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832.10 CH-TG

§ 62 Krankenversicherungsverordnung (TG KVV) - Notfallbehandlung

Spitalplanung und Spitalfinanzierung - Spitalfinanzierung
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§ 62 TG KVV · Notfallbehandlung

1. Für Notfallbehandlungen gilt

1. Leistungserbringer mit Standort ausserhalb des Kantons: Ein Notfall liegt vor, wenn der Zustand der zu behandelnden Person es nicht erlaubt, diese in ein innerkantonales Listenspital zu transportieren

2. * Für Personen mit einem Leistungsaufschub beurteilen die Leistungserbringer abschliessend, ob ein Notfall nach Art. 64a Abs. 7 KVG vorliegt

2. Notfälle sind dem kantonsärztlichen Dienst innert drei Tagen zu melden, sofern Anspruch auf Entschädigungen gestellt werden, die höher sind als die geltenden Referenztarife.

3. Der kantonsärztliche Dienst prüft die Behandlung auf ihre medizinische Notwendigkeit hin und trifft den Kostengutsprache- beziehungsweise Indikationsentscheid betreffend des anwendbaren Tarifs.

4. Für Behandlungen von Personen mit Leistungsaufschub des Krankenversicherers, die über Abs. 1 hinaus gehen, kommt der Kanton nicht auf. Die Behandlungskosten sind dem Patienten oder der Patientin in Rechnung zu stellen.

5. ...

← § 61 TG KVV Krankenversicherungsverordnung (TG KVV) - Inhalt § 63 TG KVV →

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Gerichtsentscheide zu dieser Bestimmung (30)

VBE.2022.34 · ag (Art. 62 KVG)
Heirs v. Insurer: Vidaza Co-payment Dispute
Cited as a basis for special insurance forms that allow for cost savings.
AM.21.20.36.2020 · vd (Art. 62 al. 2 LAMal)
Insurer Refusal of Specialist Reimbursement Overturned Due to Late Referral Submission
Although cited in the preamble/reasoning of the judgment, this article is not explicitly mentioned in the dispositive orders (I, II, III, IV).
S2 18 76 · vs (Art. 62 al. 1 LAMal)
Insured Liability for Medical Costs Under Telmed Insurance Refusal of Coverage for Non-Compliance
Cited in the context of the legal possibility for the insurer to offer premium reductions for limited choice of providers, supporting the legality of the Telmed model applied.
BVGE-2018-V-2 (Art. 62 KVG)
Health Insurer's Doctor List Publication Upheld
Governs special insurance models, including those with limited choice of healthcare providers, which forms the basis for the 'Hausarzt' and 'PharMed' models.
AM.18.13.22.2015 · vd (Art. 62 LAMal)
Insurer Refusal to Cover Specialist Medical Expenses Upheld After Policy Modification
Cited in the reasoning regarding premium reductions for limited choice of provider, but not explicitly in the dispositive orders.
36.2015.13 · ti (art. 62 cpv. 1 LAMal)
Insured's Untimely Appeal of Denied Pharmacy Reimbursement Dismissed
Cited in the reasoning to justify the insurer's right to offer models limiting the choice of providers based on financially advantageous criteria.
36.2015.13 · ti (art. 62 cpv. 3 LAMal)
Insured's Untimely Appeal of Denied Pharmacy Reimbursement Dismissed
Cited in the reasoning to justify the insurer's right to offer models limiting the choice of providers based on financially advantageous criteria.
Jug.2014.352 · vd (art. 62 al. 1 et 3 LAMal)
Hospital Provider v. Health Insurer over Unpaid Treatment Invoices
Mentioned in the reasoning concerning limited choice of providers, but not explicitly cited in the final payment orders (II, III, IV, V, VI).
S 13 118 · lu (Art. 62 Abs. 1 KVG)
Health Insurer's Unlawful Transfer from Managed Care Based on Facility Residence
Mentioned regarding the legal basis for reduced premiums in restricted choice insurance, which underpins the model the court upheld.
A/3261/2005 · ge (art. 62 LAMal)
Insured v. Health Insurer Regarding Unsubstantiated Premium Increase for Mandatory Basic Coverage
Cited in the reasoning (paragraph 7) regarding specific forms of insurance whose accounting must be separate from compulsory health insurance.
36.2007.52 · ti (art. 62 LAMal)
Petitioner v. Insurer Regarding Insurance Card Blockage and Supplementary Coverage
Mentioned in the reasoning section for context regarding provider choice, but not explicitly cited in the final operative orders (1-4).
36.2006.28 · ti (art. 62 LAMal)
Insured Party v. Federal Office of Public Health Regarding Health Insurance Premium Increase
Cited in the final review regarding the requirement for separate accounting for particular forms of insurance.
36.2006.31 · ti (art. 62 LAMal)
Insured Appeal Against Health Premium Increase Denied Due to Limited Judicial Review
Cited by the court as part of the legal framework regarding the requirement for separate accounting for particular forms of insurance.
36.2006.88 · ti (Art. 62 LAMal)
Insured vs. Health Insurance Premium Increase Review
The court confirmed that the separate accounting extended to particular forms of insurance under this article.
36.2006.90 · ti (Art. 62 LAMal)
Insured Denied Access to Unredacted Financial Data in Premium Increase Appeal
Cited in the reasoning regarding the required separate accounting structure.