832.10
CH-TG
CH-TG
§ 50 Krankenversicherungsverordnung (TG KVV) - Anteil an der Akut- und Übergangspflege
Pflegefinanzierung - Akut- und Übergangspflege
§ 50 TG KVV · Anteil an der Akut- und Übergangspflege
1. Der Anteil der öffentlichen Hand an der Akut- und Übergangspflege wird auf 55 % festgesetzt.
2. Der Leistungserbringer stellt dem Kanton monatlich eine detaillierte Sammelrechnung oder Einzelrechnungen zu und weist die auf Kanton und Versicherer entfallenden Anteile gesondert aus.
3. Der Leistungserbringer gibt dem Kanton alle Angaben bekannt, die er benötigt, um die Berechnung der Vergütung und die Wirtschaftlichkeit der Leistung überprüfen zu können.
Gerichtsentscheide zu dieser Bestimmung (50)
VPB 08-0544-1741 (Art. 50.1 LAMAL)
Federal Council Decree on Metal Trade Collective Labor Agreement Extension
This provision is cited in the extension of the collective labor agreement, specifying that collective insurance must comply with the provisions of the LAMal (Federal Law on Health Insurance).
KSCHG.2020.4 · sg (Art. 50 KVG)
Health Insurance Coverage for Post-Acute Hospital Stay Awaiting Rehabilitation
This article dictates the tariff applicable when acute hospital necessity ceases, which is central to determining the correct remuneration rate.
36.2021.50 · ti (Art. 50 LAMal)
Hydrocele Surgery Inpatient Coverage Appeal Denial
Cited in the reasoning section regarding the applicable tariff if the conditions for hospitalization remuneration are not met.
36.2021.21 · ti (Art. 50 LAMal)
Insured v. Insurer: Coverage for Acute Psychiatric Hospitalization
This provision states that in case of stay in a nursing home (or psychiatric clinic not meeting acute hospitalization criteria), the insurer covers the same benefits as for outpatient care according to Art. 25a LAMal.
36.2020.39 · ti (Art. 50 LAMal)
Insured Denied Coverage for Alcohol Dependence Inpatient Stay
Cited in the context of tariff application for care in nursing homes, relating to the cost analysis for alternatives to acute hospital care.
KV.2018.00063 · zh (Art. 50 KVG)
Cantonal Correctional Service v. Health Insurer: Forensic Psychiatric Care Cost Coverage
Cited in the reasoning regarding the tariff applicable if hospital necessity ceases.
A/2165/2019 · ge (art. 50 LAMal)
Health Insurer Coverage Dispute for Geriatric Rehabilitation Costs
The court cited this provision as the applicable remuneration if the condition for hospital treatment tariff is no longer met (i.e., applicable remuneration in case of stay in a nursing home).
36.2019.43 · ti (Art. 50 LAMal)
Insurer Coverage Denial for Psychiatric Inpatient Stays Lacking Acute Necessity
Cited as the provision determining that if acute care criteria are not met, the insurer covers the same benefits as for outpatient care (Art. 25a LAMal).
KV.2018.00072 · zh (Art. 50 KVG)
Home Nursing Care Costs: Insurer Must Cover if Not Grossly Disproportionate
This provision states that for stays in nursing homes, the insurer reimburses the same benefits as for outpatient and home care, which is a comparative benchmark in the cost-effectiveness assessment.
36.2018.20 · ti (Art. 50 LAMal)
Insurer's Denial of Inpatient Psychiatric Coverage Overturned Due to Inadequate Expert Review
The final order references this article as the basis for applying the outpatient care tariff if hospitalization criteria are not met.
VSBES.2017.176 · so (Art. 50 KVG)
Insurer Refusal to Cover Inpatient Psychiatric Costs Upheld Absent Acute Hospital Need
Cited as the applicable tariff when acute hospital necessity is no longer present, relating to the care department costs.
TARB.2013.1 · ne (Art. 50 LAMal)
Facility v. Insurer: Coverage of CSB Costs Under Mandatory Health Insurance
Cited to establish the extent of coverage for care provided in a medico-social institution compared to outpatient treatment.
730.13.135 · bl (Art. 50 KVG)
Health Insurer Not Liable for Full Palliative Care Hospital Costs Due to Lack of "Hospital Necessity"
Governs the reimbursement of nursing care services in nursing homes.
S 2013 24 · gr (Art. 50 KVG)
Insured v. Insurer: Denial of Post-Acute Hospital Care Coverage
This provision is mentioned in the reasoning to establish the criteria for the nursing home tariff (Pflegeheimtarif) applicable when hospital necessity is absent, which is central to the dispute, although the final order does not explicitly cite it for the grounds of the decision.
KV.2011.00024 · zh (Art. 50 KVG)
Health Insurer Not Obligated to Cover Outpatient Rehabilitation Living Expenses
This provision addresses coverage for stays in nursing homes, used by analogy to discuss the exclusion of accommodation costs in non-hospital settings.