Sondergebühren in Deutschland -- Teil 2.

The article "Special Fees in Germany - Part 2" deals with the agreement and remuneration of medical and non-medical elective services under German law, as well as the effects of contract design on remuneration and medical liability. Three typical contract constellations for the provision of elective services in hospitals are described. The contractual freedom of the parties is restricted by the Hospital Remuneration Act. The article discusses the written form and the obligation to inform in elective service agreements. Furthermore, the additional physician contract is explained, which is concluded in addition to the hospital admission contract with a specific physician. It is emphasized that the provisions of the Hospital Remuneration Act only apply to the elective service agreement and not to the additional physician contract. The text deals with the topic of split hospital admission contracts and their effects on medical liability. In a split hospital admission contract, nursing services are provided by the hospital, while medical services are solely the responsibility of the treating physician. This means that in case of medical errors, only the physician is liable and not the hospital. Case law considers the hospital admission contract with an additional physician contract as the regular case and the split hospital contract as the exception. High requirements are placed on the effective agreement of a split hospital contract, as the patient usually expects all medical services from the hospital. An ineffective elective service agreement is not void, but can still remain in effect. The article deals with the regulations for the agreement and remuneration of elective services in the German healthcare system. It is stated that a violation of the statutory formal requirements only leads to the invalidity of the remuneration provisions, while the elective service agreement otherwise remains in effect. It is also argued that a violation of the obligation to inform has the same effects as a formal violation. It is emphasized that there is no legal entitlement of the patient to conclude a contract for elective services and that the decision to offer such services lies solely with the hospital operator. The remuneration of elective services is based on the medical fee schedule (GOÄ) or the fee schedule for dentists (GOZ). The article deals with the implementation of the essential steps in treatment by elective physicians. It is emphasized that the elective physician must be closely involved in the treatment and should give it their personal touch. The delegation of medical elective services is limited, as professional instructions can only be given by physicians with the corresponding expertise. It is also pointed out that certain services can only be billed if they were actually provided by the elective physician or their permanent medical representative. The article also mentions the target performance principle, according to which only the target performance may be billed if there are overlaps with other services. It also discusses compensations such as travel expenses and travel allowances, as well as expenses that can be reimbursed. The text deals with the costs that can arise in connection with medical treatments. According to the fee schedule for physicians (GOÄ), certain costs such as accommodation costs and material costs cannot be charged. Shipping and postage costs are also mentioned. [Extracted from the article]