Sonntag I
Medizinischer Dienst der Krankenversicherung Westfalen-Lippe, Rheda-Wiedenbrück.
Gesundheitswesen. 1995 Jan;57(1):36-8.
The author discusses the network of acts of parliament, subordinate legislation and decisions of the courts. Even if a substitution is legal, this does not necessarily mean that the expenses are covered by the statutory medical insurances. While in certain cases the insurances bear the costs of a treatment with methadone, the expenses for codeine and dihydrocodeine can be covered in no case. But it is possible to prescribe both at the expense of the patient. According to the law and the opinions of leading experts it is obligatory that the distribution of substitutes be combined with further medical, psychological and social care. For the latter the insurances cannot be charged. The essay concludes with presumptions about the future development of the regulations in force.
作者探讨了议会法案、附属立法和法院判决的体系。即使替代是合法的，这也不一定意味着费用由法定医疗保险承担。虽然在某些情况下保险承担美沙酮治疗的费用，但可待因和二氢可待因的费用在任何情况下都不能报销。但以患者自费的方式开具这两种药物是可行的。根据法律和权威专家的意见，替代药物的分发必须与进一步的医疗、心理和社会护理相结合。对于后者，不能向保险机构收费。本文最后对现行法规的未来发展进行了推测。
