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Health Care Compliance issues with inpatient and outpatient activities by the same Physician

The pleasure of humans seems to be often found in crossing boundaries. However, crossing legal
boundaries provides a compliance violation that can lead to serious consequences – especially in the
highly regulated German healthcare system. Due to the large number of regulations, economic competition
is strictly limited in the German healthcare sector creating a considerable conflict between economic
pressure, entrepreneurial visions and legal requirements. The identification of clear boundaries,
the exploration of creative leeway and the crossing of compliance-related prohibition zones is oftentimes
difficult due to the considerable legal 'grey area' between black and white, which has not yet been
fully clarified by case law. The use of these grey areas as well as the crossing of permissible boundaries
takes place in various forms in reality. Cooperations in which a physician crosses the so-called sectoral
boundary (Sektorengrenze) in his own person, for example as an affiliated or fee-based physician
(Beleg- oder Honorararzt), and provides both inpatient (stationäre) and outpatient (ambulante) medical
services, are of particular relevance.
In this context, this article is intended to provide an overview of the most commonly used forms of combined
outpatient and inpatient activities (intersectoral activities) by the same person and to highlight
the associated compliance issues.

Identiferoai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:91385
Date15 May 2024
CreatorsDost, Juliane, Schmidbauer, Ina
Source SetsHochschulschriftenserver (HSSS) der SLUB Dresden
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text
Rightsinfo:eu-repo/semantics/openAccess
Relationurn:nbn:de:bsz:15-qucosa2-913641, qucosa:91364

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