Takea­ways (AI):
  • The Natio­nal Coun­cil dis­ku­tiert eine Ände­rung des KVG to Kosten­dämp­fung.
  • Ein neu­er Abschnitt 1bis at KVG soll indi­vi­du­el­le Infor­ma­tio­nen an Ver­si­cher­te ermöglichen.
  • The SGK‑S plant einen neu­en Art. 56a für geziel­te Infor­ma­tio­nen an Versicherte.
  • Ver­si­che­rer sol­len über kosten­gün­sti­ge­re Lei­stun­gen und prä­ven­ti­ve Mea­su­res infor­mie­ren können.
  • Es gibt brei­te Zustim­mung im Par­la­ment, jedoch kei­ne Grund­la­ge für Pro­fil­ing.

In the cur­rent busi­ness on the “Amend­ment to the KVG regar­ding cost con­tain­ment mea­su­res – packa­ge 2” (busi­ness no. 22.062), a pro­po­sal to amend Art. 84 KVG (data pro­ce­s­sing by the organs of the OKP) is under dis­cus­sion (see alre­a­dy here). On Sep­tem­ber 28, 2023, the Natio­nal Coun­cil pro­po­sed adding a new para­graph 1bis to Art. 56 KVG in line with a pro­po­sal made by the SGK‑N on August 31, 2023:

1bis In order to ensu­re the mea­su­res in accordance with para­graph 1, insu­r­ers may inform the per­sons insu­red with them indi­vi­du­al­ly about the bene­fits they recei­ve, about mea­su­res to pre­vent ill­ness and about offers aimed at impro­ving the effi­ci­en­cy and coor­di­na­ti­on of the pro­vi­si­on of medi­cal ser­vices and, with their con­sent, pro­vi­de ser­vice pro­vi­ders with infor­ma­ti­on about the bene­fits recei­ved by the insu­red persons.

In Art. 84, a new para. 1 lit. j should per­mit the neces­sa­ry data processing.

The SGK‑S took up this con­cern at its mee­ting on April 23, 2024, but wants to crea­te a new Art. 56a instead (and also Art. 84 para. 1 lit. j KVG). Art. 56a KVG (see the cur­rent flag) would have the fol­lo­wing wording:

Art. 56a Tar­ge­ted infor­ma­ti­on for insu­red persons
1 Insu­r­ers can pro­vi­de insu­red per­sons with tar­ge­ted infor­ma­ti­on on more cost-effec­ti­ve bene­fits, the choice of sui­ta­ble spe­cial forms of insu­rance and pre­ven­ti­ve measures.
2 The insu­r­ers shall inform the insu­red per­sons of the pur­po­se of the spe­ci­fic infor­ma­ti­on in accordance with para­graph 1 when they first make cont­act and draw their atten­ti­on to the vol­un­t­a­ry natu­re of the infor­ma­ti­on and the pos­si­bi­li­ty of objec­ting to it at any time.

Art. 84 para. 1 lit. j KVG would allow health insu­r­ers to do so,

to pro­vi­de insu­red per­sons with tar­ge­ted infor­ma­ti­on on more cost-effec­ti­ve bene­fits, the choice of sui­ta­ble spe­cial forms of insu­rance and pre­ven­ti­ve measures.

The fun­da­men­tal­ly justi­fi­ed con­cern to enable the pro­vi­si­on of advice to peo­p­le with basic health insu­rance in the area of com­pul­so­ry health insu­rance is evi­dent­ly wide­ly sup­port­ed in Par­lia­ment. It is striking that no basis for asso­cia­ted pro­fil­ing is to be crea­ted – per­haps a sin of omis­si­on, given the (over­ly) broad defi­ni­ti­on of profiling.

AI-gene­ra­ted takea­ways can be wrong.