Honorarkürzung Und Schadensersatz Wegen Unwirtschaftlicher Behandlungs- Und Verordnungsweise Im Kassenarztrecht

Name: Honorarkürzung Und Schadensersatz Wegen Unwirtschaftlicher Behandlungs- Und Verordnungsweise Im Kassenarztrecht
Brand: Springer
SKU: 9783540124979
Price: 5691.0 INR
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by E. Baader

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ISBN13: 9783540124979
Binding: Paperback
Subject: N/A
Publisher: Springer
Publisher Imprint: Springer
Publication Date: May 1, 1983
Pages: 32
Original Price: GBP 44.99
Language: German
Edition: N/A
Item Weight: 87 grams
BISAC Subject(s): Medical Law & Legislation

About The Book

Der sozialgerichtliche ProzeB, bei dem es urn Honorarkiirzungen und Schadensersatzforderungen wegen unwirtschaftlicher kassenarztli- cher Behandlungs- und Verordnungsweise geht, wirft besondere Pro- bleme auf. Dies nicht nur deshalb, weil die (regelmaBige) Grundlage des Priifungssystems, namlich die wirtschaftliche Beurteilung der arztlichen Tatigkeit anhand statistischer Vergleiche, schon ihrer Na- tur nach umstritten sein wird, sondem auch deshalb, weil ein solcher ProzeB besondere Fragen und damit auch Unsicherheiten hinsicht- lich der Beweisanforderungen und der Darlegungslast der Beteilig- ten mit sich bringt. Mit der vorliegenden Arbeit wird der (konzen- trierte) Versuch untemommen, dies en Problemstoff aus dem Ganzen des Verfahrens zu analysieren und seine Einzelheiten in einen syste- matischen Zusammenhang zu. bringen, die sich ergebenden Rechts- fragen grundsatzlich zu vertiefen und die bisherige Rechtsprechung entsprechend einzuordnen. Damit solI den mit derartigen Prozessen BefaBten - Richtem, Beteiligten (Ante, Kassenarztliche Vereinigun- gen, Krankenkassen) und Rechtsanwalten - eine Orientierungshilfe zur Bewaltigung dieses schwierigen Verfahrens gegeben werden. E. Baader Kassel, Marz 1983 Inhaltsverzeichnis A. Grundlagen . . . . . . . . . . . . 1 1. Das Wirtschaftlichkeitsgebot 1 2. Organe der Durchsetzung. . 1 3. Honorarktirzung und Schadensersatz 2 B. Unwirtschaftlichkeit als unbestimmter Rechtsbegriff . 5 1. Unwirtschaftlichkeit der Behandlung 5 2. Unwirtschaftlichkeit der Verordnung . 7 C. Rechtliche Priifung der Unwirtschaftlichkeit 9 I. Einzelfallpriifung . . . . . . . . . . . . 9 II. Priifung anhand des statistischen Vergleichs 9 1. Vergleichbarkeit der Praxen. . . 10 2. Vergleichbarkeit der Leistungen . . . 11 3. Zusammenfassung . . . . . . . . . . 12 III. Der SchluB auf die Unwirtschaftlichkeit 13 1. Normale Streuung. . . . . . . 13 2. Das Mittelfeld . . . . . . . . . 14 3. Offensichtliches MiBverhaltnis 14 IV. Einwendungen des Arztes . . . . 15 a) Berechnungsfehler . . . . .

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