This has changed:
With the passing of the law in the Federal Council, the additional assessment of medical necessity by health insurance companies or the Medical Service is no longer required. This applies if an aid is prescribed by doctors at a social paediatric center (SPZ) or a medical center for adults with disabilities (MZEB) – provided that the facility is authorized in accordance with Section 119 SGB V.
Important information for regulations:
To ensure that the new regulation can be implemented smoothly, you should note the following:
Prescriptions from other doctors: If the prescription is not directly from an SPC or MZEB, a current, informally issued recommendation from one of these centers is sufficient as a supplement.
Deadlines: The prescription and the cost estimate from the medical aid provider must be submitted to the health insurance company within three weeks of being issued.
Your benefits as a prescriber:
The legal change makes things noticeably easier. Both for you and for your patients:
Faster processing of applications
Avoidance of appeal proceedings and unnecessary delays
Better care, especially for people with disabilities, children and young people
Recommendation for practice:
As many cost bearers are not yet fully familiar with the implementation, we recommend explicitly referring to Section 33 (5c) SGB V in the event of queries or delays.
Heller Medizintechnik provides you with reliable support in implementing this new regulation and is on hand to advise you on all questions relating to the provision of medical aids.





