Determination of the Local Jurisdiction of the Cantonal Arbitration Tribunal for Service Providers Practicing in Different Cantons

Facts

Dr. med. [A.] is a specialist in anesthesiology and holds professional practice permits in the Cantons of St. Gallen and Zurich. Helsana Insurances AG and Progrès Insurances AG filed a claim with the arbitration tribunal of the Canton of St. Gallen, as Dr. med. [A.] is alleged to have provided services in the Canton of Zurich partially without the corresponding permit during the period between 2016 and 2019. The arbitration tribunal seized did not enter into the claim and referred it to the arbitration tribunal of the Canton of Zurich.

Helsana Insurances AG lodges a complaint against the decision not to enter into the claim. It argues that according to Art. 89 para. 2 KVG, the arbitration tribunal of the canton in which the service provider's permanent establishment is located is alternatively competent.

Considerations

The Federal Supreme Court upholds the complaint. It states that according to Art. 89 para. 2 KVG, the arbitration tribunal of the canton in which the service provider - taking into account his entire practice - is predominantly active is locally competent. If a physician practices at workplaces in two or more cantons, this requires a weighting of the respective activities.

For such a weighting, no excessively high requirements may be placed…