Facts
Physician Dr. [Z.] operates a medical practice and treated a patient B. insured with the health insurance fund KPT following the patient's accident. Dr. [Z.] initially billed the treatment according to the UV/MV/IV tariff, which the health insurance fund rejected, as it is not involved in the implementation of the mandatory accident insurance. Subsequently, Dr. [Z.] billed the treatment according to the private tariff, which the health insurance fund also rejected and requested him to apply the valid tariff points.
Dr. [Z.] then filed a claim with the Arbitration Tribunal KVG/UVG of the Canton of Bern, seeking a declaratory judgment that he is not obliged to bill the treatment of the insured B.'s accident consequences according to the health insurance fund tariff. The health insurance fund, in turn, requested a declaration that a physician who bills for the treatment of an accident event to an insured member of a recognized health insurance fund, which is not an UVG insurer but provides subsidiary benefits for accidents, is bound to the tariff applicable to health insurance funds.
Considerations
The Federal Insurance Court states that the Arbitration Tribunal is competent to adjudicate the dispute between the physician and the health insurance fund, as it concerns the application of tariff contract regulations, in accordance with Art. 25 KUVG.
However, the Court denies the…