care agreement to County Council

application of Act (2007:1091) on public procurement or

Act (2008:962) on the free market system, subject to the

5 a-5 g sections. For the purposes of the Act on public

procurement, conclusion of collaboration agreements be equated with

public contracts for services listed in annex 3 to the

the Act (B). Law (2009:79).



Establishment of compensation



5 a of a doctor who works with the right to compensation in accordance with

This law and who intends to transfer his activities shall notify

to the county if he or she in this context would



– terminate their right to compensation, and



– allow for other doctors to get enter into collaborative agreements with

the County with the corresponding conditions (remuneration of establishment).

Law (2009:79).



5 b of the following notification in accordance with paragraph 5 shall, without delay, (a) the County Council

publish an applications that get included

the partnership agreement. The publication shall be done by advertising in a

electronic database, which is publicly available, or by

ad in any other form that allows for effective competition.



By invitation, or else trying available supporting documentation,

should include



1. What is the business to be transferred,



2. What are the conditions that apply to the partnership agreement,



3. in paragraph 5 (e) specified requirements for the conclusion of the

the partnership agreement,



4. how an application may be made, and



5. What is the last date the application shall be submitted.



Applicants shall be given a reasonable time to submit applications.

Law (2009:79).



section 5 (c) the County Council will treat applicants equally and

non-discriminatory way and comply with the principles of transparency,

mutual recognition and proportionality. Law (2009:79).



5 d § County Council may exclude an applicant from participating in

the application procedure as provided for in 7

Cape. 1 and 2 of the Act (2008:962) on the free market system. What

It is said there about the contracting authority should instead refer to

County Councils. Law (2009:79).



5 e § County Council shall take a decision on the conclusion of the partnership agreement

with the applicant who has offered the highest price for your business

and as



1. in the case of the takeover of the business may comply with the requirements

set out in paragraphs 7 to 9,



2. not excluded according to paragraph 5 (d), and



3. don't have already, or can receive, the right to public

compensation for their health care services within the framework of the

such a free market system referred to in the Act (2008:962) if

free market system.



After the operations have been transferred to the applicant that

referred to in the first subparagraph, the county enter into partnership agreement

with the latter. The partnership agreement should include equivalent terms

as for the transferring physician's right to compensation.

The County Council may, however, change the terms if the surrendering

the doctor accepted the new terms and conditions and those set out in the

for the applications or otherwise available for the applicants

surface.



If the transferring physician Recalling their notification in accordance with paragraph 5 (a)

or if it is otherwise missing opportunities to pursue

This matter has expired. Law (2009:79).



5 f § County Council shall, without delay, notify the

the applicants and the transferring physician if a decision to enter into the

the partnership agreement in accordance with paragraph 5 (e). The same applies to

If the case expired under section 5 (e) the last paragraph.

Law (2009:79).



5 g § provisions on justice and reparation in Chapter 16.

1, 2 and 4-6 of the Act (2007:1091) on public procurement in

amended by SFS 2007:1091 and 16 Cape. section 3 of the Act on

public procurement as amended by SFS 2009:853

regarding the establishment of compensation under this Act. What

as is said there about the supplier, contracting authority, contracts

and procurement should instead refer to applicant, counties,

cartel arrangements and procedure for

establishment of compensation.



The reference in Chapter 16. the third subparagraph of paragraph 1 of the law on public

procurement to notification under Chapter 9. section 9 should instead

refer to the information referred to in paragraph 5 (f) of this Act.



The references in Chapter 16. paragraph 2 of the first subparagraph, and paragraph 5 of the law on

Government procurement to other provisions of the Act, the

instead refer to 5 b-5 (f) of this Act. Law (2011:1034).



The County Council's responsibilities, etc.



section 6 of the County Council is responsible for the läkarvårds compensation

not covered by patient fees. If the treatment has meant a patient

not residing within the County Council's area, the

County Councils in whose territory they are resident, responsible for the

läkarvårds compensation paid, unless the county councils will

agree otherwise. If the patient does not reside within any

the County, the county councils in whose territory

the patient or family member is a professional or trade activity or, when

in the case of a person who is unemployed, the county councils in whose

area the person is registered as a job seeker, the

läkarvårds paid the compensation.



The insurance fund may, upon agreement with the County Council have

care of payment of läkarvårds compensation. Act (2004:830).



Special requirements for medical activities



section 7 of the compensation to be granted to läkarvårds requires that the doctor

have specialist expertise and conducts activities receiving

within their specialty in open care for individual patients.



Läkarvårds compensation is not provided to the physician

specialist competence only in laboratory medicine

specialties, social medicine, clinical neurophysiology,

rehabilitation medicine, clinical genetics or picture and

functional medical specialities except Clinical Physiology.



Läkarvårds replacement for the receive activity in the outpatients

for individual patients should be given even to doctors who are not

specialists in general medicine but who satisfies the requirements of

Article 28 and in annex V, point 5.1.4 in the European Parliament and

Council Directive 2005/36/EC of 7 september 2005 on the

recognition of professional qualifications. The provisions of this law

If a doctor with specialist competence applies in other on

analogy for these doctors. Law (2012:312).



section 8 Läkarvårds compensation is payable only to a doctor who

at the latest one year after the operation began conducting

activities under section 7 on a full-time basis, subject to the other

paragraph or section 10. A doctor considered to be full-time active if

the doctor working at least 35 hours per week on average, or

have worked for at least this time any 12-month period under the

last two years.



Läkarvårds compensation is also paid to a doctor as a result

by illness, leave for the care of children, forthcoming

retirement, further training or research in

the profession, political or trade union or other

similar reasons do not operate on a full-time basis.

Law (2009:79).



9 § Läkarvårds compensation is not payable to a doctor who is

employee of any county health care or in a

company or other legal person in health care

that the County Council has a legal non-controlling interest in.

However, compensation may be provided if the doctor is on leave and

standing in for another doctor.



Läkarvårds compensation is not payable to a doctor

activities in the field of occupational health or student health

relates to medical interventions according to Chapter 2. section 25

Education Act (2010:800). Law (2010:864).



Temporary position



section 10 if a doctor due to illness, vacation, time off for


child care, impending retirement, retraining

or research within the profession, political or trade union

Office or other similar reasons, totally or partially

Unable to operate, get another doctor who

have the same specialty or another specialty within the same

Group of specialities substitute during absences.

Law (2009:79).



repealed by section 11 of the Act (1994:1961).



section 12 is repealed by Act (1994:1961).



13 repealed by Act (1994:1961).



Interoperability with other



paragraph 14 of a doctor who gets läkarvårds compensation shall cooperate with

others in the health care and rehabilitation area.



Läkarvårds compensation



Common provisions



15 § Läkarvårds allowance for certain action to be provided with a

amounts represent reasonable compensation for the doctor's work and

costs. Consideration with the exception of the portion thereof that relates to

the physician's travel expenses in connection with sick visit paid

the normal fee, easy fee or fees. By

patient fee paying patient all or part of the fee,

subject to section 22 or 24.



section 16 of the Normal fee is a single fee for the main

part of the medical operations that occur in the physician's

specialty. The normal fee is based on the expected reception costs

and annual visitor volume in the specialty. Simple fee is a lower

fees for simple tests and treatments performed by

the physician or under his supervision or outside the

usual activities of the physician's specialty. Measures that are

particular time or cost is replaced with a higher, particularly

fee. Law (1995:837).



section 17 If it a doctor and substitute in his business for a

calendar year läkarvårds compensation in an amount

corresponds to compensation for a full annual working time in the specialty,

be provided then compensation with the reduced amount. Reduced

compensation is paid up to an amount equivalent to one half

annual working time (replacement). If the doctor does not operate

full time reduced the annual compensation and the compensation ceiling in fair

scope.



The provisions of the first subparagraph shall not prevent the physician providing care to

patient fee set out in section 23.



Compensation for advice on birth-control purposes, or

regarding abortion or sterilization is not included in the basis for the in

the first paragraph stated limits of compensation. Law (1995:837).



18 § a doctor who carries out activities for remuneration under this

law may not provide care for higher remuneration than that resulting from the Act or the

an enforcement provision.



section 19 of A County is not liable to pay

läkarvårds remuneration before the partnership agreement has been concluded.



If a doctor has a läkarvårds replacement with too high

amount, the County Council to recover the amounts wrongly

paid. The County Council may in that case rather than settle

the amount of the claim from the doctor on

läkarvårds compensation.



If a doctor despite repeated reminders or

otherwise materially requests läkarvårds replacement with

for high amounts or otherwise incorrectly, the County Council

reduce the overall läkarvårds compensation requested for certain

time for a reasonable amount. Law (2009:79).



Special provisions for certain areas



section 20 to a doctor who establish themselves in a place within a

Special assistance area shall fees in accordance with section 15 is left with twenty

percent increase.



Fee increase referred to in the first subparagraph shall be paid by the

the County Council. After two years from the establishment to increase

reduced by five percentage points every year down to five percent.



A doctor who operates in a particular

support area, County Council provide special compensation for

phone consultations and home visits medically justified.



The Government may provide for the areas to be

be considered as specific support areas under this section.

Law (2009:79).



section 21 was repealed by law (1995:837).



Patient fee



section 22 For care provided by a physician are reimbursed under this

law, the patient requested from a patient fee. Patient fee shall not

for advice on birth control object or subject

abortion or sterilization. Patient fee may not be charged if

This is evidenced by specific provisions.



If the patient fee shall be applied section 6 of the first subparagraph of

the corresponding way.



section 23 of the Patient fee under this Act may be charged with a maximum of the same

amounts applicable for the corresponding care in the County.



If the doctor charges a lower client fee than is permitted

under the first subparagraph shall not affect the part of the

läkarvårds the remuneration paid by the County.



If the patient fee would exceed the fee that is payable for

health care, the difference shall be paid to the County.

Act (1997:435).



section 24 a patient who for some time has achieved a fee waiver under 26 a of the health care Act (1982:763) is at the same time, exempt from paying patient fees under this Act. Law (2012:928).



section 25 of the Incurred cost due to a lack of patients

from the contracted doctor visits, the patient fee provided for in section 23 of the first

the first sentence still put out by the patient. The provisions of the

section 24 does not free the patient from the fee under this provision.



25 a of the fee charged by the patient's guardian, if the patient

are under 18 years of age when



1. health care is provided, or



2. he or she fails to materialize from an agreed appointment.



If there are multiple guardians, they answer jointly and severally liable for

the fee.



If there are special reasons, the fee charged by the

minor. Law (2010:248).



Activity monitoring, etc.



paragraph 26 of A doctor who requests the compensation läkarvårds to participate

to its own operations to be monitored and evaluated.

The physician shall annually submit a report to the County Council with

information about the clinic staff and medical technology

equipment and if carried out treatment measures and the number of

patient visits.



The physician shall, at the request of the County provide information and

view up the medical records and other material relating to the

examination, care or treatment of a patient and that

needed for the control of läkarvårds demanded compensation.



Of section 6 of the Act (1998:543) on health data registers, it follows that

the doctor also will provide data to health data registers.

9 last amended 1995:837. Law (2009:79).



Enforcement regulations



section 27 of Government Announces enforcement rules of this law.



Transitional provisions



1993:1651



1. This law shall enter into force, with respect to the third subparagraph of paragraph 7 the day

the Government, and on 1 January 1994.



2. Older rules still apply in respect of remuneration of

private practitioners relating to the period prior to the entry into force.



3. For the period up to 1 July 1994 applies notwithstanding the 15--17,

20 and 21 sections to a tariff that essentially corresponds to the provisions

If the fees of the medical rate (1974:699) applies for the purpose of

determination of läkarvårds compensation.



4. Has been repealed by law (1995:837).



5. Repealed by law (1995:837).



6. Repealed by law (1995:837).



7. the notification under section 11 Has been made before 1 april 1994,

the business of läkarvårds compensation notwithstanding the

paragraph and paragraph 19 begins three months after

notification.



1994:1257



The Government states that the Act (1993:1651) on läkarvårds replacement

shall enter into force on 1 January 1995 as regards paragraph 7 of the third

paragraph.



1994:1754



1. this law shall enter into force on 1 January 1995.



2. The new provisions of section 6 apply also for care during the year

1994 by persons covered by the Act (1992:1776) on

coordination of social security schemes to persons moving

in the European economic area (EEA).



1994:1961



1. this law shall enter into force on 1 January 1995.



2. A physician who at the time of entry into force is effective against

läkarvårds compensation under this Act has the right to continue such

compensation even without cooperative agreements under the new regulations.



3. A physician who is not covered by paragraph 2 but before 14

November 1994 made the notification under section 11 in its previous wording and

that meets the requirements for läkarvårds payments may begin

the business six months after notification, even without

the partnership agreement. If the activity is not started on 14 May 1995

required collaboration agreements. If the doctor does not have the specialist expertise

required, however, that the County Council has accepted the doctor's establishment in

the County Council's area.



1995:837



1. This law shall enter into force, with respect to paragraph 17, first subparagraph, first

and the second sentence on 1 January 1997, and on 1 January

1996.



2. Older rules still apply in respect of remuneration of

private practitioners relating to the period prior to the entry into force.



3. A physician who at the time of entry into force is effective against

läkarvårds compensation under this Act without a cooperation agreement with

the County Council and without fulfilling the requirement of specialist qualifications

under section 7 or the requirement for a full-time activities under section 8 can also without

the partnership agreement receiving compensation under this Act unless otherwise provided

of paragraph 4. The same applies to anyone who is active at the time of entry into force

as a private practitioner under the Act (1993:588) if the family doctor.

If the activities of a doctor who falls within the scope of this paragraph is amended in

materially, however, the question of the right to

läkarvårds compensation be examined under this Act.




4. If a physician who at the time of entry into force is effective against

läkarvårds compensation under this Act, does not meet the age requirement in

§ 9 handed läkarvårds compensation at the end of 1996, about

not the doctor and the County Council agree otherwise.



1996:1159



1. this law shall enter into force on 1 January 1997.



2. Older provisions shall continue to apply to such

cost relief incurred before the end of 1996.



1997:435



1. This law shall enter into force, with respect to section 9 on 1 July 1997,

and in General on 1 January 1998.



2. Older rules still apply in the case of health care that

refers to the time before the entry into force.



1999:842



1. this law shall enter into force on 1 January 2000.



2. Older provisions, however, until the end of the year 2003

care provided by physicians at the time of entry into force is active

in occupational health care and then has the right to

läkarvårds compensation under this Act.



2009:79



1. this law shall enter into force on 1 april 2009.



2. Older rules still apply in respect of remuneration

for the care given before the entry into force.



3. Older version of section 7 is still valid for physicians

such specialist as indicated in the earlier wording.



4. Older version of section 20 apply to physicians at the

entry into force operating in such areas as

specified in the older wording.



2010:248



1. this law shall enter into force on 1 June 2010.



2. The new provisions do not apply to charges for which

payment obligations incurred prior to the entry into force.



2010:1318



1. this law shall enter into force on 1 January 2011.



2. Older provisions still apply to the

covered by Council Regulation (EEC) No 1408/71 of 14

June 1971 on the application of social security schemes

When employed persons, to self-employed persons and to members of their families

moving within the community.



2011:1034



This law shall enter into force on 1 January 2011, but applied for

time from 15 July 2010.