Pensions- und Pflegevorsorge (German Edition)
V of the Social Code take into account the heterogeneity in the structure of the existing payment flows. In addition, internal audits are carried out based on the transmitted contribution statements, for instance audits in accordance with Section a, Vol. The effective assessment of shortcomings of the authorities paying the contributions is effectively not only performed by personnel of the GFIO. V of the Social Code within legal or contractual mandates. These audits do not only serve as a basis for the required compensation, but also aim at contributing decisively to the detection of shortcomings in the calculation and the payment proceedings of the contributions in order to create a preventive effect for the future.
The primary objective of these DMPs is to improve the care provided to insured persons with chronic diseases.
These programmes aim in particular at avoiding the occurrence of certain consequent damages and complications that may arise for the affected insured persons due to chronic diseases. DMPs are hence intended to help ensure the provision of responsive and cost-effective care services, with a view to remedying existing deficiencies such as excessive, poor or incorrect care services in the health care system. These programmes additionally aim at reducing overall treatment costs by avoiding complications, hospitalisation and secondary damage.
This ensures a standardised procedure and a neutral assessment of the prerequisites for programme accreditation. In order to maintain the accreditation, the programme must be subject to evaluation.
A scientific board assists the GFIO in this task. In order to promote the DMPs, since 1 January health insurance providers have been allocated funding from the Health Fund for each insured person registered under the programmes to cover the required medical expenses as well as documentation and coordination services a so-called fixed programme expenditure allowance. For , this allowance amounts to ,12 Euros per registered insured person. It is only due to this compensation scheme that the long-term care insurance system may adopt a contribution rate, which is uniform at federal level, of 1.
When the monthly expenses of long-term care insurance providers exceed their income, the compensation scheme ensures that they are provided with funds up to the amount of the legal defined target working capital and reserves. At present, up to 0. In order to finance these allocations, long-term care insurance providers with a monthly income exceeding their expenses transfer the difference between their income and their target working capital and reserves to the compensation fund.
Since long-term care providers do not dispose of their own administrative staff and their respective tasks are carried out by the staff members of the health insurance providers, their administrative costs are reimbursed by the long-term care insurance providers on a lump sum basis. This fund serves as a fluctuation reserve for all insurance providers and is used to carry out the financial equalisation. Besides transfer payments of long-term care insurance providers, the equalisation fund also contains the long-term care insurance contributions for pensioners received directly from pension insurance providers as well as certain contributions payable by the state, districts, and local governments in their capacity as social service providers.
The equalisation fund is also the disbursing agent for funding of up to 25 million Euros granted by the National Association of Statutory Health Insurance Funds for the further development of care-giving structures in accordance with Section 45c and d, Vol. Private compulsory long-term care insurance providers contribute 10 per cent of the funding provided by the long-term care insurance system. In addition, a budget of 5 million euros is granted annually for model projects implemented by the National Association of Statutory Health Insurance Funds for the further development of long-term care insurance in accordance with Section 8 3 , the Vol.
An additional budget of 60 million Euros was granted to fund care support centres in accordance with Section 92c, Vol. The new burden-sharing mechanism, which replaces the former system for burden-sharing in commercial occupational accident insurance, is being introduced step-by-step over a transitional period from to The new system provides that each professional insurance association bears its pension liabilities according its current economic structure while retaining the principle of sector specificity and primary responsibility of individual industry sectors for accidents at work and occupational diseases caused by them.
The same applies to the premises that, being assets in administrative use, are due to the Social Insurance and are to be classified according to the Unification Treaty as joint property assets owned by the Social Insurance in the acceding territory. The German Federal Government has set up a commission which is responsible for submitting proposals.
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Jochen Pimpertz | German Economic Institute
Affiliation; English-German Dictionary! Souls of Darkness. Long-term care insurance in Germany. Dictionary Navigation. Hitlers Pressechef: Otto Dietrich Eine Biografie German Edition. Comment P flegeversicherung It is an independent part of the social security in Germany, in the Sozialgesetzbuch and makes financial provision for the risk of care necessity. Long-term care insurance was introduced as the fifth column of social insurance after health insurance, industrial injuries, pensions and unemployment insurance.
This fifth column is carried by the care fund, which was built for all the individual health insurances.
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