Art. 73 Verordnung vom 27. Juni 1995 über die Krankenversicherung (KVV) - Limitierungen

S2 23 2 · vs (art. 73 OAMal)

Insurer Upheld in Denying Reimbursement for Weight-Loss Medication Post-Initial Period

Cited in the case description header, relating to the limitations that can be placed on the admission of a medication in the List of Specialties (LS).

S2 23 2 · vs (art. 73 OAMal)

Insurer Upheld in Denying Reimbursement for Weight-Loss Medication Post-Initial Period

Cited regarding the possibility of attaching limitations (quantity or indications) to the admission of a medication in the LS.

C-2586/2021 (Art. 73 KVV)

Federal Office of Public Health v. Medication Price and Indication Limitation

Cited for the possibility of limiting the inclusion of a medicine in the specialities list, particularly concerning quantity or medical indication.

C-2364/2021 (Art. 73 KVV)

Federal Administrative Court Upholds FOPH's Vitamin D Reimbursement Limitations

Specifically allows for limitations regarding quantity or medical indication as a condition for inclusion in the specialties list.

C-2631/2021 (Art. 73 KVV)

Pharmaceutical Company v. Federal Office of Public Health (Drug Pricing and Comparability)

Allows for the imposition of limitations on the use of medicinal products.

C-415/2020 (Art. 73 KVV)

Federal Court Upholds FOPH Medication Reimbursement Limits

Basis for the introduction of limitations on the medical indication of a medicinal product.

C-6605/2018 (Art. 73 KVV)

Topical Medications Reimbursement Dispute

This provision allows for limitations to be imposed on the inclusion of medicines, such as quantity or medical indication, as a condition.

C-3382/2018 (Art. 73 KVV)

Economic Viability and Efficacy Challenge Leads to Drug Removal from Special List

Cited as the provision allowing for the inclusion of a medicinal product in the list of pharmaceutical specialties under a limitation.

KV.2018.7 · sg (Art. 73 KVV)

Insurer Coverage Denial Overturned Due to Failure to Pursue Further Inquiry

Cited in the context of limitations provided in the SL, which is relevant to the main ground for partially allowing the appeal.

KV.2018.7 · sg (Art. 73 KVV)

Insurer Pre-Authorization Requirement Overruled in Testosterone Coverage Dispute

Cited in the introductory summary regarding limitations that can be imposed on drugs listed in the SL.

A/4291/2017 · ge (art. 73 OAMal)

Insured v. Health Insurer re: Champix Coverage Limit

Cited in the reasoning section regarding the possibility of attaching limitations to the admission in the list of specialties.

CDP.2017.60 · ne (Art. 73 OAMal)

Insurer Coverage Denial for Off-Label Drug Use Rendered Moot by Regulatory Change

Cited in the reasoning when explaining the limitations set in the list of specialties that governed initial coverage decisions.

200 2016 968 · be (Art. 73 KVV)

Health Insurer Upheld in Refusing Coverage for Unapproved Cannabis Epilepsy Treatment

Cited as the regulation specifying limitations applicable to the coverage of medicines.

C-3770/2014 (Art. 73 KVV i.V.m. Art. 22 KLV)

Federal Office of Public Health v. Drug Reimbursability Reconsideration

Cited as the legal basis for imposing limitations on the inclusion of medicines in the specialty list.

AM.30.12.50.2012 · vd (art. 73 OAMal)

Insured v. Health Insurer Regarding Off-Label Dormicum Coverage Denial

This provision, allowing for quantitative or indication limitations on the admission of drugs to the list of specialties, was explicitly cited by the lower court decision confirmed by the final order.