Easier application of mother-child cures

New guidelines for approval and rejection of mother-child cures

08.02.2012

In the future, plagued parents can more easily apply for a mother-child cure. In a joint statement of the GKV-Spitzenverband, the Bundesverband Deutscher Privatkliniken e.V. and the German Müttergenesungswerk, the associations pointed out that now after lengthy negotiations the „Assessment Policy Prevention and Rehabilitation“ has been completely revised. The uniform guidelines also took into account emotional exhaustion or marriage problems.

Mother-child cures can be applied more easily
In the future, it will be easier for mothers and fathers to apply for a mother or father-child cure at the statutory health insurance funds. A uniform regulation has been agreed by all associations and institutions involved. In recent years, the austerity efforts of the health insurance funds have led to a significant decline in the approved mother-child cures. In 2009, a decline of 6 percent and in 2010 even 10 percent registered. In the first half of 2011, about 35 percent of all petitions made by plagued parents were rejected.

Refusals were often arbitrary
On the part of the Federal Government and opposition was criticized several times that the rejections „in many cases unfounded and therefore arbitrary.“ The redesigned policy is now supposed to „Transparency about the socio-medical recommendations and performance decisions“ as the Association of Statutory Health Insurance Funds emphasized. Criteria such as fatigue, anxiety, constant time pressure, multiple work and family burdens, as well as constant sleep disturbances were also taken into account so that affected parents can apply for a cure more easily with their children. Finally, the health disorders cause a variety of physical and mental illnesses.

Doctor must consider cure as medically reasonable
Since 2007, cash patients have a legal right to a common cure with their children, if the family doctor came to the conclusion that the measure is justified in the medical sense. The diagnosis as such, however, is often insufficient to actually take the cure. First, the health insurance must give her consent. Frequently, the applications were rejected on the grounds that initially would have to be initiated ambulatory measures, as the SPD member of parliament Marlene Rupprecht reports. However, there are no cures with this principle. In addition, many funds had not sent sufficient remedies with the refusal decrees.

Federal Government is satisfied
Are the innovations a guarantee that more cures will be granted? First of all, the guidelines, which were revised on behalf of the joint health committee and the Federal Ministry of Health, are a form that makes it possible to justify refusals. In the opinion of the Minister of Health Daniel Bahr (FDP) are the „Revisions one „Significant improvement in the licensing practice of health insurances in terms of affected mothers and fathers“. The Federal Family Minister Kristina Schröder (CDU) added that „Diseased and disease-threatened parents may have more hope in the future that a needs-based application processing is implemented“.

All interlocutors emphasize that all „Scientific findings of the research group on family health“ included in the development. Finally, be the „Talks to a good result“ get to one „needs-based application processing and care of families affected by health problems“ to reach. In the coming years, following the rise in denials in the past, it will become apparent whether the directive will not only increase transparency, but will allow more parents to take advantage of the offer. (Sb)

Also read:
Better chances for mother-child cures
Mother-child cures in danger
Health insurance companies grant fewer and fewer cures
Frequent rejection of mother-child cures

Image: Lucie Kärcher