The Act on the Further Development of Health Care (GVWG), which was passed by the Bundestag on 11 June, contains extensions and changes with regard to financial relief for those in need of care, but also important details for care workers. These include, among other things, the innovation that care professionals will be granted more decision-making powers in the future. Specifically, it is about the prescribing authority of care professionals when the right care and care aids are to be selected in the interest of the person in need of care. Accordingly, care professionals are allowed to make decisions independently when they are active in home care. The law that has just been passed thus gives care professionals more leeway to make important decisions.
Detailed changes can be found in the 11th Social Code (SGB XI), which can be summarised in seven points:
- care professionals can now make concrete recommendations for aids that are necessary and beneficial for their service provision and for the patient. The legislator safeguards this point with sections 36, 37 and 37c of the Fifth Book, as well as in the case of counselling interventions according to section 37 paragraph 3.
A presumption of the necessity of these (care) aids must exist and is verified. There are certain guidelines for this. These regulate the specified prerequisites of the necessity of the supply according to paragraph 1 sentence 2 in the guidelines according to sentence 6 as well as the necessity of the prescription according to section 33 paragraph 1 SGB V.
- after the nursing specialist has made the recommendation, the application must not take longer than two weeks.
- a medical prescription is not required. The recommendation of the nurse counts even without a prescription.
5 The GKV-Spitzenverband has until 31 December of this year to determine the guidelines that decide in which cases and which aids can be used according to the presumption of necessity and need. The association also determines whether the caregiver is suitable for independent decision-making.
- the GKV-Spitzenverband also has the mandate to evaluate the procedures laid down in the guidelines in a proper and professional manner The evaluation must also take the economic side into account and is done with the help of the Medical Service of the National Association of Health Insurance Funds (MDS), the Federal Chamber of Nursing and the associations of nursing professions at federal level. In addition, the events of the professional and economic evaluation are expected to be submitted to the Federal Ministry of Health (BMG) by 1 January 2025 at the latest.
- the long-term care insurance fund must then have decided within three weeks at the latest after receipt of the application whether the long-term care aid is approved that was recommended by the long-term care specialist when the application was submitted.
Source: Summary Seven