Germany - Services within the framework of statutory social insurance

Description

All suitable and interested companies will be offered the opportunity to conclude or join the contract on the basis of uniform contract terms and conditions and a uniform access procedure. The care insurance funds of the AOK in Hesse and the BAHN-BKK intend to conclude non-exclusive agreements with suitable companies within the framework of a so-called open-house procedure for the purpose of promoting preventive measures within the meaning of § 5 SGB XI non-exclusive. The companies carry out: - qualification measures on the subject of "food intolerances in old age" in the partly and fully inpatient care facilities, - sharing a so-called handout and a participant certificate with the participants, - after the implementation, carry out the quality assurance using a feedback form, - the overall evaluation of the feedback forms is sent to the AOK care insurance fund in Hesse. It should be noted that the total expenditure of the nursing care insurance funds for the performance of their tasks for the purpose of promoting preventive measures pursuant to § 5 (2) SGB XI in 2016 amounts to EUR 0.30 for each of their insured persons. The expenses shall be adjusted in subsequent years in accordance with the percentage change in the monthly reference value in accordance with § 18 (1) of the Fourth Book. The reference value is determined by the estimators and published by the Federal Ministry of Health once a year in September/October. Consequently, the amount of expenditure (financial resources that may be used in this context for the purpose of promoting preventive measures) is limited by law in accordance with the provisions of § 5 (2) SGB XI. The care fund of the AOK in Hesse is obliged, in the name of the care funds, to monitor the amount of financial expenditure legally stipulated for prevention services in accordance with § 5 Para. 2 SGB XI and to use it exclusively for the promotion of the tasks legally stipulated in § 5 SGB XI. For this purpose, the AOK nursing care fund in Hesse has set up a controlling mechanism in your home. The financial support ends with immediate effect upon written notification by the AOK nursing care fund in Hesse if it is established within the framework of the controlling to be carried out that the available and legally limited financial resources could be exceeded or have been used. In order to ensure that there is no exceedance, contractual regulations provide for the following procedure within the framework of the provision of services: The nursing facilities wishing to take part in the qualification measure first inform the nursing insurance funds of their interest. Only after the nursing care insurance funds have received positive feedback from a nursing care facility is it possible for a nursing care facility to participate in the qualification measure covered by the contract. The respective company will then be informed by the nursing care insurance fund in writing that it is now allowed to carry out the qualification measure. The nursing facilities select a company from a so-called provider directory which carries out the underlying qualification measure for the nursing facility. The nursing insurance fund has no influence on this. The provider directory is made available to the nursing facilities by the nursing insurance fund of the AOK in Hesse. The companies agree that their data may be included in the aforementioned directory and made available to the care institutions in Hessen after the conclusion of the contract. The provider himself is not entitled to be taken into account in the implementation of the qualification measure. As a result, the supplier may have the underlying contract but may not be able to obtain it on a number of occasions during the term of the contract and may therefore not be entitled to remuneration in this case.

Opportunity closing date

30 May 2019

Value of contract

to be confirmed