No inpatient chemotherapy

LSG Chemnitz: Cost advantage in the hospital does not matter
Cancer patients can not easily opt for inpatient chemotherapy. The outpatient treatment has priority, as long as a hospital stay is not medically necessary, as the Saxon State Social Court (LSG) in Chemnitz in several on Tuesday, August 1, 2017, decided rulings (Az .: L 12 KR 244/16 and others). The costs are not important.

(Image: Zerbor / fotolia.com)

A hospital in the Chemnitz area treated several inpatients with chemotherapy. The health insurances commissioned the medical service with a review of the treatments. After that, they refused to pay the costs. The hospital stays were not necessary.

With his complaint, the hospital argued that it was not clear that the chemotherapy would be uncomplicated. In addition, the inpatient treatment is cheaper than the outpatient. Because the drugs purchased for outpatient treatment through a pharmacy are particularly expensive.

Like the Social Court of Chemnitz, the LSG rejected the lawsuit. As a reason, it referred to the legal priority of outpatient treatment. If this had been possible, the hospital was not entitled to any compensation according to the legal requirements. "This also applies if outpatient treatment would have cost the health insurance company more than in-patient hospital treatment," emphasized the LSG.

Medical reasons for treatment in the hospital did not exist in the cases decided here. Therefore, it was "misplaced" acted. The only reason for the cost advantage of the hospitals is the statutory price maintenance of public pharmacies, according to the LSG in its judgments of 30 May 2017, which have already been published in writing. Mwo / fle