832.10 KVGLAMAL

CH

Art. 44 Bundesgesetz vom 18. März 1994 über die Krankenversicherung (KVG) - Tarifschutz

KVG; 2. Titel: Obligatorische Krankenpflegeversicherung; 4. Kapitel: Leistungserbringer

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Art. 44 KVG · Tarifschutz

Die Leistungserbringer müssen sich an die vertraglich oder behördlich festgelegten Tarife und Preise halten und dürfen für Leistungen nach diesem Gesetz keine weitergehenden Vergütungen berechnen (Tarifschutz). Die Bestimmungen über die Vergütung für Mittel und Gegenstände, die der Untersuchung oder Behandlung dienen (Art. 52 Abs. 1 Bst. a Ziff. 3), bleiben vorbehalten.

Lehnt ein Leistungserbringer es ab, Leistungen nach diesem Gesetz zu erbringen (Ausstand), so muss er dies der von der Kantonsregierung bezeichneten Stelle melden. Er hat in diesem Fall keinen Anspruch auf Vergütung nach diesem Gesetz. Wenden sich Versicherte an solche Leistungserbringer, so müssen diese sie zuerst darauf hinweisen.

← Art. 43 KVG Bundesgesetz vom 18. März 1994 über die Krankenversicherung (KVG) Art. 45 KVG →

Gerichtsentscheide zu dieser Bestimmung (54)

BGE 150 V 210 (Art. 44 Abs. 1 Satz 1 KVG)

Reimbursement of hospital pharmacy compounding tax for aseptically prepared cytostatic infusions under Swiss mandatory health insurance

Confirms that the invoiced service respects the tariff protection rules, being based on a provisionally valid tariff.

C-5606/2010 (Art. 44 Abs. 1 KVG)

Hospital Tariff Appeal Partially Upheld, Daily Rate Adjusted

Referred to regarding the principle of not exceeding tariffs and the possibility of generating additional income from services beyond the basic mandatory insurance.

C-5601/2010 (Art. 44 Abs. 1 KVG)

Hospital Tariff Challenge for Inpatient Treatments

This article was referenced in relation to the prohibition of exceeding KVG tariffs and the possibility of cross-financing.

BVGE-2012-18 (Art. 44 Abs. 1 KVG)

Hospital Tariffs Appeal: Partial Upholding and Adjustments

Establishes the principle of tariff protection, preventing healthcare providers from charging more than agreed or set tariffs.

C-5550/2010 (Art. 44 al. 1 KVG)

Hospital Tariff Appeal: Insurer Licensing and Cost Transparency Ruling

Used to determine that hospitals cannot charge more than the statutory tariffs for services covered by mandatory health insurance, even for privately insured patients in the general ward.

JAAC 66.71 (Art. 44 cpv. 1 LAMal)

Health Insurer Tariff Negotiation and Application

Cited stating that healthcare providers must adhere to established tariffs and prices without charging higher remuneration for LAMal-covered services.

A/2905/2019 · ge (art. 44 de la loi fédérale sur l'assurance-maladie du 18 mars 1994 (LAMal - RS 832.10))

Sickness Funds v. Physician: TARMED Fee Schedule Billing Dispute and Expert Examination Order

Cited in the reasoning by TARIFSUISSE SA as a potential ground for demanding reimbursement due to fraudulent means.

KV.2022.00036 · zh (Art. 44 KVG)

Appeal Dismissed: Foreign Health Insurance Not Equivalent to Swiss Mandatory Insurance

Cited to explain the requirement for service providers to adhere to statutory tariffs, which impacts the assessment of 'Gleichwertigkeit' (equivalence).

SG.2019.7 · bs (Art. 44 KVG)

Aseptic Compounding Fees for Cytostatics vs. Principle of Economy

Cited in the reasoning (point 6.3.2) regarding the rule that the claimant may only claim the applicable tariff.

I 2021 38 · sz (Art. 44 Abs. 1 KVG)

Insurer Refusal Upheld for Premium Astigmatism-Correcting Intraocular Lenses

Mentioned in the context of tariff protection applicable to agreed lump-sum tariffs.

Arr.t.2020.213 · vd (art. 44 al. 1 LAMal)

Insurers v. Pathology Laboratory: Restitution of Travel and Visit Fees for On-Site Analysis

Cited concerning the prohibition against charging more than the fixed tariff, which relates to the economical principle being violated.

SG 15 2 · lu (Art. 44 Abs. 1 KVG)

Clinic v. Federal Council Ordinance on Health Insurance Tariffs

This article regarding tariff protection was cited in the reasoning but not explicitly used in the dispositive orders.

C-3900/2015 (Art. 44 Abs. 1 KVG)

Hospital Tariffs: Retroactive Limitation Invalidated

Cited as a violated principle due to the tariff limitation leading to a lack of tariff protection for insured persons.

36.2016.72 · ti (art. 44 cpv. 1 LAMal)

Orphan Drug Reimbursement for Light-Sensitivity Disorder

Cited regarding the principle of tariff protection, relevant to the court's decision on the reimbursement price.

PVG 2013 12 · gr (Art. 44 Abs. 1 KVG)

Tariff Justification for Complex Physiotherapy in Multimorbid Patient

Cited in the reasoning regarding the obligation for service providers to adhere to established tariffs.