Current articles on Medical and social law

On November 26, 2024, the Federal Constitutional Court (BVerfG) ruled by a narrow majority that the compulsory medical treatment of people who are under legal care due to an illness or disability can also be carried out outside of hospitals in individual cases in future. The groundbreaking ruling thus breaks with the previous hospital reservation and allows coercive medical measures to be carried out in assisted living facilities or at home. The decision thus marks a significant step towards taking greater account of the rights and needs of vulnerable people.

Outpatient specialist care (ASV) offers the opportunity to overcome the sector boundaries between outpatient and inpatient care. The aim of ASV is to diagnose and treat complex, difficult-to-treat diseases that require special qualifications, interdisciplinary cooperation and special technical equipment.

The doctor's letter is basically used for the targeted exchange of information between the doctors providing treatment or continuing treatment. As a result of the Act to Accelerate Digitalization in the Healthcare System (Digital-Gesetz DigiG), all doctors and facilities participating in SHI-accredited medical care are now obliged to be able to receive electronic doctor's letters (eDoctors' letters) by 30 June 2024 at the latest.

All relevant medical measures are documented in the patient file. According to Section 630g of the German Civil Code (BGB), patients have the right to inspect their medical records. This right is a concrete form of the principle of informational self-determination. However, the right of access is not unlimited, but can be denied by the treating physician in individual cases.

In its ruling dated April 4, 2024 (case no. III ZR 38/23), the Federal Court of Justice (BGH) made a fundamental decision on the German Medical Fee Schedule (GOÄ) and thus on flat-rate medical fees. The highest court has thus ruled that the GOÄ always applies to medical services provided on an outpatient basis.

In principle, all doctors and dentists who participate in contracted (dental) medical care are obliged to participate in the organized emergency service (also: "emergency service" or "on-call service"). The emergency service is organized by the Associations of Statutory Health Insurance Physicians (KVs) and Associations of Statutory Health Insurance Dentists (KZVs), whose mandate under Section 75 (1b) SGB V also includes the provision of care by statutory health insurance physicians during non-office hours. (Dental) doctors who otherwise do not or no longer participate in SHI-accredited medical care (so-called "pool doctors") can also voluntarily participate in the emergency service.

It has been disputed for some time whether a doctor requires a manufacturing authorization under pharmaceutical law for an autologous fat transplant that he performs in his practice.

What should be done if the MD determines that the requirements of an emergency level are not met?

The legally compliant agreement and billing of elective services repeatedly causes difficulties for hospital operators. It is particularly annoying when patients can refuse to pay for elective services for formal reasons because no effective contract has been concluded. For this reason, particular importance should be attached to the formal conclusion of a contract with the patient.

As of 02.12.2024, the ability to prescribe dressings at the expense of statutory health insurance for wound care will change. Manufacturers of dressings should check whether the products they manufacture can continue to be prescribed as dressings or whether they fall under the newly created category of other products for wound treatment.

The Federal Supreme Court has now ruled on an all too tiresome issue: a practice can demand a cancellation fee from a patient who does not show up for an agreed treatment appointment or cancels it at short notice (provided certain conditions are met).

Before a distributor is allowed to make a medical device available on the market, they must check whether the product complies with certain regulatory requirements. According to Art. 14 para. 1 of the Medical Device Regulation 2017/745 EU (MDR):"When making a device available on the market, distributors shall act with due care in relation to the applicable requirements."