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Section 137d of Book V of the Social Code - Quality assurance in out-patient and in-patient care or rehabilitation

(1) For in-patient rehabilitation facilities with which a contract exists in accordance with section 111 or section 111a, and for out-patient rehabilitation facilities with which a contract on the provision of out-patient benefits for medical rehabilitation exists in accordance with section 111c subsection (1), the National Association of Statutory Health Insurance Funds shall conclude the quality assurance measures in accordance with section 135a subsection (2) No. 1 on the basis of the recommendations in accordance with section 20 subsection (1) of the Ninth Book with the national organisations relevant for representing the interests of the out-patient and in-patient rehabilitation facilities and the facilities of the Maternal Convalescence Movement, or similar facilities at federal level. The costs of the evaluation of measures of inter-institutional quality assurance shall be met proportionately by the health insurance funds according to their occupation level of the facilities or special departments. Intra-institutional quality management, and the obligation for certification for in-patient rehabilitation facilities, shall be orientated in accordance with section 20 of the Ninth Book.

(2) For in-patient prevention facilities with which a care contract exists in accordance with section 111, and for facilities with which a care contract exists in accordance with section 111a, the National Association of Statutory Health Insurance Funds shall agree with the national organisations relevant for representing the interests of the in-patient prevention facilities and the facilities of the Maternal Convalescence Movement, or similar facilities at national level, the quality assurance measures in accordance with section 135a subsection (2) No. 1 and the requirements of intra-institutional quality management in accordance with section 135a subsection (2) No. 2. In doing so, the joint recommendations shall be taken into account in accordance with section 20 subsection (1) of the Ninth Book and their fundamentals taken over. The obligation to meet the costs in accordance with subsection (1) sentence 3 shall apply mutatis mutandis.

(3) For healthcare providers providing out-patient prevention services in accordance with section 23 subsection (2), the National Association of Statutory Health Insurance Funds shall agree with the National Association of Statutory Health Insurance Physicians, and with the relevant national associations of the healthcare providers which provide out-patient prevention services, the fundamental requirements of intra-institutional quality management in accordance with section 135a subsection (2) No. 2.

(4) The contracting partners shall ensure by means of suitable measures that the requirements of quality assurance for out-patient and in-patient care and rehabilitation satisfy uniform principles, and that the requirements of cross-sectoral care and care across professional groups are suitably taken into account. The German Medical Association, the Federal Chamber of Psychotherapists and the German Hospital Federation shall be afforded the opportunity to make a statement with regard to agreements in accordance with subsections (1) and (2).

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