55. Amendment of the agreement on forms for statutory health care from April 1, 1995 (Annex 2 BMV-Ä)

Announcements

, Kdö.R., Berlin - on the one hand - and the GKV-Spitzenverband (National Association of Health Insurance Funds), Kdö.R., Berlin - on the other hand - agree the following:

55. Change to the agreement on forms for statutory health care from April 1, 1995 (Annex 2 BMV-Ä)

Article 1

Changes to the form agreement

1. Numbers 2.1 to 2.1.4 change as follows on 01.01.2021:

" 2.1 Sample 1: Certificate of incapacity for work (as of 01.2021)

2.1.1 For the certificate of incapacity for work, in addition to the agreements according to Appendix 2b BMV-Ä to use the attached sample 1.

2.1.2 The data of the certificate of incapacity for work intended for the health insurance company will be used from 01.01.2021 digitally transmitted. Annex 2b regulates the rest of the digital transmission. The paper version of the copies for the health insurance company and the doctor is no longer required.

The paper version of sample 1 consists of two-part set of forms with adhesive headed from self-copying paper:

Sample 1a: Copy for the insured

Sample 1b: Copy for the employer

2.1.3 Yellow color is to be used for the surface printing of pattern 1a. Pattern 1b is to be made on yellow paper. Sample 1a is DIN A5 upright, sample 1b is DIN A 6 landscape.

2.1.4 unoccupied “

2. Numbers 2.1 and 2.1.1 will be revised as follows on 01.01.2022:

" 2.1 Sample 1: Certificate of incapacity for work (as of 01.2022)

2.1.1 The inability to work is certified in accordance with Annex 2b BMVÄ based on the previously valid template 1. “

3. Number 2.4 changes as follows:

" Model 4: Ordinance on patient transport (as of 07.2020) "

4. Numbers 2.16.1, 2.16.2 and 2.16.3 change as follows:

" 2.16.1 The prescription of pharmaceuticals and others according to § 31 SGB V in the pharmaceutical supply included products takes place in accordance with the legal requirements. The attached sample 16 can be used in the following cases in particular:

1. If the infrastructure (hardware, software, network connection) required for the digital transmission of the regulation fails

Announcements

, Kdö.R., Berlin - on the one hand - and the GKV-Spitzenverband (National Association of Health Insurance Funds), Kdö.R., Berlin - on the other hand - agree the following:

55. Change to the agreement on forms for statutory health care from April 1, 1995 (Annex 2 BMV-Ä)

Article 1

Changes to the form agreement

1. Numbers 2.1 to 2.1.4 change as follows on 01.01.2021:

" 2.1 Sample 1: Certificate of incapacity for work (as of 01.2021)

2.1.1 For the certificate of incapacity for work, in addition to the agreements according to Appendix 2b BMV-Ä to use the attached sample 1.

The paper version of sample 1 consists of two-part set of forms with adhesive headed from self-copying paper:

Sample 1a: Copy for the insured

Sample 1b: Copy for the employer

2.1.3 Yellow color is to be used for the surface printing of pattern 1a. Pattern 1b is to be made on yellow paper. Sample 1a is DIN A5 upright, sample 1b is DIN A 6 landscape.

2.1.4 unoccupied “

2. Numbers 2.1 and 2.1.1 will be revised as follows on 01.01.2022:

" 2.1 Sample 1: Certificate of incapacity for work (as of 01.2022)

2.1.1 The inability to work is certified in accordance with Annex 2b BMVÄ based on the previously valid template 1. “

3. Number 2.4 changes as follows:

" Model 4: Ordinance on patient transport (as of 07.2020) "

4. Numbers 2.16.1, 2.16.2 and 2.16.3 change as follows:

1. If the infrastructure (hardware, software, network connection) required for the digital transmission of the regulation fails

2.Creation of regulations in the context of house and home visits

2.16.2 Consultation hours for drugs and other products and aids included in drug supply according to Section 31 SGB V, with the exception of vision aids and hearing aids can be prescribed on sample 16.

2.16.3 Digital health applications in accordance with Section 73 (2) sentence 1 no. 7a SGB V are prescribed on sample 16 in accordance with the explanations on the form. “

The previous number 2.16.3 becomes number 2.16.4.

Article 2

Changes to the explanations of the form

1. The explanation of the form for sample 1 changes as follows:

" Sample 1: certificate of incapacity for work

The assessment of the incapacity for work and its probable duration requires special care with regard to its significance. Incapacity for work can therefore only be certified on the basis of medical examination. Incapacity for work also exists during gradual reintegration and must be certified with sample 1 during this time. The doctor should archive the data on the certificate of incapacity for work for at least 12 months. The guidelines of the Federal Joint Committee on the assessment of incapacity for work and the measures for gradual reintegration (work incapacity guideline) must be observed.

The following information must be observed when filling the fields:

1 Initial / follow-up certificate

The certificate of incapacity for work must show whether it is First or follow-up certification. The box “initial certificate” must be ticked by the contract doctor who first determined the incapacity for work, otherwise the box “follow-up certificate” (also for co-treatment / further treatment) must be ticked. If new illness occurs and has in the meantime been able to work, even if only for short time, "Initial certificate" must be ticked; this also applies if new incapacity for work begins the day after the end of the previous incapacity for work.

3 Incapable of working since

2.16.3 Digital health applications in accordance with Section 73 (2) sentence 1 no. 7a SGB V are prescribed on sample 16 in accordance with the explanations on the form. “

The previous number 2.16.3 becomes number 2.16.4.

Article 2

Changes to the explanations of the form

1. The explanation of the form for sample 1 changes as follows:

" Sample 1: certificate of incapacity for work

The following information must be observed when filling the fields:

1 Initial / follow-up certificate

3 Incapable of working since

In the line "Incapable of working since", enter the day from which the Insured person is incapable of work according to the findings made by the contract doctor. In principle, incapacity for work should not be certified for period prior to the first use of the contract doctor.Backdating the beginning of the incapacity to work to day prior to the start of treatment is only permitted in exceptional cases and only after careful examination and generally only for up to three days. When the certificate of incapacity for work is issued for the first time (initial certificate), both the line “Incapable of working since” and the line “determined on” must be filled in, even if the data match. If it is follow-up certificate, the date can be omitted in the line "Incapable of working since".

4 probably incapable of working up to and including the last day of incapacity for work

In the box “Probably incapable of work up to and including or last day of incapacity”, enter the date up to which incapacity for work is expected to exist on the basis of the medical findings. The prognosis of the duration of the incapacity for work should not be certified for period more than two weeks in advance. If it is appropriate due to the illness or particular course of illness, the inability to work can be certified for period of one month. If you are unable to work on days off, e.g. B. on Saturdays, Sundays, public holidays, vacation days or non-working days due to flexible working time regulation (so-called "bridge days"), it must also be certified for these days. If there is potential case of sick pay and the contract doctor can already assess when determining the incapacity for work that the incapacity will actually end, will end or has ended on the date specified in the "Probably incapable of work up to and including the last day of incapacity" , in addition to specifying the last day of incapacity for work, the box “Endbescheinigung” must be ticked. Particular care must be taken with this information, because the certified date is important for the continued payment of wages by the employer, the continued payment of benefits by the Employment Agency and the payment of sick pay.

5 determined on

The determination of incapacity for work may neither be predated nor backdated; Rather, the day on which the incapacity for work was actually determined by doctor for the period of incapacity specified in the current certificate of incapacity should be used. The determination date is important for complete proof of the continued incapacity for work. For this purpose, the further incapacity for work must be medically determined again at the latest on the working day following the previously attested probable end of the incapacity for work.Backdating the beginning of the incapacity to work to day prior to the start of treatment is only permitted in exceptional cases and only after careful examination and generally only for up to three days. When the certificate of incapacity for work is issued for the first time (initial certificate), both the line “Incapable of working since” and the line “determined on” must be filled in, even if the data match. If it is follow-up certificate, the date can be omitted in the line "Incapable of working since".

4 probably incapable of working up to and including the last day of incapacity for work

5 determined on

The determination of incapacity for work may neither be predated nor backdated; Rather, the day on which the incapacity for work was actually determined by doctor for the period of incapacity specified in the current certificate of incapacity should be used. The determination date is important for complete proof of the continued incapacity for work. For this purpose, the further incapacity for work must be medically determined again at the latest on the working day following the previously attested probable end of the incapacity for work.Saturdays are not considered working days in the aforementioned sense. A belated determination of incapacity for work leads to incomplete evidence of incapacity for work; as result, there is risk of loss of sick pay for the insured person.

6 Diagnosis (s) based on AU

When filling out the fields "AU-justifying diagnosis (s)", all diagnoses justifying the current incapacity for work must be given in the ICD 10 format. Additional information as plain text / free text is only permitted if it is necessary to provide further information outside of the ICD-10 coding.

7 other accident , Consequences of an accident

In the event of an accident or consequences of an accident, this must be ticked accordingly. If it is an accident at work or the consequences of an accident at work, "Work accident / consequences, occupational disease" must be ticked instead.

8 Diseases (e .g . BVG)

If there is pension problem, this must be ticked accordingly. Ailments are understood to mean all illnesses or health impairments that have arisen due to publicly ordered or suggested measure or as result of criminal offense and which have been recognized by the welfare office. These include e.g. to subsume the following claims:

● Federal Supply Act (war damage)

● Victims Compensation Act (e.g. victims of acts of violence)

● Infection Protection Act (e.g. vaccination damage, other damage to health through prophylaxis)

● Soldiers Supply Act

9 The following special measures are considered to be necessary

If the contract doctor indicates the need to initiate medical rehabilitation services in stages If reintegration or other measures (e.g. benefits for participation or operational integration management) are necessary, this should be initiated together with the insured person on the application / prescription template provided for this purpose and the application should be specified under "Other". If direct initiation is not possible, the recommendation must be given here.

10 from 7th week of AU or other sick pay case

As soon as the continuous duration of the incapacity for work is more than 6 weeks or the contract doctor becomes aware of the existence of another sick pay case (e.g. due to creditable previous illnesses or incapacity for work during the first four weeks of the employment relationship) In each of the incapacity certificates following this incapacity, check the box “from 7.Saturdays are not considered working days in the aforementioned sense. A belated determination of incapacity for work leads to incomplete evidence of incapacity for work; as result, there is risk of loss of sick pay for the insured person.

6 Diagnosis (s) based on AU

7 other accident , Consequences of an accident

8 Diseases (e .g . BVG)

● Federal Supply Act (war damage)

● Victims Compensation Act (e.g. victims of acts of violence)

● Infection Protection Act (e.g. vaccination damage, other damage to health through prophylaxis)

● Soldiers Supply Act

9 The following special measures are considered to be necessary

10 from 7th week of AU or other sick pay case

As soon as the continuous duration of the incapacity for work is more than 6 weeks or the contract doctor becomes aware of the existence of another sick pay case (e.g. due to creditable previous illnesses or incapacity for work during the first four weeks of the employment relationship) In each of the incapacity certificates following this incapacity, check the box “from 7.AU week or other case of sick pay “to be checked. The information is an indication of the contract doctor for the health insurance company that the current certificate of incapacity for work was issued in potential sickness benefit case; the doctor does not judge whether the insured person is actually entitled to sickness benefit.

11 Final certificate

If there is case of sickness benefits and the contract doctor can already assess when determining the incapacity for work that the incapacity for work actually occurred on the field "Probably incapable of work up to and including or last day of incapacity" Date ends, will end or has ended, the box "Endbescheinigung" must be checked. "

2. The form explanation for sample 4 changes as follows:

< Sample 4: Ordinance on patient transport

A prerequisite for prescribing patient transport is that the journey is medically necessary in connection with service provided by the health insurance company. Decisive for the selection of the means of transport is the medical necessity in the individual case, taking into account the principle of economic efficiency. The patient's current state of health and his ability to walk must therefore be taken into account when making selection. Trips without compelling medical reasons, e.g. B. to coordinate appointments, inquire about findings or collect prescriptions, may not be prescribed. In addition, trips to social long-term care insurance benefits in accordance with SGB XI, e.g. B. Trips from the patient's home to the nursing home. In principle, the ordinance must be issued before the transport.

The basis of the ordinance on patient transport is the ambulance transport guideline of the Federal Joint Committee (KT-RL).

The prescription is to be handed over to the insured person, who can pass it on directly to the transporter in the case of journeys without authorization. In the case of journeys that require authorization, the insured person must send the prescription to the health insurance company before starting the journey so that the latter can arrange for data protection-compliant authorization.

Changes and additions to the regulation require new signature from the contracting doctor Stamp and date.

When filling the fields, the following information is given Please note:

1 No co-payment or co-payment obligation

Here it is to be indicated whether the insured Has to make additional payments.AU week or other case of sick pay “to be checked. The information is an indication of the contract doctor for the health insurance company that the current certificate of incapacity for work was issued in potential sickness benefit case; the doctor does not judge whether the insured person is actually entitled to sickness benefit.

11 Final certificate

2. The form explanation for sample 4 changes as follows:

< Sample 4: Ordinance on patient transport

The basis of the ordinance on patient transport is the ambulance transport guideline of the Federal Joint Committee (KT-RL).

Changes and additions to the regulation require new signature from the contracting doctor Stamp and date.

When filling the fields, the following information is given Please note:

1 No co-payment or co-payment obligation

Here it is to be indicated whether the insured Has to make additional payments.In principle, patient transport is subject to co-payment and therefore the field "co-payment obligation" is to be ticked.

The field "co-payment-free" is only to be ticked

● in the case of prescriptions at the expense of an accident insurance company (see 2),

● in the case of prescriptions for the insured due to pension illness (see 2 ) as well as

● in cases in which the insured person can prove an exemption from the co-payment obligation.

2 Accident, result of an accident, work accident, occupational disease, supply disorder (e.g. BVG)

If there is an accident, an accident at work, an occupational disease or supply disorder, this must be marked.

In the event of an accident at work (including school accident) or recognized occupational disease, the regulation must be issued at the expense of an accident insurance institution. For this, the responsible accident insurance institution must be named in the personal field.

Ailments are understood to mean all illnesses or health impairments that have arisen due to publicly ordered or suggested measure or as result of criminal offense and recognized by the pension office. These include: B. to subsume the following claims:

● Federal Supply Act (war damage),

● Victims Compensation Act (e.g. victims of Acts of violence),

● Infection Protection Act (e.g. vaccination damage, other damage to health through prophylaxis),

● Soldier Welfare Act.

3 Outward journey, return journey

In connection with health insurance benefit, only Trips on the direct route between the patient's whereabouts and the next available, suitable treatment option can be prescribed.

In the interests of economic efficiency, the contract doctor checks the medical necessity for the outward journey and for the Return trip. If, for example, only the return journey is not possible with public transport, then only this can be prescribed. If necessary, the waiting time for the transporter should be confirmed by the contract doctor under 17 .

1. Reason for transportation

Permit-free journeys

4 a) full / partial inpatient hospital treatment - / post-inpatient treatment

The prescription of medically necessary patient transport for full or partial inpatient hospital treatment or for pre- or post-inpatient treatment is permitted without prior approval by the health insurance company.In principle, patient transport is subject to co-payment and therefore the field "co-payment obligation" is to be ticked.

The field "co-payment-free" is only to be ticked

● in the case of prescriptions at the expense of an accident insurance company (see 2),

● in the case of prescriptions for the insured due to pension illness (see 2 ) as well as

● in cases in which the insured person can prove an exemption from the co-payment obligation.

2 Accident, result of an accident, work accident, occupational disease, supply disorder (e.g. BVG)

If there is an accident, an accident at work, an occupational disease or supply disorder, this must be marked.

● Federal Supply Act (war damage),

● Victims Compensation Act (e.g. victims of Acts of violence),

● Infection Protection Act (e.g. vaccination damage, other damage to health through prophylaxis),

● Soldier Welfare Act.

3 Outward journey, return journey

In connection with health insurance benefit, only Trips on the direct route between the patient's whereabouts and the next available, suitable treatment option can be prescribed.

1. Reason for transportation

Permit-free journeys

4 a) full / partial inpatient hospital treatment - / post-inpatient treatment

The prescription of medically necessary patient transport for full or partial inpatient hospital treatment or for pre- or post-inpatient treatment is permitted without prior approval by the health insurance company.In the case of pre-inpatient treatment, the expected start of inpatient treatment should be given under 17 The transport to pre- or post-inpatient treatment may take place for no more than three days of treatment within five days before the start of treatment or, in principle, for no more than seven treatment days within 14 days of the end of inpatient treatment. In the case of an organ transplant, transport to post-inpatient treatment may be carried out up to three months after the end of inpatient treatment.

5 b) outpatient treatment at Merkzeichen "AG", "BI", "H", care level 3 with permanent mobility impairment, care level 4 or 5 (only taxi, rental car; travel with KTW is to be prescribed under f))

The prescription of medically necessary medical trip for outpatient treatment is possible for patients who present severely handicapped ID with the mark “aG”, “Bl”, “H” or notification of care level 3, 4 or 5 with the prescription. In the case of patients with care level 3 who were not classified at least in care level 2 by December 31, 2016, there must also be need for support during transport because of permanent (at least over 6 months) physical, cognitive or psychological impairment of their mobility, so that they do not be able to drive independently (e.g. by public transport) to outpatient treatment. This has to be assessed in each individual case. In doing so, the contract doctor can rely on existing findings regarding the mobility of the insured person (e.g. mark “G” [significant impairment of mobility in road traffic] in the severely handicapped ID card). In the case of patients with care level 3 who were classified in care level 2 by December 31, 2016, corresponding permanent mobility impairment can be assumed.

Journeys in taxi or in Rental cars must be carried out. The rental cars also include vehicles with facilities for the disabled, e.g. B. with stretcher, with carrying chair or for transporting non-ambulatory patients in their own wheelchair. The checkboxes 11 and, if applicable, 13 are to be used for this. If it is necessary to travel in an ambulance, this must be ordered under 9 .

6 c) other reason, e.g. B.In the case of pre-inpatient treatment, the expected start of inpatient treatment should be given under 17 The transport to pre- or post-inpatient treatment may take place for no more than three days of treatment within five days before the start of treatment or, in principle, for no more than seven treatment days within 14 days of the end of inpatient treatment. In the case of an organ transplant, transport to post-inpatient treatment may be carried out up to three months after the end of inpatient treatment.

5 b) outpatient treatment at Merkzeichen "AG", "BI", "H", care level 3 with permanent mobility impairment, care level 4 or 5 (only taxi, rental car; travel with KTW is to be prescribed under f))

6 c) other reason, e.g. B.Trips to hospices

The prescription of medically necessary patient transport for "other reasons" is permitted

● for trips to other inpatients Facilities (hospices [§ 39a SGB V] and short-term care facilities [§ 39c SGB V] as health insurance benefits),

● for trips to ward replacement outpatient operation in accordance with § 115b SGB V in the hospital or for an outpatient operation in the contracted doctor's practice as well as in connection with pre- or post-treatment and

● in the case of transfer trip to another hospital during an urgent medical reason inpatient treatment (exceptional case) and

● during rescue trips to the hospital (even without subsequent inpatient treatment).

The occasion must be entered in the free text line 6 .

Vorau is required for outpatient operations A stipulation that this avoids full or part inpatient hospital treatment, which is required for medical reasons, or that this cannot be carried out. In this case, hospital treatment is not “necessary” if inpatient hospital treatment would be necessary if the planned outpatient operation is not carried out. Rather, an inpatient treatment that is necessary from medical point of view must be carried out on an outpatient basis for special reasons, e.g. B. because the patient consciously decides against full or part inpatient hospital treatment and the operation is therefore carried out on an outpatient basis. A justification for the ward-replacing implementation must be given under 17 .

If pre- or post-treatment is required, the statutory deadlines apply analogously to pre- and post-inpatient treatments under 4 . At the same time, the day of the operation must be entered under 17 .

In the case of outpatient operations that do not replace wards, it is not possible to prescribe patient transport, e.g. B. in non-ward-replacing cataract operations.

Trips to outpatient treatments that require approval

7 d) high-frequency treatment dialysis, oncol. Chemotherapy or radiation therapy

In exceptional cases, trip to the hospital for outpatient treatment can be prescribed if this is absolutely medically necessary.

An exceptional case is to be assumed if patients require dialysis treatment, oncological radiation therapy, parenteral antineoplastic drug therapy or parenteral oncological chemotherapy (according to Appendix 2 of the KT-RL) with high treatment frequency.Trips to hospices

The prescription of medically necessary patient transport for "other reasons" is permitted

● for trips to other inpatients Facilities (hospices [§ 39a SGB V] and short-term care facilities [§ 39c SGB V] as health insurance benefits),

● in the case of transfer trip to another hospital during an urgent medical reason inpatient treatment (exceptional case) and

● during rescue trips to the hospital (even without subsequent inpatient treatment).

The occasion must be entered in the free text line 6 .

If pre- or post-treatment is required, the statutory deadlines apply analogously to pre- and post-inpatient treatments under 4 . At the same time, the day of the operation must be entered under 17 .

In the case of outpatient operations that do not replace wards, it is not possible to prescribe patient transport, e.g. B. in non-ward-replacing cataract operations.

Trips to outpatient treatments that require approval

7 d) high-frequency treatment dialysis, oncol. Chemotherapy or radiation therapy

In exceptional cases, trip to the hospital for outpatient treatment can be prescribed if this is absolutely medically necessary.

7 comparable exceptional case

A comparable exceptional case is to be assumed if patients with The treatment regimen prescribed for the underlying disease must be treated, which has high treatment frequency over longer period of time and the patient is so impaired by the treatment or the course of the disease leading to this treatment that transportation is essential to avoid harm to life and limb. The comparability must be justified under 17 , if necessary, stating the relevant ICD-10.

8 e) permanent Mobility impairment comparable to b) and duration of treatment at least 6 months (justification under 4. required)

With comparable impairment of mobility according to the criteria specified in field 5 (Marks “aG”, “Bl”, “H”, care level 3 with permanent mobility impairment, care level 4 or 5) prescription can only be considered if the patient requires outpatient treatment for at least 6 months. The comparability of the mobility impairment is to be justified, if necessary, stating the relevant ICD-10 under 17 .

9 f) another reason for driving with KTW z. B. professional storage, carrying, lifting required (please state reasons under 3. and, if applicable, 4.)

Reasons other than the above can be the regulation of patient transport with an ambulance (KTW ) if patients need medical care or special facilities at KTW during the journey or if it is to be expected that this will be necessary (e.g. because proper storage, carrying, lifting during the journey due to decubitus without degree of care is required) or if this avoids the transmission of serious, contagious diseases to the patient.

The checkbox must also be used if insured persons with mark “aG”, “Bl "," H "or care level 3 with permanent mobility impairment, care level 4 or 5, trip in the KTW is required.

Information as to why professional care or special facilities are required under 12 .

In addition, relocation trips that require approval (exceptional case), e.g. B. transfer to local hospital to order. The medically required means of transport for relocation journeys must be specified under 11 to 15 . Furthermore, the reason "relocation" must be entered under 17 .

10 2.

7 comparable exceptional case

8 e) permanent Mobility impairment comparable to b) and duration of treatment at least 6 months (justification under 4. required)

9 f) another reason for driving with KTW z. B. professional storage, carrying, lifting required (please state reasons under 3. and, if applicable, 4.)

The checkbox must also be used if insured persons with mark “aG”, “Bl "," H "or care level 3 with permanent mobility impairment, care level 4 or 5, trip in the KTW is required.

Information as to why professional care or special facilities are required under 12 .

10 2.Treatment day / frequency and the nearest accessible, suitable treatment facility

Here, information about the (expected) treatment day or treatment frequency and the treatment facility (e.g. name of the hospital / contracted doctor) must be given or specialty of the contracted doctor).

If the day of treatment is not known for trips that do not require permit, the day of treatment can be omitted in individual cases, e.g. B. if the need for specialist visit is determined during home visit or an appointment is made via the appointment service point. In these cases, justification must be given under 17 .

When specifying the treatment center, it should be noted that health insurances usually cover travel costs up to the next , take on suitable treatment options (e.g. contract doctor practice). If another treatment option is chosen, the insured person must bear the additional costs incurred.

3. Type of transport

11 Taxi / rental car

A taxi / rental car can be prescribed if the patient cannot use public transport or private vehicle for compelling medical reasons. The rental cars also include vehicles with facilities for the disabled. If patient is to be transported in wheelchair, in carrying chair or lying down, these requirements for the taxi / rental car must also be marked under 13 . There is no medical-professional care of the patients.

12 KTW, since medical-professional care and / or equipment is necessary because of

The prescription of patient transport by means of KTW is only permissible if technical support and / or the special facility of the KTW is necessary during the journey for compelling medical reasons and transport by less expensive means of transport not possible. It should be noted that it is not the diagnosis or the treatment itself that constitutes the “compelling medical necessity” of the KTW, but the type and extent of the functional disorder. This must therefore be specified here (if necessary, stating the relevant ICD-10) (e.g. risk of bleeding) or it must be derived from the reason. When ordering KTW, the fields under 13 wheelchair, carrying chair or lying down can also be ticked.

13 wheelchair, Carrying chair, lying

The "Wheelchair" field must be checked if patient who is unable to walk has to be transported in his own wheelchair or in an ambulance chair (vehicle with wheelchair-accessible equipment).Treatment day / frequency and the nearest accessible, suitable treatment facility

3. Type of transport

11 Taxi / rental car

12 KTW, since medical-professional care and / or equipment is necessary because of

13 wheelchair, Carrying chair, lying

The "Wheelchair" field must be checked if patient who is unable to walk has to be transported in his own wheelchair or in an ambulance chair (vehicle with wheelchair-accessible equipment).

The field "Carrying chair" must be checked if the patient is not able to walk and can be transported while seated. Due to the lack of accessibility, carrying capacity of two people is required (vehicle equipment: carrying chair).

The "lying" field must be crossed if patient can only be transported lying down (vehicle equipment: stretcher ).

14 Ambulance

Ambulances are to be prescribed for emergency patients who Before and during the transport, in addition to the first aid measures, additional measures are required that are suitable to maintain or restore the vital functions.

In emergencies, the transport can be carried out afterwards may be prescribed.

15 NAW / NEF

Emergency ambulance (NAW) or ambulance vehicles ( NEF) are to be prescribed for emergency patients for whom immediate life-saving measures are to be carried out or are to be expected before or during the journey, for whom emergency medical care is required.

In emergencies, transport can be ordered retrospectively.

16 others

Is the regulation of other means of transport such as B. rescue helicopter (RTH) is necessary, this should be noted here. The prescription of an RTH is possible if faster transport with ground-based life-saving appliance is not sufficient.

17 4. Justification / Other

Free text field to justify comparability according to 7 and 8.

This free text field is can also be used for other relevant information, e.g. For example:

● Date of the (planned) start of inpatient treatment when prescribing trips to inpatient treatment,

● Specification of further planned treatment appointments,

● Specification of treatment frequency that cannot be recorded under 10 (e.g. 5 x every 2 weeks from DDMMYY to DDMMYY),

● Justification, if treatment day under 10 is not known

● Treatment which was arranged via the appointment service point,

● Duration of the waiting time of the carrier for the outward and return journey in temporal context,

● Possibility of using joint trips, if necessary

The "lying" field must be crossed if patient can only be transported lying down (vehicle equipment: stretcher ).

14 Ambulance

In emergencies, the transport can be carried out afterwards may be prescribed.

15 NAW / NEF

In emergencies, transport can be ordered retrospectively.

16 others

17 4. Justification / Other

Free text field to justify comparability according to 7 and 8.

This free text field is can also be used for other relevant information, e.g. For example:

● Date of the (planned) start of inpatient treatment when prescribing trips to inpatient treatment,

● Specification of further planned treatment appointments,

● Specification of treatment frequency that cannot be recorded under 10 (e.g. 5 x every 2 weeks from DDMMYY to DDMMYY),

● Justification, if treatment day under 10 is not known

● Treatment which was arranged via the appointment service point,

● Duration of the waiting time of the carrier for the outward and return journey in temporal context,

● Possibility of using joint trips, if necessarystating the number of passengers,

● location, if the journey does not take place from / to the patient's apartment,

● Weight in the case of heavy patients,

● Date of the (planned) operation when prescribing trips to pre- / follow-up treatments for outpatient operations,

< p> ● Justification of the ward-replacing outpatient operation (medical and / or patient-specific reasons),

● Information that there was no authorization option with the time (for trips to outpatient treatment),

● Indication that an accompanying person is medically necessary,

● Indication of "relocation", if there is if this is not relocation journey that is necessary for compelling medical reasons,

● Notice that patient requiring intensive ventilation is being transported,

● Anga be sure that the patient has rollator or

● Specification that the patient cannot climb steps.

BACK

The information provided on the back of the health transport regulation must be completed by the transporter and the patient. “

3. The explanation of the form for sample 16 changes as follows:

" Sample 16: drug prescription sheet

The contract doctor may only use drug prescription sheets that have the establishment no. contained in the coding bar 1 , at the associated business premises of which the respective service was provided. If the doctor no. already imprinted, it is not permitted to pass on the marked form to another contracted doctor as temporary measure. and hearing aids are prescribed. Separate prescription sheets are to be used for the simultaneous prescription of drugs and medical aids as well as digital health applications.

When prescribing formulas, only the front of the form may be used. One prescription sheet must be used for each recipe.

Recipes for parenteral use can be prescribed for up to week if required. The prerequisite for this is that the preparations to be used individually are identical in type and quantity (e.g. infusion bag). Patient-specific partial quantities (especially weekly blisters) taken from finished medicinal products can be prescribed for up to four weeks as part of long-term medication.stating the number of passengers,

● location, if the journey does not take place from / to the patient's apartment,

● Weight in the case of heavy patients,

● Date of the (planned) operation when prescribing trips to pre- / follow-up treatments for outpatient operations,

< p> ● Justification of the ward-replacing outpatient operation (medical and / or patient-specific reasons),

● Information that there was no authorization option with the time (for trips to outpatient treatment),

● Indication that an accompanying person is medically necessary,

● Indication of "relocation", if there is if this is not relocation journey that is necessary for compelling medical reasons,

● Notice that patient requiring intensive ventilation is being transported,

● Anga be sure that the patient has rollator or

● Specification that the patient cannot climb steps.

BACK

The information provided on the back of the health transport regulation must be completed by the transporter and the patient. “

3. The explanation of the form for sample 16 changes as follows:

" Sample 16: drug prescription sheet

When prescribing formulas, only the front of the form may be used. One prescription sheet must be used for each recipe.

Changes and additions to prescriptions for drugs, bandages and aids as well as digital health applications require new doctor's signature with the date.

The medication prescription sheet cannot be used

● for prescribing narcotic drugs. Due to the Narcotics Prescription Ordinance, narcotics may only be prescribed on the three-part official form of the Federal Institute for Drugs and Medical Devices.

● for the prescription of drugs with the active ingredients lenalidomide, pomalidomide or Thalidomide. Due to the Medicines Prescription Ordinance, the two-part official form ("T-Prescription") of the Federal Institute for Drugs and Medical Devices must be used for this purpose.

● for the prescription of means and measures, which are not necessary for the treatment of the patient or which are not covered by the statutory health insurance benefits (e.g. contraceptives for insured persons who have reached the age of 22). A private prescription should be used here.

When filling in the fields The following instructions must be observed:

2 Prescription: free or subject to fee

Basically it is to be assumed that the ordinance is subject to fee and thus the field "Fee-payable" is to be crossed.

The field "Fee free" is only to be crossed

● for insured persons who have not yet reached the age of 18,

● if medication and bandages are used for pregnancy symptoms or in connection with the Childbirth can be prescribed,

● in the case of prescriptions charged to an accident insurer,

● in the case of prescriptions for insured persons with supply disorder,

● when prescribing digital health applications

● as well as in the cases i n for which an exemption from the co-payment obligation (e.g. B. hardship regulation).

3 Exemption from the emergency service fee

If the drug picked up in the pharmacy's emergency service (within the times in accordance with Section 6 of the Drug Price Ordinance), the patient must pay fee (EUR 2.50), unless the doctor makes corresponding note (ticking the "noctu" field).

4 Others

In the case of prescription at the expense of another payer such as Post Office Health Insurance Fund A, free medical care the police, federal police, armed forces etc. a. the field "Other" must be ticked.

Changes and additions to prescriptions for drugs, bandages and aids as well as digital health applications require new doctor's signature with the date.

The medication prescription sheet cannot be used

When filling in the fields The following instructions must be observed:

2 Prescription: free or subject to fee

Basically it is to be assumed that the ordinance is subject to fee and thus the field "Fee-payable" is to be crossed.

The field "Fee free" is only to be crossed

● for insured persons who have not yet reached the age of 18,

● if medication and bandages are used for pregnancy symptoms or in connection with the Childbirth can be prescribed,

● in the case of prescriptions charged to an accident insurer,

● in the case of prescriptions for insured persons with supply disorder,

● when prescribing digital health applications

● as well as in the cases i n for which an exemption from the co-payment obligation (e.g. B. hardship regulation).

3 Exemption from the emergency service fee

4 Others

5 Accident / work-related accident

If regulation is issued to the detriment of an accident insurance institution, so In addition to the designation of the responsible accident insurance institution, the day of the accident and the accident operation (if applicable, kindergarten, school, university) must be specified in the fields provided. Furthermore, the checkbox "Work accident" must be marked. If the personal details field is filled using an electronic health card, the cost unit identification must be deleted.

If the regulation is the result of an accident that is not an accident at work, but home, sports or was traffic accident, the field "Accident" must be crossed.

6 Eligible persons under the Federal Compensation Act / Federal Supply Act

In the case of ordinances for beneficiaries under the Federal Compensation Act (BEG), field 6 (BVG) is to be marked as for beneficiaries under the Federal Pension Act.

All illnesses or Understood health impairments that have arisen due to publicly ordered or suggested measure or as result of criminal offense and have been recognized by the pension office. These include: B. to subsume the following claims:

● Federal Supply Act (war damage),

● Victims Compensation Act (e.g. victims of Acts of violence),

● Infection Protection Act (e.g. vaccination damage, other damage to health due to prophylaxis),

● Soldiers Welfare Act .

7 Special code for the prescription of medication, bandages and aids

For For the prescription of medication, bandages and aids, the following special markings must be made on the prescription sheet:

For prescription

● of vaccines within the framework of the valid vaccination agreement, field 8 is to be marked by entering number 8.

● field 7 is to be marked by entering number 7 of aids.

● the requirement for consultation hours is

○ field 9 for medication and bandages by entering the number 9.

○ for aids, field 9 by entering number 9 and field 7 by entering number 7.

○ of vaccines field 8 by entering the number 8 and field 9 by entering the number 9.

8 Obligation to give reasons

The "Obligation to give reasons" field is currently not available and is initially used to identify dental prescriptions.

5 Accident / work-related accident

If the regulation is the result of an accident that is not an accident at work, but home, sports or was traffic accident, the field "Accident" must be crossed.

6 Eligible persons under the Federal Compensation Act / Federal Supply Act

In the case of ordinances for beneficiaries under the Federal Compensation Act (BEG), field 6 (BVG) is to be marked as for beneficiaries under the Federal Pension Act.

● Federal Supply Act (war damage),

● Victims Compensation Act (e.g. victims of Acts of violence),

● Infection Protection Act (e.g. vaccination damage, other damage to health due to prophylaxis),

● Soldiers Welfare Act .

7 Special code for the prescription of medication, bandages and aids

For For the prescription of medication, bandages and aids, the following special markings must be made on the prescription sheet:

For prescription

● of vaccines within the framework of the valid vaccination agreement, field 8 is to be marked by entering number 8.

● field 7 is to be marked by entering number 7 of aids.

● the requirement for consultation hours is

○ field 9 for medication and bandages by entering the number 9.

○ for aids, field 9 by entering number 9 and field 7 by entering number 7.

○ of vaccines field 8 by entering the number 8 and field 9 by entering the number 9.

8 Obligation to give reasons

The "Obligation to give reasons" field is currently not available and is initially used to identify dental prescriptions.

9 Billing fields

The billing fields in the upper right part of the medication prescription sheet (service provider IK (e.g. Pharmacy IK), additional payment, total gross amount, drug / aid no., Factor, tax) are filled in by the issuing office (pharmacy, medical supply store).

10 Aut idem

If it is to be excluded that the pharmacies dispense an inexpensive drug with the same active ingredient instead of the prescribed agent, the Aut-idem field is on the prescription sheet to be ticked.

Note:

If no aut-idem-cross has been set, substitution by pharmacies according to the legal Specifications and the provisions of the framework agreement concluded between the National Association of Health Insurance Funds and the German Pharmacists Association in accordance with Section 129 SGB V.

Medicines that contain an active ingredient, d it is on the substitution exclusion list (Drugs Directive, Annex VII Part B) cannot be replaced by the pharmacy even without the aut-idem cross being set.

11 ordinances in the context of an "artificial fertilization" or "replacement ordinance according to § 31 Ab sentence 3 sentence 7 SGB V". For the prescription of drugs within the framework of the provision of services according to § 27a SGB V (Artificial Insemination) on the regulation sheet, the information "Regulation according to § 27a SGB V" has to be stated. This takes place against the background that the health insurance company only bears 50% of the costs with these regulations and only these can be billed to the health insurance company by the pharmacy. The other 50% are to be borne by the insured person.

If drug has to be prescribed again for drug due to drug recall or restriction on usability announced by the competent authority, this is to carry out new prescription of drug or comparable drug on separate drug prescription sheet and to mark it with the imprint "Substitute regulation according to § 31 paragraph 3 sentence 7 SGB V".

12 Dosage information

If medication plan or written dosage instruction is available, there is an additional label in front of the prescribed product at the beginning of the prescription line using: "≫Dj≪". That means, yes, there is written dosage instruction. If the additional labeling is not available, the dosage instructions appear on the prescription.

13 Regulations for digital health applications ("health apps") according to Section 73 Paragraph 2 sentence 1 no.

9 Billing fields

10 Aut idem

If it is to be excluded that the pharmacies dispense an inexpensive drug with the same active ingredient instead of the prescribed agent, the Aut-idem field is on the prescription sheet to be ticked.

Note:

12 Dosage information

13 Regulations for digital health applications ("health apps") according to Section 73 Paragraph 2 sentence 1 no.7a SGB V

For the prescription of digital health application according to § 73 Abs. 2 Satz 1 Nr. 7a SGB V the regulation field has to be filled out as follows:

Line 1 and 2: Name of the application (optional) 1

Line 3: Unique directory number

Line 4: Unoccupied 2

Line 5: Duration of use in days

< p> Line 6: Unoccupied

Only one digital application may be prescribed per drug prescription sheet.

14 Forgery-proof filling out of the medication prescription sheet

When filling out the medication prescription sheet, make sure that no empty spaces are left or created that could be used for manipulation. In order to avoid that further drug prescriptions (especially those with addictive potential) can be added in an unauthorized manner, the contract doctor has to put his signature immediately under the last prescription on the drug prescription sheet.

15 Position of the contract doctor's stamp

If the contents of the contract doctor's stamp are not already imprinted on the medication prescription sheet, make sure that the contract doctor's stamp is in the prescription field in the designated area Position is printed. Overstamping may not be done in the field above or below, because otherwise machine reading of these fields is not possible. "

Article 3

Entry into force

The changes to sample 4 and 16 come into effect on July 1st, 2020.

The changes to sample 1 come into effect on January 1st, 2021 and January 1st, 2022, respectively.

Old samples 1 and 4 lose their validity.

Berlin, April 30, 2020

National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin

GKV-Spitzenverband, Kdö.R., Berlin

The National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin - on the one hand - and the GKV-Spitzenverband (National Association of Health Insurance Funds), Kdö.R. , Berlin - on the other hand - agree the following:

17. Amendment of the agreement on the use of the blank form printing process for the production and printing of forms for statutory health care from October 1, 2014 (Annex 2a BMV-Ä)

Article 1

1. In the overview in chapter 1.4, the entry for sample 1 / E changes as follows on 01.01.2021:

2. In the overview in chapter 1.4, the entry for sample 1 / E is deleted as of 01.01.2022:

3.7a SGB V

For the prescription of digital health application according to § 73 Abs. 2 Satz 1 Nr. 7a SGB V the regulation field has to be filled out as follows:

Line 1 and 2: Name of the application (optional) 1

Line 3: Unique directory number

Line 4: Unoccupied 2

Line 5: Duration of use in days

< p> Line 6: Unoccupied

Only one digital application may be prescribed per drug prescription sheet.

14 Forgery-proof filling out of the medication prescription sheet

15 Position of the contract doctor's stamp

Article 3

Entry into force

The changes to sample 4 and 16 come into effect on July 1st, 2020.

The changes to sample 1 come into effect on January 1st, 2021 and January 1st, 2022, respectively.

Old samples 1 and 4 lose their validity.

Berlin, April 30, 2020

National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin

GKV-Spitzenverband, Kdö.R., Berlin

17. Amendment of the agreement on the use of the blank form printing process for the production and printing of forms for statutory health care from October 1, 2014 (Annex 2a BMV-Ä)

Article 1

1. In the overview in chapter 1.4, the entry for sample 1 / E changes as follows on 01.01.2021:

2. In the overview in chapter 1.4, the entry for sample 1 / E is deleted as of 01.01.2022:

3.Numbers 2.1 to 2.1.11 change as follows on 01.01.2021:

" 2.1 Sample 1 / E: Certificate of incapacity for work (as of 01.01.2021)

2.1.1 For the certificate of incapacity to work, samples 1a / E to 1b / E are to be used in accordance with the form shown in Sections 2.1.8 to 2.1.9.

2.1.2 The certificate of incapacity for work comprises two pages:

Sample 1a / E: Copy for the insured person

Sample 1b / E: Copy for the employer

2.1.3 Samples 1a / E to 1.b / E are to be drawn up on security paper in A5 format .

2.1.4 unoccupied

2.1.5 The samples 1a / E to 1b / E are not shown with barcode provided.

2.1.6 unoccupied

2.1.7 unoccupied

2.1.8 Sample 1a / E

Orig inal: DIN A5 portrait

2.1.9 Sample 1b / E

Original: DIN A5 portrait

2.1.10 unoccupied

2.1.11 unoccupied “

4. Numbers 2.1 to 2.1.11 will be deleted on 01/01/2022: 1

5. Numbers 2.4 and 2.4.7 are changed as follows:

" 2.4 Model 4 / E:

Ordinance on patient transport

(Status: 07.2020)

2.4.7 Sample 4 / E

Original: DIN A4 horizontal “

Article 2

Entry into force

The changes to pattern 4 come into effect on July 1st, 2020.

The changes to pattern 1 come into effect on January 1st, 2021 or January 1st, 2022 in force.

Berlin, April 30th, 2020

National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin

GKV-Spitzenverband, Kdö.R., Berlin

The National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin - on the one hand - and the GKV-Spitzenverband (National Association of Health Insurance Funds), K. d. ö. R., Berlin - on the other hand - conclude the following

agreement on the use of digital forms in contract medical care (form agreement digital forms) as Annex 2b to the Federal Medical Insurance Contract (BMV-Ä) p>

from 01.07.2020

General part

§ 1 General and purpose of the agreement

(1) This agreement regulates the use of the digital forms specified in § 4 in statutory health care.

(2) This agreement is divided into general and special part subdivided.Numbers 2.1 to 2.1.11 change as follows on 01.01.2021:

" 2.1 Sample 1 / E: Certificate of incapacity for work (as of 01.01.2021)

2.1.1 For the certificate of incapacity to work, samples 1a / E to 1b / E are to be used in accordance with the form shown in Sections 2.1.8 to 2.1.9.

2.1.2 The certificate of incapacity for work comprises two pages:

Sample 1a / E: Copy for the insured person

Sample 1b / E: Copy for the employer

2.1.3 Samples 1a / E to 1.b / E are to be drawn up on security paper in A5 format .

2.1.4 unoccupied

2.1.5 The samples 1a / E to 1b / E are not shown with barcode provided.

2.1.6 unoccupied

2.1.7 unoccupied

2.1.8 Sample 1a / E

Orig inal: DIN A5 portrait

2.1.9 Sample 1b / E

Original: DIN A5 portrait

2.1.10 unoccupied

2.1.11 unoccupied “

4. Numbers 2.1 to 2.1.11 will be deleted on 01/01/2022: 1

5. Numbers 2.4 and 2.4.7 are changed as follows:

" 2.4 Model 4 / E:

Ordinance on patient transport

(Status: 07.2020)

2.4.7 Sample 4 / E

Original: DIN A4 horizontal “

Article 2

Entry into force

The changes to pattern 4 come into effect on July 1st, 2020.

The changes to pattern 1 come into effect on January 1st, 2021 or January 1st, 2022 in force.

Berlin, April 30th, 2020

National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin

GKV-Spitzenverband, Kdö.R., Berlin

The National Association of Statutory Health Insurance Physicians, Kdö.R., Berlin - on the one hand - and the GKV-Spitzenverband (National Association of Health Insurance Funds), K. d. ö. R., Berlin - on the other hand - conclude the following

agreement on the use of digital forms in contract medical care (form agreement digital forms) as Annex 2b to the Federal Medical Insurance Contract (BMV-Ä) p>

from 01.07.2020

General part

§ 1 General and purpose of the agreement

(1) This agreement regulates the use of the digital forms specified in § 4 in statutory health care.

(2) This agreement is divided into general and special part subdivided.While the general part describes the principles and various technical requirements of digital forms, the special part regulates individual questions about the forms. The technical manual for digital forms with its technical attachments specific to the form (hereinafter referred to as the “technical manual”) describes the technical rules for the digital forms. It is created and constantly updated as an annex to this agreement by the National Association of Statutory Health Insurance Physicians in agreement with the National Association of Statutory Health Insurance Funds.

(3) The partners of this agreement agree that when new digital forms are introduced, where Health insurance companies are involved in the transmission process, lead time of at least 9 months is required after the technical requirements have been agreed.

(4) The National Association of Statutory Health Insurance Physicians provides the National Association of Statutory Health Insurance Funds with information about changes to existing forms or . if agreed forms are newly introduced, the corresponding information for the digital forms is available.

§ 2 Use and creation of digital forms

(1) The contracting doctor decides according to the legal and sub-legal regulations for each form whether it is digitally created, transmitted and received The details are determined for each form in § 4.

(2) Only the use of digital forms that have been created by appropriately certified software is permitted for statutory health care. The KBV certifies practice management systems with regard to compliance with the requirements for the creation and processing of digital forms. Every certified software receives test number (PRF.NR.). This must be stated on the digital form. The National Association of Statutory Health Insurance Physicians regulates the details of the certification of the PVS; Annexes 23 and 29 are agreed between GKV-SV and KBV in accordance with Section 73, Paragraphs 9 and 10 of SGB V.

(3) Digital forms are either in the format

1. PDF / A or

2. as an FHIR bundle

according to the specifications of the technical manual and its technical appendices specific to the form.

The visualization of the data according to number 2 takes place via XML stylesheets, which are created and published by the GKV-SV and which are binding in statutory health care. The layout of the stylesheets is based on the specifications of Annex 2 BMV-Ä.

§ 3 Requirements for the transmission route

Digital forms must be sent securely be transmitted. The transmission takes place

1. via the communication service in medicine (KIM) in accordance with the requirements of gematik and taking into account the requirements of the technical manual and its technical systems or

2.While the general part describes the principles and various technical requirements of digital forms, the special part regulates individual questions about the forms. The technical manual for digital forms with its technical attachments specific to the form (hereinafter referred to as the “technical manual”) describes the technical rules for the digital forms. It is created and constantly updated as an annex to this agreement by the National Association of Statutory Health Insurance Physicians in agreement with the National Association of Statutory Health Insurance Funds.

§ 2 Use and creation of digital forms

(3) Digital forms are either in the format

1. PDF / A or

2. as an FHIR bundle

according to the specifications of the technical manual and its technical appendices specific to the form.

§ 3 Requirements for the transmission route

Digital forms must be sent securely be transmitted. The transmission takes place

1. via the communication service in medicine (KIM) in accordance with the requirements of gematik and taking into account the requirements of the technical manual and its technical systems or

2.via transmission service specified by gematik according to § 291a paragraph 5d SGB V

as soon as the transmission channels are available and if the necessary technical components for the contract doctor's practice are available. The details are determined for each form in § 4.

§ 3a Transitional regulation on the transmission route

(1) Notwithstanding § 3 sentence 1 number 1, if the pre-print-specific regulations provide for this and, if the service according to § 3 sentence 1 number 1 is not available, the transmission takes place in another secure way that meets the following requirements:

be encrypted. The encryption has to be done end-to-end. Decryption must only be possible by the intended recipient.

2. During the transmission, the transmission content must not be changed unnoticed. For this purpose, an electronic transport signature must be used on the transmission path.

3. A suitable method recommended by the Federal Office for Information Security must be used for transport encryption and transport signature.

4. Meta-information that enables or controls the correct transmission, e.g. B. Information on the sender and recipient are not to be understood as transmission content according to 1.

5. The transmission path must ensure clear identification of the sender and recipient.

(2) During transitional phase of 12 months after the service according to § 3 sentence 1 number 1 is available, both the transmission path according to § 3 sentence 1 number 1 and the path according to paragraph 1) are possible.

Special part

§ 4 Digital forms

The requirements for using the digital forms are specified below.

4.1 Certificate of incapacity for work (form e01)

4.1.1 The transmission of the incapacity data to the responsible health insurance company takes place digitally from 01.01.2021.

4.1.2 The form is available as an XML data record (in FHIR standard) according to § 2 paragraph 3 number 2.

4.1.3 The copies for the insured and the employer are to be given to the insured from 01.01.202 1 to be signed and handed over by December 31, 2021 in paper form (conventional or blank form printing). From 01.01.2022, the paper form (conventional and blank form printing) will no longer be used for sample 1. From this point in time, insured persons will receive printout of the form created using the stylesheet (copy of the insured person). Upon request, insured persons will receive signed printout of the copy of the insured and / or the copy of the employer from this point in time.

4.1.via transmission service specified by gematik according to § 291a paragraph 5d SGB V

as soon as the transmission channels are available and if the necessary technical components for the contract doctor's practice are available. The details are determined for each form in § 4.

§ 3a Transitional regulation on the transmission route

be encrypted. The encryption has to be done end-to-end. Decryption must only be possible by the intended recipient.

2. During the transmission, the transmission content must not be changed unnoticed. For this purpose, an electronic transport signature must be used on the transmission path.

3. A suitable method recommended by the Federal Office for Information Security must be used for transport encryption and transport signature.

4. Meta-information that enables or controls the correct transmission, e.g. B. Information on the sender and recipient are not to be understood as transmission content according to 1.

5. The transmission path must ensure clear identification of the sender and recipient.

Special part

§ 4 Digital forms

The requirements for using the digital forms are specified below.

4.1 Certificate of incapacity for work (form e01)

4.1.1 The transmission of the incapacity data to the responsible health insurance company takes place digitally from 01.01.2021.

4.1.2 The form is available as an XML data record (in FHIR standard) according to § 2 paragraph 3 number 2.

4.1.4 Unless there is malfunction, the data is transmitted to the health insurance companies in accordance with 4.1.1 at least once day via the KIM service (§ 3 sentence 1 number 1).

4.1.5 If the data is transmitted to the health insurance company is not possible, the data will be saved by the PVS and sent as soon as this is possible again. In this case, insured persons receive paper-based certificates of the insured person and the employer’s copy.

4.1.6 The electronic certificate of incapacity for work must be signed electronically using the eHBA. If the signing with the components of the telematics infrastructure is not possible for technical reasons or for other reasons that are not the responsibility of the contract doctor, the electronic certificate of incapacity for work is signed for this period using SMC-B. In this case, insured persons receive paper-based certificates signed by the contract doctor, stating the copy of the insured person and the copy of the employer. Insured persons also receive printout of the new certificate of incapacity for work.

4.1.8 If health insurance company receives data on incapacity for work from an insured person who is not currently insured with this health insurance company, it deletes the data immediately and sends standardized error message to the contracting doctor. If the health insurance company or the insured person also reports corresponding need, the data will be sent again to the correct health insurance company after the insured person's master data has been updated.

4.1.9 The copies for the insured person and the employer according to 4.1. 3, 4.1.5, 4.1.6 and 4.1.7 can also be sent digitally to the insured person at the request of the insured person.

4.6 Transfer slip (form e06)

4.6.1 The sample 6 can be used digitally if no doctor-patient contact is required for the performance of the referral-accepting contract doctor.

4.6.1.1 For the referral to the radiological teleconsultation (Annex 31a BMV-Ä), the template 6 digitally.

4.6.2 Contract physicians are only permitted to use the digital form if the sender and recipient have connection to the infrastructure described in Section 3 sentence 1 number 1 or Section 3a paragraph 1.

4.6.3 The form is in Format PDF / A according to § 2 paragraph 3 number 1.

4.6.4 The electronic transfer to sample 6 is qualified to be electronically signed using eHBA.

4.6.4 Unless there is malfunction, the data is transmitted to the health insurance companies in accordance with 4.1.1 at least once day via the KIM service (§ 3 sentence 1 number 1).

4.1.9 The copies for the insured person and the employer according to 4.1. 3, 4.1.5, 4.1.6 and 4.1.7 can also be sent digitally to the insured person at the request of the insured person.

4.6 Transfer slip (form e06)

4.6.1 The sample 6 can be used digitally if no doctor-patient contact is required for the performance of the referral-accepting contract doctor.

4.6.1.1 For the referral to the radiological teleconsultation (Annex 31a BMV-Ä), the template 6 digitally.

4.6.3 The form is in Format PDF / A according to § 2 paragraph 3 number 1.

4.6.4 The electronic transfer to sample 6 is qualified to be electronically signed using eHBA.

4.6.5 In coordination with the recipient of the form, it must be ensured that patient documents and / or sample materials can be clearly assigned to the referral. This can be done, for example, using an order number or the name of the patient.

4.10 Referral slip for laboratory tests as an order service (form e10)

4.10.1 Sample 10 can be used as referral slip for laboratory tests .

4.10.2 Contract doctors are only permitted to use the digital form if the sender and recipient have connection to the infrastructure described in § 3 sentence 1 number 1 or § 3a paragraph 1.

4.10.3 The form must be created in PDF / A format in accordance with Section 2 Paragraph 3 Number 1.

4.10.4 The electronic laboratory transfer to sample 10 must be signed electronically using eHBA.

4.10.4 The order number of the laboratory must be given on the digital form. Instead of the order number, different system can also be used to uniquely assign the digital order to the sample materials.

4.10 A Request form for laboratory tests in laboratory communities (form e10A)

4.10A. 1 Sample 10 A digital can be used as request form for laboratory tests in laboratory communities.

4.10A. 2 Contract doctors are only permitted to use the digital form if the sender and recipient have connection to the infrastructure described in Section 3 Clause 1 Number 1 or Section 3a Section 1.

4.10A. 3 The form must be created in PDF / A format in accordance with Section 2, Paragraph 3, Number 1.

4.10A. 4 The electronic request form for laboratory tests for laboratory groups on sample 10A is sent without digital signature.

4.10A. 5 The order number of the laboratory must be stated on the digital form. Instead of the order number, different system can also be used to clearly assign the digital order to the sample materials.

4.16A Electronic medication prescription (form e16A)

4.16A.1 For electronic prescription of Pharmacy-only pharmaceuticals and other products included in the supply of pharmaceuticals in accordance with Section 31 of the Social Code Book V must use form e16A.

4.16A.2 Contract physicians are only permitted to create an electronic drug prescription if the software used for this is approved by the statutory health insurance physician Federal Association is certified on the basis of Annex 23 BMV-Ä in the currently valid version and the contract doctor has connection to the infrastructure described under § 3 sentence 1 number 2.

4.16A.3 The form is to be created as an XML data record (in the FHIR standard) according to § 2 paragraph 3 number 2.

4.16A.5 In coordination with the recipient of the form, it must be ensured that patient documents and / or sample materials can be clearly assigned to the referral. This can be done, for example, using an order number or the name of the patient.