Appointment service and supply law

Faster appointments, more office hours, better offers for legally insured persons

Appointment Service and Supply Act (TSVG)

Patients should receive medical appointments faster, health insurance benefits and care are improved. These are the goals of the “Law for faster deadlines and better care” (Term Service and Supply Act, TSVG), which comes into force on May 11, 2019.

“Statutory insureds too often wait too long for medical appointments. We want to change that. And together with the doctors. Therefore, those who help to improve care should be better remunerated. Then it is also worthwhile for doctors to give patients a timely appointment. Supply should be better, faster and more digital.

Federal Health Minister Jens Spahn

The core of the law is the expansion of appointment service points. They should become central contact points for patients and reachable 24 hours a day, 7 days a week. At the same time, the minimum number of consultation hours offered by contract physicians will be increased. In underserved areas, the associations of statutory health insurance physicians must in the future open their own practices or offer alternative care.

In addition, the scope of benefits of the statutory health insurance will be extended by additional offers. The health insurances are obliged to offer electronic patient files for their insured persons no later than 2021.


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5 questions

What you should know about the Term Service Law

Do I get a doctor’s appointment faster as a legally insured person? Does the fund pay more benefits under the new law? Federal Health Minister Jens Spahn answers the five most frequently asked questions about the appointment service and care law.

The regulations in detail:

Patients should get appointments faster

Appointment service points will be further developed into service centers for outpatient care and emergencies by 1.1.2020:

Also appointment mediation to family doctors and pediatricians and support in the search for permanently caring for house, children and youth doctors;

4-week period also applies to the placement of on-schedule child care examinations (U-examinations);

Can be reached via nationwide uniform emergency service number (116117) at the latest on 1 January 2020 24 hours a day, seven days a week (24/7);

In acute cases, patients will be referred to doctor’s offices or emergency outpatient clinics or hospitals as late as January 1, 2020, during office hours;

Waiting for a psychotherapeutic acute treatment may be a maximum of 2 weeks;

Online offer for appointment service points (so appointments can be arranged not only by phone, but also online or via app);

The National Association of Statutory Health Insurance Physicians regulates the details of the uniform implementation by the Kassenärztlichen associations.

Doctors should offer more office hours in the future

The minimum number of consultation hours offered by general practitioners is being extended to include:

At least 25 hours per week (home visits are taken into account);

The Kassenärztliche associations inform on the Internet about the consultation hours of the contract doctors;

Specialist groups in primary care and local care (such as conservative ophthalmologists, gynecologists, ENT specialists) must offer at least 5 hours per week as an open consultation (without prior appointment); Bundesmantelvertragspartner agree to August 31, 2019 details;

The associations of statutory health insurance physicians will monitor compliance with the supply contracts, including minimum consultation hours, nationwide.

Doctors are better remunerated for additional offers

Extra budgetary compensation, surcharges, decommitment or better support for:

Successful placement of an urgent specialist appointment by a family doctor (surcharge of at least 10 euros from 1 September 2019);

(Acute) benefits for patients mediated by the appointment service (extra-budgetary compensation for all services in the case of treatment and in the quarter, as well as staggered supplements after 1 September 2019 after waiting for the treatment);

Benefits for new patients in practice (extra-budgetary reimbursement of all benefits in the treatment case and in the quarter);

Benefits provided during open consultation hours (extra-budgetary compensation for all treatment and quarterly services);

Benefits for transferred patients after arranging appointments by a family doctor (extra-budgetary remuneration of all services in the treatment case and in the quarter).

Medical care in the countryside is improved

mandatory regional surcharges for doctors in the country;

structural funds KVs are made mandatory and doubled to up to 0.2 percent of total compensation; Uses (for example also for investment costs in case of takeovers, etc.);

CBs are required to provide their own practices in underserved areas (Own facilities) or to offer mobile and telemedicine care alternatives when there are too few doctors;

Countries can determine if existing approval Block may be omitted for establishment in rural or less developed areas.

More services and better care

Tenders for aid (eg incontinence and walking aids) will be abolished. This ensures that there is no compromise on the quality of the supply of aids.

Both Heilmittelerbringern The prices for the therapists’ services will be adjusted to the highest level nationwide on 1 July 2019. The fee development will be decoupled from the basic wage bill and will allow for higher fee increases than before. In addition, there should be nationwide uniform contracts, the access conditions of the therapist to the care are improved and the therapists can decide more independently on the treatment of patients (so-called “blank regulation”). Such contracts must be concluded by 15 November 2020.

For young adults who have cancer, the cost of the cryopreservation taken over by the statutory health insurance. By conserving germ cell tissue, egg and sperm, this group of patients can still have children after cancer treatment.

The supply with vaccines will be improved. The possibility for exclusive contracts with individual manufacturers for seasonal influenza vaccines is eliminated and the pharmacy compensation for these vaccines will be reorganized.

Pure Nursing services (with assistance in housekeeping and home care services such as conducting interviews, memory-enhancing employment, accompaniment during walks, etc.) are allowed for the provision of benefits in kind in outpatient care. This improves care at home, because more occupational groups are available for care.

The supply with midwives will be improved. The GKV-Spitzenverband is entrusted with the task of providing insured persons with a search directory for contact details and the range of services offered by midwives on the Internet (and via an app). Former midwives and birthing nurses will be relieved to return to work. Hospitals receive support to offer their midwives appropriate childcare.

The Fixed subsidies for dentures will increase from 50% to 60% of the cost of regular care from 1 October 2020. As a result, the insured, who are dependent on a supply of dentures, financially relieved.

More digitization in the supply

Patients want easy, safe and fast access to their treatment data. For that the must electronic patient file Become everyday life. It also improves medical care. Therefore we oblige the health insurance companies to offer such documents to their insureds until 2021 at the latest. Anyone who wants to, even without the use of the electronic health card with smartphone or tablet to access medical data.

In the case of illness, most insured persons are familiar with the “yellow bill” for many years. This Work disability certificates should be transmitted from 2021 by the treating physicians to the health insurance only digitally.

Apps can help chronically ill patients to organize their daily lives. Therefore, we allow health insurances to benefit from the structured treatment programs for the chronically ill (DMP ) to use digital applications.

Decisions of self-government are accelerated

Decision making in the Gesellschaft für Telematik (Gematik) will be more effective in speeding up the roll-out of other e-Health applications and telematics infrastructure applications. The Federal Ministry of Health is taking over 51 percent of Gematik’s shares.

The Requirements Planning Policy should be adapted quickly by the Joint Federal Committee (G-BA). For this purpose, the deadline for the review by the G-BA is set at 1 July 2019. In addition, the competences of the G-BA will be further developed so that the existing supply needs can be better represented.

Simplified procedures at the G-BA for Testing of new examination and treatment methods: Manufacturers of medical devices are given the opportunity to commission the scientific monitoring and evaluation of a trial. If you decide against it or if you allow the deadline set by the G-BA to elapse, the G-BA continues to award the contract according to a tendering procedure.

More transparency in care and self-administration

Insured persons should know what their contributions are spent on. We are therefore improving the transparency of the publication of the CEO compensation health insurance funds, the medical service of the health insurances (MDK) and the associations of statutory health insurance physicians and their leading organizations, create more concrete legal requirements for the assessment of the appropriateness of the remuneration by the supervisory authorities and limit future increases in remuneration of the top organizations at the federal level.

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Christina Cherry
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