BSG High hurdles for practice seat transfer in cities

BSG: Degree of care of physicians in city districts

(Jur). Physicians and psychotherapists admitted in large cities are generally unable to move their practice seat from a less well-supplied district to a better-served district. According to the will of the legislator, the permit for a transfer of a practice seat in a planning area is dependent on the degree of coverage of the insured in the respective district, the Federal Social Court (BSG) in Kassel ruled on Wednesday, 3 August 2016 (Ref .: B 6 KA 31 / 15 R).

The specific case concerned a psychological psychotherapist who had taken over a practice with a half-life care contract in Berlin-Neukölln on April 1, 2013. But after half a year, the former practice owner wanted to use the premises elsewhere. The psychotherapist therefore requested the Admissions Committee to relocate the practice seat to their place of residence in Berlin's Tempelhof-Schöneberg district.

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This rejected the application and justified this with a shortage of psychotherapists in Neukölln in the amount of 83.7 percent. In Tempelhof-Schöneberg, however, give it with 344 percent oversupply.

The psychotherapist filed an objection. The Appeals Committee approved their application for relocation. For the patients in Neukölln the new practice seat would not be a significant disadvantage. The definition of how the degree of coverage is in each district is not decisive. "The decisive factor is how well the insured person can achieve the practice," said Dirk Vallentin, chairman of the appeal committee in the BSG.

Here, the therapist's previous practice is only about five kilometers away from the previous practice and can be easily reached by public transport in twelve minutes.

The Kassenärztliche Vereinigung (KV) Berlin saw this differently. "Whether a practice seat transfer can be approved must be made dependent on the degree of care in the respective Berlin district," said Wolfgang Pütz, responsible for the approval of doctors and psychotherapists at the KV. "Otherwise, everyone moves to where the private patients are," says Pütz.

He also referred to a letter of intent from the Berlin Senate Administration and representatives of doctors and health insurance companies. Thereafter, a practice seat transfer should be approved only from better supplied to poorly served Berlin districts .

"It's probably also about who has this hat," said Ulrich Wenner, chairman of the 6th Council of the Council of the BSG on the dispute between the appeal committee and KV. After the verdict, this is now the KV. According to the legal regulations, a transfer of a practice seat could be approved "if the reasons of the contract medical care do not conflict with this," the SPC said. According to the will of the legislator should be prevented in a metropolitan planning area, as here Berlin, that the medical and psychotherapeutic supply of the population in individual districts worsened by practice seat transfers.

Therefore, the degree of coverage determines whether the transfer of the registered office can be approved. Only in exceptional cases, for other reasons, but still be granted the approval, for example, if a doctor due to illness no longer be able to work at his previous practice seat. fle