• In a word - application for liposuction with lipedema and BSG case law

    When discussing surgical therapy and the occurrence of a fictitious approval, the aspect of applying for liposuction with lipedema is often neglected. But right here there are some hooks and eyes, of which I would like to highlight two of the most important ones, as these can lead to the victory of the opposing health insurance company, especially in a lawsuit - although

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  • BSG 06.11.2018/XNUMX/XNUMX: Fictitious approval in the event of not timely notification of the involvement of the MDK

    In its last session on November 06.11.2018th, 1, the Federal Social Court again passed two interesting judgments on the subject of fictitious approval (file number B 30 KR 18/1 R, formerly B 3 KR 17/1 R; file number B 13 KR 17/XNUMX R). This is about the constellation that the health insurance only after the statutory three-week period has passed through the involvement of the MDK

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  • A dormant proceeding is not always as calm as it seems

    What does suspension of proceedings mean? The proceedings can be suspended both in the preliminary proceedings and in the legal action. In 2017 in particular, a suspension proposal was very popular with the health insurance companies, as a final decision by the Federal Joint Committee on liposuction in lipedema was expected on July 20.07.2017, 30.09.2022. As we know, the method evaluation process was up until XNUMX/XNUMX/XNUMX

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  • What does the GdB bring for those affected by lipedema?

    First of all: This article deals with small excerpts from the GdB. Questions about the application, what do I do if “too little GdB” comes out, are the subject of a separate article. What does GdB mean? This is short for degree of disability. With special needs? Not me, some might think. Especially since the choice of words “disability” has meanwhile been seen by those affected anyway

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  • BSG rulings of April 24.04.2018, XNUMX as a strengthening of patients' rights?

    First of all: I do not represent the legal opinion of the Federal Social Court, I am only trying to make it understandable here in this blog. Potential is not the same as potential With two rulings from April 24.04.2018th, XNUMX, the Federal Social Court ruled on the compatibility of inpatient liposuction for lipedema with the quality requirement according to the Social Security Code V (SGB V), which is used by statutory health insurers to grant benefits

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  • Fictitious approval required?

    Everyone who has to deal with the legal facets of our disease sooner or later comes across the concept of approval fiction. The hot topic of approval fiction Hardly any legal construction has heated people up as much in recent years as the approval fiction. For everyone who doesn't know what to do with this term or doesn't know much (for the professionals

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