832.10
CH-TG
CH-TG
§ 57 Krankenversicherungsverordnung (TG KVV) - Daten
Spitalplanung und Spitalfinanzierung - Spitalplanung
§ 57 TG KVV · Daten
1. Die Listenspitäler stellen dem Amt für Gesundheit und dem Amt für Daten und Statistik die Daten gemäss Art. 59a KVG vollständig, fristgerecht und kostenlos zur Verfügung. Das Amt für Gesundheit und das Amt für Daten und Statistik dürfen betriebsbezogene Daten und Daten nach Art. 59a KVG bearbeiten und veröffentlichen. Veröffentlichte Daten dürfen keine Rückschlüsse auf natürliche Personen zulassen
2. Für die betriebliche Rechnungslegung sind die Richtlinien des Branchenverbandes Hplus (Rekole) verbindlich anzuwenden.
3. Für die Wirtschaftlichkeitsprüfung sind die Kosten nach dem Integrierten Tarifmodell Kostenträgerrechnung (ITAR-K) des Branchenverbandes Hplus und in Abstimmung mit der Finanzbuchhaltung darzustellen. Für Projekte und zusätzliche Aufträge sind im Leistungsauftrag separate Regelungen zu treffen.
Gerichtsentscheide zu dieser Bestimmung (125)
A/2603/2019 · ge (art. 57 al. 4 LAMal)
Health Insurers v. Physician Overbilling and Obstruction
Role of the medical advisor in assessing the necessity and economic efficiency of services.
S2 24 80 · vs (Art. 57 Abs. 4 und Abs. 5 KVG)
Insurance Coverage for Chronic Pain Physiotherapy
These articles are cited in the reasoning section to confirm that insurers have no right to instruct treating physicians (Vertrauensärzte), although they are mentioned in the reasoning, not the final orders.
730.24.107 · bl (Art. 57 Abs. 1 KVG)
Jogging Accident Not Causal for Tooth Fractures
Cited to establish the obligation of health insurers to appoint medical advisors.
730.24.107 · bl (Art. 57 Abs. 4 und 5 KVG)
Jogging Accident Not Causal for Tooth Fractures
Cited for the role and independence of medical advisors in health insurance.
36.2024.23 · ti (Art. 57 LAMal)
Insured Denied Appeal for Disclosure of Expert Assessment History
Mentioned in the factual section as a point of contention regarding the status of the medical expert, but not cited in the dispositive.
A/2905/2019 · ge (art. 57 al. 5 LAMal)
Sickness Funds v. Physician: TARMED Fee Schedule Billing Dispute and Expert Examination Order
Cited in the reasoning regarding the independence of the medical advisor, justifying the need for an independent expert opinion.
36.2023.38 · ti (Art. 57 cpv. 1 LAMal)
Insured v. Health Insurer: Blepharoplasty Coverage Denial Upheld
Cited regarding the designation of medical experts by insurers in agreement with cantonal medical associations.
36.2023.38 · ti (Art. 57 cpv. 4 LAMal)
Insured v. Health Insurer: Blepharoplasty Coverage Denial Upheld
Cited regarding the role of the medical expert in advising the insurer on medical matters and assumption of costs.
36.2023.38 · ti (Art. 57 cpv. 5 LAMal)
Insured v. Health Insurer: Blepharoplasty Coverage Denial Upheld
Cited concerning the autonomous decision-making power of the medical expert.
36.2023.38 · ti (Art. 57 cpv. 6 LAMal)
Insured v. Health Insurer: Blepharoplasty Coverage Denial Upheld
Cited regarding the duty of service providers to transmit information to the medical expert and the expert's right to examine the insured in person.
36.2023.38 · ti (Art. 57 cpv. 7 LAMal)
Insured v. Health Insurer: Blepharoplasty Coverage Denial Upheld
Cited concerning the limited information the medical expert transmits to the insurer's competent bodies for decision-making.
VSBES.2023.181 · so (Art. 57 Abs. 4 KVG)
Insurer Not Obligated to Cover Third Liposuction for Lipedema Without Established Disease Value Threshold
Cited in the reasoning regarding the tasks of medical consultants.
VSBES.2023.181 · so (Art. 57 Abs. 6 KVG)
Insurer Not Obligated to Cover Third Liposuction for Lipedema Without Established Disease Value Threshold
Cited in the reasoning regarding the right of medical consultants to examine insured persons.
VSBES.2023.181 · so (Art. 57 KVG)
Insurer Not Obligated to Cover Third Liposuction for Lipedema Without Established Disease Value Threshold
Cited in the reasoning regarding the role and authority of medical consultants (Vertrauensärzte).
608 2020 117 · fr (Art. 57 al. 4 LAMal)
Insurer Upheld in Refusing Dental Coverage for Non-Meeting Statutory Criteria
Cited in the reasoning regarding the role of the medical advisor, although not explicitly in the final orders, it is procedural context.