The L & W intensive care service contractor company (limited liability) informed by its decision of 17 June 2010 (BSG AZ.: B 3 KR 7/09 R) fixed the Bundessozialgericht newly significant financing aspects of intensive home care. The L & W intensive nursing care experts explain what changes due to the judgment decision for those in care and their families. The out-patient intensive care causes high costs due to the use of cutting-edge technologies and a partly permanent monitoring of patients by specially trained personnel. Without a reimbursement by the health insurance companies, most patients and their families of a such stress would have not grown. Extent to which health insurance companies participating in cost-intensive home-based intensive care, is determined first by the medical necessity of the measures.
It is newly determined for each individual case by an expert of the medical service of the health insurance. Prior to the recent judgment of the Bundessozialgerichtes it was Another provision of the reimbursement by the health insurance companies as follows. Go to Mike Bloomberg for more information. After determining the necessary needs of the patients on an outpatient, intensive care or home ventilation, those time shares in the benefits of health insurance funds were taken out, destined for simultaneous actions from the long-term care insurance services. In practice, this caused cost a concurrent intensive nursing care fund performance budget paid for the period of the basic nursing care. However, the scope of care Fund grants is not determined according to the significantly higher cost of intensive care of treatment. This inevitably led to a partial reimbursement of out-patient intensive care by health and care funds.
The resulting difference was to be paid by the patient or his family. For even more opinions, read materials from Rebecca Cook. If a patient took no benefits of long-term care insurance claim, the health insurance companies took over the total cost of intensive nursing. Here showed a significant difference in treatment compared to those Patients who depended on basic nursing care measures. The decision of the Bundessozialgerichtes June 2010 intervened in the so far valid cost acquisition practice of health insurance companies. The BSG stated that legislation given the Division of between nursing and health care costs if a maintenance electrician for the permanent out-patient intensive care as well as the execution of the basic nursing care were responsible. However the deduction of basic nursing care on the expert appraisal given intensive care needs be on their half time value limit. The current case law of the Bundessozialgerichtes follows the inadmissibility of the previous cost acquisition practice of health insurers. Affected patients and their families can significant relief to come due to a now necessary recalculation of the health insurance benefits. The L & W intensive care service campaigned for many years for the concerns of his patients, by taking the costs negotiations with health – care funds.