Facts
Mrs. [H.] , born in 1954, was mandatorily insured for healthcare with Helsana Insurances AG (Helsana). She suffered from Multiple Sclerosis and had been receiving outpatient nursing care services for years. Since 1 September 1996, her husband [K.] had been providing basic care services as an employee of the Spitex-Dienste [F.] (Spitex Association). However, Helsana refused to reimburse these services as of 1 April 2002, since [K.] did not have the appropriate nursing training. The Administrative Court of the Canton of Thurgau, acting as the Insurance Court, subsequently ordered Helsana to reimburse the Spitex services for the period from 1 October to 31 December 2002. Helsana then filed a public law appeal with the Federal Supreme Court.Considerations
The Federal Supreme Court dismissed Helsana's appeal. It stated that neither the law nor the ordinances contained specific requirements regarding the minimum professional qualifications for employees of home care organizations. Rather, it was within the discretion of the management of the Spitex Association and the responsible physician to decide what professional and personal requirements were necessary for the care of the insured person at home. There was also room for discretion in the assessment of whether it was "basic care in simple situations" or "relatively…