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Physio Elite

Kerststrasse 27-31, 67655 Kaiserslautern

Sole proprietorship Charlie Clay

physioelitekl@gmail.com

Tel: 0631 31168673

www.physioelite.de

corporate conception

ELITE GROUP CONCEPTS

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Technical management: Mr. Di Vincenzo, Marco

§ 124 SGB V approval

(1) Remedies that are provided as services, in particular physiotherapy, voice, speech and language therapy, ergotherapy, podiatry or nutritional therapy, may only be provided to insured persons by authorized service providers who

1.

have the training required for the provision of services and a corresponding license entitling them to use the professional title or a comparable academic degree,

2.

have practice equipment that ensures appropriate and economical service provision, and

3.

recognize the contracts applicable to the supply of medicinal products in accordance with Section 125 subsection 1 and Section 125a.

(2) The state associations of the health insurance companies and the substitute funds form a working group jointly and uniformly with one of the state associations or the substitute funds, which makes the decisions on approvals with effect for all health insurance funds. The working groups are entitled to issue, change or repeal administrative acts in order to fulfill this task. The possibility of changing or repealing also applies to administrative acts that have been issued by the state associations of health insurance companies or the substitute health insurance funds. The working group can also extend to several federal states. The costs are borne by the state associations and the substitute health insurance funds proportionately according to the insured persons according to the KM 6 statistics. The working group may collect, process and use the data from service providers required for checking the requirements under paragraphs 1 and 2a. It has to transmit the relevant data for approval according to sentence 6 to the Central Association of Health Insurance Funds, which regularly informs the health insurance funds about the approved service providers. The central association of health insurance companies regulates the details of data transmission and the procedure. The working groups are to be formed by August 31, 2019. Until then, Section 124 (5) applies in the version valid until May 10, 2019. The Central Association of Health Insurance Funds has to publish a list of the approved service providers with the relevant data of the approved service provider on the basis of the data according to sentence 7; The contractual partners agree on the scope of the data to be published in the respective contracts according to § 125 paragraph 1.

(2a) The working groups according to paragraph 2 also check whether service providers meet the requirements according to § 125 paragraph 2 sentence 1 number 3 for the implementation of special physiotherapy measures, taking into account the guidelines according to § 92 paragraph 1 sentence 2 number 6. If the requirements are met, the working group issues a corresponding billing permit. Paragraph 2 sentences 2 and 3 applies accordingly.

(3) The working group pursuant to paragraph 2 is entitled to check the service providers to be admitted with regard to the contractually agreed spatial, material and personnel requirements. For this purpose, the service providers must grant access to their practice during normal practice hours. Multiple practice tests by the working group are to be avoided.

(4) The approvals existing on June 30, 2008, which were granted by the associations of the substitute funds, continue to apply as approval granted for the substitute funds pursuant to paragraph 2. Paragraph 2 sentence 3 applies accordingly.

(5) Hospitals, rehabilitation facilities and comparable facilities may dispense the medicinal products specified in subsection 1 by persons who meet the requirements under subsection 1 number 1 if they have practice equipment within the meaning of subsection 1 number 2. Approval is not required. The contracts concluded in accordance with Section 125 (1) shall apply accordingly to the institutions named in sentence 1 without the need for recognition of these contracts. Section 125b applies accordingly.

(6) Service providers who received their approval before the entry into force of the respective nationwide contract pursuant to Section 125 paragraph 1 must recognize this contract with the working group pursuant to sentence 2 within six months of the contract coming into force or of the decision by the arbitration board . The approval will continue to apply during this period. Until the entry into force of the respective nationwide contract according to § 125 paragraph 1, the applicable agreements according to § 125 paragraph 2 in the version valid until May 10, 2019 are to be recognized. Sentences 1 and 2 apply accordingly to the recognition of the agreement under Section 125a on the supply of medicinal products with extended supply responsibility. The recognition of this agreement is not a prerequisite for admission according to paragraph 1 number 3 until the agreement comes into force according to § 125a or until the decision by the arbitration board The version in force on May 10, 2019 shall continue to apply until the contract comes into force in accordance with Section 125 Paragraph 1 or until the decision has been made by the arbitration board.

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