Criteria relaxed: IV has more leeway when it comes to helping children with birth defects

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In the future, the IV may also reimburse resources and objects for treatments or examinations that are not included in the health insurance benefit catalog.

The state government amended the corresponding ordinance on Wednesday, as announced. The change also affects medical measures whose costs are higher than those stated in the relevant list.

More than 300 families have been affected

The stricter criteria for remuneration have only been in effect since the beginning of 2022. It has turned out that this has led to uncertainties, the Federal Council writes in its communiqué. For example, a supplier of medical products charged the extra costs directly to the recipient of the service. More than 300 families were affected.

According to the Federal Council, the IV bureaus subsequently changed their practice. With the amendment of the Regulation, this change is now reflected in practice. In this way, an investigation in individual cases is always possible.

In children and adolescents with congenital defects, the IV reimburses the medical measures necessary to treat this defect up to the age of 20. This also applies, for example, to physiotherapy or occupational therapy. Only then is the health insurer liable. (SDA)

Source:Blick