Art. 32 Loi portant introduction de la loi fédérale sur l’assurance-maladie (LiLAMal)

BGE 152 V 184 (Art. 32 KVG)

Therapeutic cross-comparison for multi-indication drug price review: combination product with added antibacterial main indication not a valid comparator to single-agent product.

Basis for the review of the drug's listing conditions and the setting of the public price.

BGE 151 V 233 (Art. 32 Abs. 1 KVG)

Cost-effectiveness review of medical provider under compulsory health insurance: practice peculiarities including extended opening hours, delegated psychotherapy, and patient morbidity substantiation.

Could not be applied because the dispositive was not included in the provided text.

BGE 150 V 178 (Art. 32 Abs. 1 KVG)

Billing audit reimbursement based on extrapolating a non-representative random sample of MRI tariff positions violates statistical validity requirements.

Cited in the dispositive as part of the substantive basis for the reimbursement claim.

BGE 150 V 210 (Art. 32 Abs. 1 Satz 1 KVG)

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

Basis for confirming that the contested service meets the statutory requirements of effectiveness, appropriateness, and economic efficiency.

5V 22 402 · lu (Art. 32 Abs. 1 KVG)

Denial of Mandatory Health Insurance Coverage for Foreign Gender Confirmation Surgery Upheld

Cited in relation to the general requirement for services to be effective, appropriate, and economical, although the court ultimately relied on the territoriality principle exception criteria.

200 2018 9 · be (Art. 32 Abs. 1 KVG)

Insured vs. Health Insurer: Coverage for Hospitalized Varicose Vein Surgery vs. Economical Outpatient Alternative

Cited as the primary legal basis requiring services to be effective, appropriate, and economical.

VVGE.2009.10.Nr.32 · ow (Art. 32 Abs. 1 KVG)

Health Insurance Denies Coverage for Off-Label Ritalin Use in Adult ADHD Case

This article is cited in the reasoning to state the requirement that services provided by health insurance must be effective, appropriate, and economical, with effectiveness proven by scientific methods. This forms a key criterion for Ritalin coverage.

200 2014 903 · be (Art. 32 KVG)

Service Provider Tariff Dispute for Ambulatory Nursing Care Services

Cited in order 2 (implicitly, via the discussion of effectiveness, purposefulness, and cost-efficiency requirements derived from it, as seen in section 5.1 onwards) regarding the assessment of the services provided to C.________ sel.

C-5606/2010 (Art. 32 KVG)

Hospital Tariff Appeal Partially Upheld, Daily Rate Adjusted

Cited as one of the articles defining the conditions under which the mandatory health insurance covers costs.

C-5601/2010 (Art. 32 bis 34 KVG)

Hospital Tariff Challenge for Inpatient Treatments

These articles were referenced as setting the conditions for cost coverage by compulsory health insurance.

VPB 08-1240-7183 (Art. 32 LAMal)

Federal Council Response to LAMal Quality Assurance Report

Cited in relation to the principle that services covered by insurance must be effective, appropriate, and economical (EAE).

AGVE.2005.21 · ag (§ 32 Abs. 2 EG KVG)

Jurisdiction over Sickness Daily Allowance Insurance shifts to Insurance Court.

This provision is used to establish that sickness daily allowance insurance policies under VVG are to be classified as supplementary insurance to mandatory health care insurance and thus fall within the jurisdiction of the Insurance Court.

C-326/2022 (Art. 32 Abs. 1 KVG)

Drug Pricing: Average Dosage and Packaging Size for Comparison

States that services must be effective, appropriate, and economical (WZW criteria).

36.2025.26 · ti (Art. 32 LAMal)

Insurance Coverage Dispute for Home Care Services for Minor with Epileptic Encephalopathy

Cited as the legal basis for ensuring that recognized benefits are effective, appropriate, and economical.

VBE.2024.560 · ag (Art. 32 KVG)

Insurance Coverage for Parental Home Nursing Care for Autism

Cited as the basis for assessing the necessity of basic care services, considering effectiveness, appropriateness, and cost-efficiency.