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Das Recht der Vergütungsvereinbarungen der stationären Altenpflege nach §§ 84, 85 SGB XI

Die Änderungen des gesetzgeberischen Ausgangsmodells unter besonderer Berücksichtigung der Bestimmung des angemessenen Zuschlags für das Unternehmerrisiko
Nomos,  2022, 349 Pages, E-Book

ISBN 978-3-7489-3314-4

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englischThe book deals with the development of nursing care rates from the 1970s until the establishment of nursing care insurance with the legislative idea of pricing with elements of the market to the current state. The author does not share the assumption that there was a pure cost recovery principle until the Long-Term Care Insurance Act. He can prove on the basis of the nursing rate framework agreements of the 1970s and 1980s that surpluses were either explicitly provided for or were possible through cost overruns, because there were few control rights for the payers. With the introduction of long-term care insurance, the legislature explicitly wanted to break away from the formal principle of cost coverage and introduce elements of the market and competition as price-determining elements. The author also takes a look at the development of the question of the submission obligation of the facility in care rate negotiations or in arbitration proceedings according to § 85 SGB XI. The author has represented facility operators in arbitration proceedings for many years. One chapter is therefore devoted to the law of the arbitration board and the question of the scope of the court's discretionary power of judgment.

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