Berlin: (hib/BAL) The federal government considers the current regulations for the inclusion of new aids in the reimbursement of the statutory health insurance companies to be sufficient. She writes that in her answer (20/7949) to a small question (20/7765) from the CDU/CSU parliamentary group. Among other things, she asked what measures the federal government believed were necessary to prevent delays in the application process.
The federal government writes: “The processing of applications for inclusion in the list of medical aids is complex and sometimes individual, which must be checked conscientiously in the interests of quality-assured care for the insured. According to the GKV-SV, non-consensual deadlines are rarely exceeded.”
In its preliminary remarks, the Union faction had stated that patients were in fact not provided with aids such as medical compression stockings, bandages, orthoses or insoles that were not listed in the aids directory (HMV). In its reply, the federal government nonetheless writes that the HMV does not represent a conclusive catalog of services, “but rather an interpretation and orientation aid for all those involved”. However, she concedes that “due to its effects on the prescribing behavior of doctors, it has a market-controlling effect”.
Overall, according to the response, the application procedures for the inclusion of an aid in the HMV last an average of 62 days, and 203 days for new products, in each case without an objection procedure. In the period from July 18, 2022 to July 19, 2023, 34 new products were included in the HMV. Since October 2019, a total of 15,782 application procedures for admission to the HMV have been conducted. In 17 cases, this was followed by a lawsuit. “There is no need for legal adjustments from this,” writes the federal government.