Medical Aid Law

Therapeutic appliances within the meaning of § 33 SGB V are all means required by the insured person to ensure the success of a medical treatment, to prevent an impending disability or to accommodate a disability. This includes hearing aids, orthopaedic insoles, electro stimulation devices, prostheses as well as software. As a rule, therapeutic appliances are reimbursed by the statutory health insurance funds based on a medical prescription. The directory of therapeutic appliances according to § 139 SGB V, provides (as an important management tool), an overview of the therapeutic appliances available on prescription at the expense of the health insurance funds; albeit a non-exhaustive list.
 
Service providers (such as hearing care professionals, orthopaedic shoemakers, medical supply companies), may only provide insured persons with therapeutic appliances if they meet the requirements for adequate, appropriate and functional manufacture, sale and adaptation of the therapeutic appliances and this has been confirmed as part of a so-called pre-qualification procedure. In addition, they must conclude a corresponding supply contract with the statutory health insurance funds, authorising them to sell the therapeutic appliance in question.


We advise individual service providers and their associations on all questions surrounding therapeutic appliance legislation; this applies in particular to tenders as well as the drafting and negotiation of supply contracts with the health insurance funds.

It goes without saying that all associated legal matters such as competition, advertising, data protection, craft and criminal law, form part of this. For service providers, we also enforce remuneration claims against the purchasers.

We are the right contact partners when it comes to the acceptance of innovative medical products in the directory of therapeutic appliances.