Rewritten Article:
Breaking News: Medical On-Call Service Restrictions in Schleswig-Holstein
Get ready for changes in the medical on-call service in Schleswig-Holstein. The cause? A ruling by the Federal Social Court on the social insurance obligation of pool doctors, as announced by the Schleswig-Holstein Association of Statutory Health Insurance Physicians (KVSH) last Friday.
Here's what you need to know:
The Ruling's Impact
Some general practices will have to close their doors at 9 out of 32 locations. The affected areas include Bad Oldesloe, Eckernförde, Oldenburg, Preetz, Westerland, Büsum, Ratzeburg, Kappeln, and Neustadt. However, don't panic just yet – there will be no changes on Wednesdays, Fridays, weekends, or public holidays. In the tourist destinations of Kappeln and Neustadt, a continuous service will resume again from April to September 2024.
The decision affects 12 pediatric practices, the on-call service for ENT and ophthalmologists, and the medical telephone consultation service, which will remain unaffected.
The Pool Doctor Exodus
To respond to the ruling, the KVSH took the drastic step of terminating the contracts of around 450 pool doctors at the turn of the year. These are doctors who are not registered in Schleswig-Holstein but willingly lend their services to the medical on-call service. According to them, these doctors once provided up to 30% of the required services.
Dollar Signs and the Financial Fallout
The ruling from the BSG implies that pool doctors are subject to an additional social insurance obligation in the organized on-call service. As a result, KVSH faces additional annual costs of around three to five million euros. And, if pension insurance companies also demand back payments for the past four years, the financial burden could reach an eye-watering 15 million euros. Bearing this burden would be untenable for the KVSH.
Implications for Policyholders
Although the specifics of the ruling are yet to be revealed, its potential consequences for policyholders are significant. This ruling may result in changes in the availability or cost of medical services, forcing KVSH to strike a delicate balance between combating the financial aftermath and upholding the quality of care for its policyholders.
For background information, see the enrichment data below.
Enrichment Data
The Federal Social Court's ruling in Schleswig-Holstein introduces financial burdens and service changes for the Association of Statutory Health Insurance Physicians (KVSH). Here are the key points:
- Financial Burden: The ruling might impose additional costs on KVSH, necessitating higher expenditures related to pool doctor management and the on-call service.
- Service Changes: The ruling could necessitate changes in the way KVSH handles pool doctor and on-call services, such as adjustments to staffing, scheduling, or resource allocation to comply with the court's directives.
- Legal Uncertainty: This ruling might also bring legal uncertainty for KVSH regarding its responsibilities in managing these services, potentially causing operational upheavals.
- Fraud Concerns: The ruling's context might relate to fraud concerns, especially in light of COVID-19 testing fraud in Germany. If the ruling addresses such issues, KVSH may need to enact new measures to halt such challenges, compounding financial and operational hurdles.
- Impact on Policyholders: Ultimately, the implications of this ruling might affect policyholders by potentially leading to changes in the availability or cost of medical services, necessitating KVSH to find a balance between combating financial repercussions and maintaining the quality of care for its policyholders.
