AOK Bayern announces general practitioner contracts without notice

Dispute between family doctors and AOK Bayern

The health insurance AOK Bavaria announces family doctor contracts without notice. The Bavarian Association of General Practitioners still remains in his position and wants to force the health insurance companies to renegotiate negotiations on higher fees.

16.12.2010

A new escalation level in the dispute between the Bavarian medical profession and health insurance has been reached: The general local health insurance AOK has terminated the family doctor contracts without notice. The termination of the contracts with family doctors also has far-reaching consequences for AOK health insurance in Bavaria.

In the next week, Bavaria's GPs wanted to discuss whether a majority of primary care physicians at the beginning of 2011 in protest of health care reform their Kassenärztliche approval back and thus complete the withdrawal from the statutory health system. But this announcement by the family doctors is now the AOK came before. The fund announced with immediate effect and without notice the family doctor contract with the Bavarian family doctors association. The health fund justifies this drastic step with the fact that the association of family physicians in their turn had announced that they would leave the system of statutory health insurance. According to the representatives of the cash register, such a project violates German social legislation, as emphasized by Bavaria's AOK treasurer Helmut Platzer. It was "impossible and unreasonable for the AOK almost to cooperate with a federation that behaves unlawfully in key issues of social legislation." Finally, the health insurance already threatened at the beginning of the month of December with a termination, if the medical association of its system exit plans do not refrain. The termination of the contracts is without notice, however, the AOK offers the medical association, a period of expiry on 13 December 2010 to take, so that the current billing quarter can still be used and offset.

Far-reaching consequences for patients
For the patients the termination of the family doctor contracts has far-reaching consequences. For example, AOK patients now have to forego add-on benefits that have been laid down in the contracts. These include, for example, pension benefits such as the free health check which insured persons can carry out once a year. It is becoming much more dramatic for patients suffering from chronic diseases. Here are first special therapies for those affected away. In addition, the full practice fee will be due immediately for the chronically ill as well. According to the contract guidelines, those affected had to pay the regular practical contribution of 10 euros only once a year before the termination. This cost cap now falls away for AOK insured.

Regular health care at the family doctor can still be claimed, as the AOK emphasized. The insured can of course continue to go to the family doctor and get treatment. The contract termination does not affect the cash register of doctors. The approval remains for the time being, unless the family doctors are serious and denounce their turn the Kassenärztliche approval. "The security of supply of patients is fully guaranteed," said the treasurer board chairman Platzer. The AOK will now fully inform AOK members about the state of affairs and answer questions. Affected by the escalation of the dispute are about 2.6 million health insured and about 7000 physicians in Bavaria.

Planned system exit with economic consequences for GPs
At the same time, the AOK informed the Bavarian Minister of Health Markus Söder (CSU) about the termination without notice. Here they showed concern and admonished the family doctors for prudence. Once you get out of the cash register system, you stay out of it, as Söder said in an interview. The planned return of the POS approval was a health minister „One-way ticket“.

The AOK Bavaria sees through the planned system exit of the BHÄV the outpatient care of the Bavarian population and the economic existence of thousands of medical practices threatened. "Because in the case of a collective system exit, all contracts with health insurance lose their validity by law." For the participating physicians this results in massive consequences. Thus, they receive neither from the Kassenärztliche Vereinigung Bayerns (KVB) nor from the health insurance companies a fee. Patients can only be treated on private bills, which may not be reimbursed by the health insurances. A new approval as a contract doctor is possible at the earliest after six years.

Bayerische Hausärzteverband remains in its position
In a circular letter to the insured, the Bayerische Hausärzteverband informs the insured persons. So there is to read: „There will be no more family doctor contracts in the current form. This is ensured by a change in the law that drastically limits the possibilities of arranging GP contracts. Without family doctor contracts, however, physicians can only work under the umbrella of the Kassenärztliche Vereinigung. That means budgeting for medication, treatment itself, and limiting the number of patients treated, all at a fee that will not maintain the high standard of CO. "For this reason, the Association of Family Physicians is demanding higher fees for those Family physicians in Bavaria With the new planned protests and the system exit the medical representatives want to force the coffers to negotiate new contracts.The AOK admonishes the medical profession: „For the AOK Bavaria, the implementation of the supply-political idea of ​​GP-centered care remains one of the major tasks in the healthcare sector“, so Platzer. The patient benefits from a significantly better quality of care when being piloted through the complicated healthcare system with the help of a qualified family doctor. The GPs would therefore remain partners of AOK Bayern. „However, this is only within the scope of applicable laws“, so the AOK boss. On this basis, the AOK Bayern continue to offer their cooperation in GP-centered care.

At the same time stressed the cashier boss, he had "no understanding" that just the family doctors in Bavaria break such a fight on the fence. Because the case value, ie the turnover per patient, is very high for Bavaria's physicians in the national comparison. Currently, the average is around 43 euros per quarter. The cashier's fee in Bavaria is 60 euros. The AOK Bayern pay more than 80 euros again significantly more, said the cash manager Platzer. (Sb)

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Patient majority does not know their rights

Picture: Andreas Morlok