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Doctors newspaper online, 02.08.2019
Radiology
The blanket billing of contrast media has come under criticism, according to media reports. Radiologists are also concerned with freedom of therapy.
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BERLIN. According to a media report, X-ray doctors can earn a considerable amount of money through the flat-rate billing of contrast media with the health insurance companies. In Bavaria, Bremen, Hamburg, Lower Saxony and North Rhine-Westphalia, there are such fixed lump sums, report NDR, WDR and "Süddeutsche Zeitung" (Friday).
This led to gains as resident physicians bought contrast media for computed tomography (CT) and magnetic resonance imaging (MRI) at significantly lower prices. Thus, radiologists in Bavaria could have bought contrast media for 760 euros per liter and received a flat-rate refund of 3900 euros.
The Federal Ministry of Health stated that agreements on contrast agent lump sums are not mandatory. Such contracts would generally be concluded between Kassenärztliche associations in the countries and several funds. It was the commandment that services should be sufficient, appropriate and economic. In case of violations, the supervisory authorities could intervene.
The consortium of health insurance associations in Bavaria (ARGE), including the AOK, reports that a review of the pricing of contrast media had been planned with the agreement on the lump sums: "The health insurance in Bavaria have 2016 in the agreement of the contrast agent lump sums with the Association of Statutory Health Insurance Physicians of Bavaria to check the pricing of the lump sums for non-ionic X-ray contrast agents and MRI contrast agents on the basis of the submitted invoices. "
Professional Association fights back: AOK and KVen knew
The current evaluation shows, "that doctors sometimes draw significantly lower prices contrast media, as is paid by the health insurance on the lump sums," it continues. Based on these results, the health insurance funds in Bavaria had entered into new negotiations with KVB in April. The aim is, in future, "to achieve a remuneration based on market prices."
The professional association of German radiologists (BDR) reported on request, "a difference between the lump sum and the purchase price was knowingly accepted by the AOK". The radiologists have asked several times at AOK and KVen – these had assured that the models are legal. The BDR rejected the lump-sum model in most of the federal states.
In the five named countries, the federal association structures had to "agree to the lump-sum model under duress of the AOK in order to maintain freedom of choice in the selection of contrast agents on the patient," it continues. And: In the eleven countries without flat-rate model, the radiologists ordered contrast media from the health insurance companies or additional providers. The cash registers then settled with the manufacturers. The radiologists have no influence on the price or the costs.
Criticism of the packages came on Friday by the green health expert Kordula
Schulz-ash. She complains in a statement "the serious damage" for contributors, if radiologists "can make horrendous additional profits through the use of contrast agents."
Schulz-Asche demands that "tenders for contrast media become common practice nationwide, because it is well known that this halves the use of non-harmless contrast media". (en / hom / dpa)
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