Facts
[A.] is a self-employed physician in his own practice and holds a specialist medical degree in gynecology and obstetrics obtained in Germany and recognized in Switzerland in 2010. He has been registered under the service provider number (ZSR-No.) xxx since April 18, 2012 and provides services chargeable to the mandatory health insurance (OKP) in this capacity.
On February 21, 2020, [A.] filed a lawsuit with the Insurance Court of the Canton of Aargau, Arbitration Tribunal in Social Insurance Matters, against Helsana Versicherungen AG (Helsana) and Progrès Versicherungen AG (Progrès). The health insurers filed counterclaims and demanded the reimbursement of amounts they had paid to [A.] for pregnancy ultrasound examinations between April 9, 2014 and April 8, 2019.
Considerations
The Arbitration Tribunal denied the complainant's qualitative dignity (Art. 43 para. 2 lit. d KVG; Art. 7 para. 1 TARMED Framework Agreement) to provide pregnancy ultrasound services for the period prior to April 9, 2019. Based on this, it considered that the health insurers were entitled to reclaim the benefits that had been wrongly paid in this context between April 9, 2014 and April 8, 2019, as the time limit for the reimbursement claim had not expired at the time it was asserted on March 14, 2019.
The Federal Supreme Court dismissed [A.] 's appeal against this judgment. It stated that the possession of the Certificate of Competence in Pregnancy Ultrasound (SGUM) was a prerequisite for billing a pregnancy ultrasound to the OKP…