Termination of the family doctor contract by AOK right

The immediate termination of the family doctor contract by the AOK Bayern was lawful. The Social Court of Munich rejects lawsuit of the Bavarian family doctor association.

21.01.2011

The Bavarian family doctors are subject to court. The termination without notice of the family doctor contract in Bavaria by the AOK was right, judged the social court today in Munich.

The dispute between the AOK Bayern and the Bavarian GPs escalated at the end of last year and culminates in the fact that the AOK due to the call of the Bavarian Association of General Practitioners (BHÄV) to its members to return their coffers collectively, the family doctor contract with the Bavarian doctors announced , By contrast, the BHÄV had filed a lawsuit, which the Social Court of Munich on Friday, however, in an express decision rejected (file reference: S 39 KA 1248/10 ER).

Family doctor association fails with application for legal protection
The BHÄV had made after the termination of the family doctor contract by the AOK Bavaria before the Social Court of Munich, a motion for interim relief, in order to prevent the withdrawal of the health insurance from the previous regulations by legal means yet. However, the Social Court rejected the claim of the BHÄV now as unfounded, because the call for the collective return of the cash approval operated by the BHÄV was forbidden by law and therefore clearly abusive, the Social Court ruled. With the threat of collective system exit the BHÄV have one „threat of force“ want to establish, among other things, a better compensation for doctors to the AOK. The BHÄV had at least temporarily accepted the gaps in primary care in Bavaria, according to the court. According to the express resolution of Friday, the termination without notice of the family doctor contract by the AOK Bavaria in December 2010 due to serious breaches of contract of the BHÄV was lawful.

The AOK also showed problematic behavior
However, the judges at the Social Court also referred to the fact that the AOK Bayern in terms of contractual duty of loyalty to the contractor sometimes a „problematic behavior” have shown. The massive breach of contract by the call for the collective return of the POS approval by the BHÄV, but this is not justifiable, so the judgment of the Social Court. The BHÄV and the AOK Bayern were asked by the court now to work quickly towards the conclusion of a new family doctor contract. The AOK stated in a first statement that it was basically still willing to negotiate new GP contracts and also interested in a quick conclusion of the contract. It is the AOK Bayern „In the interest of our insured (...) firmly convinced that the GP-centered care must be further strengthened“, emphasized the chairman of the board of the AOK Bayern, Helmut Platzer. However, the AOK is under a considerable political pressure anyway, because only last week, the Bavarian health minister Markus Söder had the health insurance funds and the BHÄV invited to a hearing in the parliament and obliged to take up new negotiations until the end of the month.

Threat of system exit without success
The BHÄV obviously did not do itself and its members with the call for the collective return of the censuses in the end. Not only that the required majority for the collective return of the cash approvals at the general meeting in December had not come to pass, also that in addition to the AOK most other Bavarian health insurance companies have also terminated their family doctor contracts, should have been a significant setback for the BHÄV. However, now is the negotiation of new family doctor contracts and the BHÄV can start here a new attempt to enforce the desired improvement in terms of the Bavarian family doctors. Since the AOK also clearly professes family-centered care as a cornerstone of medical care in Bavaria and emphasizes the better quality and more effective by the pilot function of the family doctor treatment, the chances for an amicable compromise - despite partially hardened fronts - not bad. (Fp)

Also read:
AOK Bayern announces general practitioner contracts without notice
Bavaria calls doctors to reason
Substitute funds also terminate family doctor contract
Dispute between AOK and family doctors escalates
Bavaria: family doctors make front against health insurance

Picture: Gerd Altmann