Austria’s New Healthcare Laws for reimbursement

In Austria, there have been recent changes related to reimbursement coding for Medical procedures that make life easier for people interested in outpatient procedures.

These changes are outlined in the Vereinbarungsumsetzungsgesetz 2024 (VUG 2024), which modifies several key laws and regulations in the healthcare sector. Let’s break down the main points:

1. Amendments to Health Target Control Act (Gesundheits-Zielsteuerungsgesetz): This law has been updated to address specific aspects of health management and control.
2. Changes to Hospital and Sanatorium Act (Krankenanstalten- und Kuranstaltengesetz): The regulations governing hospitals and sanatoriums have been revised.
3. Modifications to General Social Insurance Act (Allgemeines Sozialversicherungsgesetz): This act, which deals with social insurance, has undergone adjustments.
4. Revisions to Primary Care Act (Primärversorgungsgesetz): The rules governing primary healthcare services have been amended.
5. Updates to Physicians Act 1998 (Ärztegesetz 1998): The regulations concerning medical practitioners have been changed.
6. Alterations to Dentists Act (Zahnärztegesetzes): The provisions related to dental professionals have been updated.
7. Amendments to Health Telematics Act (Gesundheitstelematikgesetz): The law governing health information technology and telemedicine has been modified.

The Gesundheits-Zielsteuerungsgesetz (Health Target Control Act), commonly referred to as the G-ZG, has undergone several amendments to enhance health management and control in Austria. Let’s delve into the key aspects of these changes:

1. General Principles:
   • The law emphasizes partnership-based health target control.
   • It promotes health considerations across all policy fields and encourages a public health-oriented approach.
   • The principles of health target control are outlined, emphasizing efficient and effective healthcare management.
2. Goals and Action Areas:
   • The law defines specific health goals and outlines the action areas for achieving them.
   • It emphasizes quality improvement within the Austrian healthcare system.
   • Transparency and patient-centric approaches are key components.
3. Health Target Control Process:
   • The multi-stage health target control process is established.
   • Partners involved in health management provide mutual data sharing to facilitate informed decision-making.
4. Specific Focus Areas:
   • The law specifies areas for health target control, including:
     • Outcome-oriented steering: Focusing on health outcomes.
     • Structural steering: Addressing healthcare structures.
     • Process steering: Enhancing healthcare processes.
5. Financial Goal Steering:
   • The law introduces financial goal steering principles.
   • It defines the scope and content of financial goal control.
6. Planning Austrian Healthcare Structure:
   • The law outlines principles for healthcare planning.
   • It establishes the Austrian Health Structure Plan and regional health structure plans.

These amendments aim to optimize Austria’s healthcare system, ensuring better health outcomes, transparency, and efficient resource allocation. 

The Krankenanstalten- und Kuranstaltengesetz (KAKuG), also known as the Hospitals and Sanatorium Act, has recently undergone revisions in Austria. Let’s explore the key points related to this law:

1. Scope and Definitions:
   • The KAKuG covers both general hospitals (Krankenanstalten) and sanatoriums (Kuranstalten).
   • General hospitals cater to individuals without discrimination based on gender, age, or the type of medical care required.
   • Sanatoriums focus on examination and treatment.
2. Ownership and Equity Stakes:
   • Ownership of private hospitals is open to various legal entities.
   • Investors can take equity stakes, whether minority or majority, or even set up joint ventures with existing owners or operators.
   • This flexibility allows for effective participation in the healthcare sector.
3. Benefits of Consolidation:
   • Hospital consolidation aims for synergies by eliminating administrative layers and shared procurement.
   • Increased specialization leads to higher case numbers, better service quality, efficiency gains, and improved bed occupancy.
   • Commercially attractive practice areas are emphasized where possible under regulatory rules.
4. Complex Regulatory Framework:
   • The KAKuG is part of a federal framework for hospital regulations.
   • Additionally, there are nine regional hospital laws, one for each province (Bundesland).
   • Foreign investors should navigate this complex framework carefully.

In summary, the revisions to the Hospitals and Sanatorium Act aim to optimize Austria’s health

The Allgemeines Sozialversicherungsgesetz (ASVG), or the General Social Insurance Act, plays a crucial role in Austria’s social insurance system. Let’s explore the recent adjustments made to this act:

1. Scope and Coverage:
   • The ASVG defines the scope of social insurance in Austria.
   • It outlines the extent of coverage provided by the social insurance system.
2. Leistungsrechte (Benefits):
   • Recent modifications have focused on benefits within the pensions insurance domain.
   • These changes impact the rights and entitlements of insured individuals regarding pensions.
3. Employment Considerations:
   • The ASVG addresses employment within Austria and specifies the place of employment.
   • It ensures that social insurance provisions apply to individuals working within the country.
4. Language Equality:
   • The act emphasizes linguistic equality in its provisions.
   • It promotes non-discriminatory language use across the social insurance system.
5. Implementation of Union Law:
   • Adjustments have been made to align the ASVG with European Union regulations.
   • This ensures consistency and compliance with EU standards.

Remember that the ASVG covers various aspects of social insurance, including health, pensions, and accident insurance. For more detailed information, you can refer to the official document.

The Primärversorgungsgesetz (Primary Care Act) in Austria has recently undergone significant revisions. Let’s explore the key changes related to primary healthcare services:

1. Expansion of Primary Care Facilities:
   • The recent amendments aim to substantially expand the niedergelassenen Bereich (outpatient sector) within primary care.
   • The goal is to establish a comprehensive and locally accessible healthcare system for all individuals.
2. Increase in Primary Care Units (PVE):
   • Instead of the current 45 Primary Care Units (PVE), the plan is to triple this number by 2025.
   • These units play a crucial role in providing essential healthcare services to the population.
3. Enhanced Accessibility:
   • The revised act emphasizes improved access to primary care services.
   • It aims to reduce barriers and ensure that individuals can easily seek medical attention close to their place of residence.
4. Collaborative Approach:
   • The amendments encourage a collaborative model involving various healthcare professionals.
   • This includes general practitioners, nurses, pharmacists, and other specialists working together to enhance patient care.
5. Quality and Efficiency:
   • The focus is on quality improvement within primary care.
   • Efficient resource allocation and streamlined processes are key objectives.

In summary, the changes to the Primary Care Act are designed to create a robust and patient-centric primary healthcare system in Austria. For more detailed information, you can refer to the official document¹².

Updates to Physicians Act 1998 (Ärztegesetz 1998): The regulations concerning medical practitioners have been changed.

1. Recognition of EWR-Berufsqualifikationen (EU Professional Qualifications):
   • The act outlines procedures for the automatic recognition of professional qualifications obtained within the European Economic Area (EEA).
   • It ensures that physicians with qualifications from EEA countries can practice in Austria without additional hurdles.
2. Verordnung über Berufsqualifikationen (Regulation on Professional Qualifications):
   • The Austrian Federal Minister of Health issues detailed regulations regarding the recognized professional qualifications.
   • These regulations specify the requirements for practicing medicine in Austria.
3. Ausbildung zum Arzt für Allgemeinmedizin (Training for General Practitioners):
   • The act defines the training process for becoming a general practitioner.
   • It ensures that physicians receive comprehensive training in primary care.
4. Ausbildung zum Facharzt (Specialist Training):
   • The act outlines the training path for becoming a specialist in a specific medical field.
   • It covers various specialties, including surgery, internal medicine, pediatrics, and more.
5. Quality Assurance and Visitation:
   • The act emphasizes quality standards in medical education and practice.
   • Regular visitation ensures compliance with these standards.
6. Diplomas and Certificates:
   • The act addresses the recognition of diplomas and certificates obtained during medical education.
   • It ensures transparency and consistency in qualifications.

These changes aim to enhance the quality of healthcare services provided by physicians in Austria. For more detailed information, you can refer to the official document¹².

 The Health Telematics Act 2012 (Gesundheitstelematikgesetz) in Austria has recently undergone amendments to enhance health information technology and telemedicine. Let’s explore the key points related to these changes:

1. Electronic Immunization Card:
   • The recent proposal introduces an Electronic Immunization Card to replace the existing paper-based immunization card.
   • This digital documentation will list all vaccinations received by an individual.
   • It aims to address the limitations of the current system, where handwritten entries are often incomplete, inconsistent, and difficult to evaluate.
2. Central Register of Vaccinations:
   • Alongside the Electronic Immunization Card, a central register of vaccinations will be established.
   • This register will consolidate vaccination data from different healthcare providers.
   • It ensures a comprehensive and accurate record of an individual’s immunization status.
3. Public Health Benefits:
   • The availability of digital vaccination data will facilitate public health measures.
   • Vaccination coverage rates can be assessed, allowing targeted interventions to prevent disease spread.
   • In cases of highly contagious diseases like measles, contact tracing can be more effective.
4. Optimization of ELGA Infrastructure:
   • The amendments contribute to the generic development of the Electronic Health Record (ELGA) infrastructure.
   • Quality metadata ensures reliable accessibility and usability of documents within ELGA.

These changes aim to strengthen vaccination management, improve public health outcomes, and enhance Austria’s healthcare system. For more detailed information, you can refer to the official document

Changes to Documentation in Healthcare Act (Bundesgesetz über die Dokumentation im Gesundheitswesen):

1. This act provides the legal framework for the documentation of health-related data in both intra- and extramural (outpatient and inpatient) healthcare settings.
2. The key purposes of this documentation include:
   • Healthcare system management: By observing epidemiological trends, disease patterns, and treatment processes, the act contributes to the long-term management of Austria’s healthcare system.
   • Quality improvement: It aims to enhance process and outcome quality by monitoring and evaluating health-related data.
   • Integrated health structure planning: The act supports planning that covers all levels and areas of healthcare delivery.
   • Financial and reimbursement mechanisms: It facilitates adjustments in financing and payment systems, especially for cross-sectoral shifts in services.
   • Patient safety: Ensuring that healthcare documentation contributes to patient safety.
3. The act also emphasizes pseudonymization of personal data for privacy protection.
4. Revisions to Pharmacy Act (Apothekengesetz):
   • The Pharmacy Act governs the operation of pharmacies in Austria.
   • Recent adjustments include:
     • Ownership and equity stakes: The act allows various legal entities to own private pharmacies, encouraging investment and joint ventures.
     • Benefits of consolidation: Consolidation of pharmacies aims for efficiency gains, specialization, and improved service quality.
     • Complex regulatory framework: The act is part of a federal framework, and there are regional laws specific to each province.
     • Foreign investors: The act provides guidelines for foreign investors navigating the complex regulatory landscape.
5. Alterations to Narcotics Act (Suchtmittelgesetz):
   • The Narcotics Act deals with controlled substances and narcotics in Austria.
   • Recent updates include:
     • Harmonization with EU standards: The act aligns Austrian narcotics law with prevailing European Union standards.
     • Local and provincial regulations: Some vestiges of earlier laws remain, including local and provincial regulations for patients dependent on narcotics.
     • Codeine availability: The act addresses the over-the-counter availability of codeine and similar drugs.
     • Pseudonymization: Personal data related to narcotics must be maintained using pseudonyms.
6. Updates to Prescription Requirement Act (Rezeptpflichtgesetz):
   • The act concerns the prescription of medications.
   • Recent changes include:
     • Telemedicine flexibilities: The act temporarily extends telemedicine flexibilities for prescribing controlled substances.
     • COVID-19 waivers: The full set of COVID-19 waivers for telemedicine prescribing remains in effect.
     • Patient safety: Ensuring continuity of care during the pandemic.
7. Modifications to Health Quality Act (Gesundheitsqualitätsgesetz):
   • The Health Quality Act focuses on quality improvement within Austria’s healthcare system.
   • Recent revisions include:
     • Systematic quality work: The act aims to implement and intensify quality work across all provinces and sectors.
     • Patient orientation and transparency: Quality work should be patient-oriented, transparent, and effective.
     • Medium- and long-term improvement: Quality work contributes to improving effectiveness, efficiency, and financial sustainability.
     • Pseudonymization: Personal data for quality work must be maintained using pseudonyms.
8. Changes to Health Austria GmbH Act (Bundesgesetz über die Gesundheit Österreich GmbH):
   • The provisions governing the Health Austria GmbH have been updated.
   • Details about the specific changes are not provided in the available sources.

These revisions aim to enhance Austria’s healthcare system, improve patient care, and ensure efficient management. For more detailed information, you can refer to the official documents¹²³.