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Section 115b subsections (1) and (2) of Book V of the Social Code - Out-patient operations in hospital

(1) The National Association of Statutory Health Insurance Funds, the German Hospital Federation, or the federal associations of the hospital facilities together and the National Associations of Statutory Health Insurance Physicians, shall agree

1. a list of operations that can be carried out on an out-patient basis and other non-in-patient procedures,

2. standard fees for hospitals and registered contract doctors.

The agreement in accordance with sentence 1 No. 1 shall separately designate, by 31 December 2000, the operations which can be carried out on an out-patient basis, and other non-in-patient procedures which as a rule can be carried out on an out-patient basis, and shall determine general criteria which may trigger the necessity of their implementation on an in-patient basis. The agreement shall take account of the quality prerequisites in accordance with section 135 subsection (2), as well as of the guidelines and resolutions of the Federal Joint Committee in accordance with section 92 subsection (1) sentence 2 and section 137. The agreement shall provide that the benefits in accordance with sentence 1 can also be provided in the hospital on an out-patient basis on the basis of contractual cooperation between the hospital and registered contract doctors in private practice.

(2) The hospitals shall be registered to carry out the operations and non-in-patient procedures designated in the list on an out-patient basis. To this end, a notification from the hospital to the Land associations of the health insurance funds and the Substitute Health Insurance Funds, the Association of Statutory Health Insurance Doctors and the Registration Committee (section 96) shall be necessary; the Association of Statutory Health Insurance Doctors shall inform the Land Hospital Federation concerning the level of care in the healthcare provided by registered contract doctors. The hospital shall be obliged to comply with the contract in accordance with subsection (1). The benefits shall be paid directly by the health insurance funds. The test of value for money and quality shall be carried out by the health insurance funds; the hospitals shall transmit to the health insurance funds the data in accordance with section 301 where this is necessary in order to carry out the tasks of the health insurance funds.



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