Decision on Transport Costs during Hospitalization in Private Ward

Facts

S. was insured with Assura for compulsory health insurance (HIA) benefits and with Assura S.A. for private ward benefits. From June 24 to 27, 2006, he was hospitalized in the private ward of hospital X., then transferred on June 26 to hospital Y. Hospital X. invoiced the transfer transport of 255 CHF to S. After disagreement on the payment of these transport costs, the health insurance filed an appeal with the cantonal arbitration tribunal pursuant to Art. 89 HIA. The tribunal dismissed the claim, considering that the hospital had rightfully invoiced the 255 CHF transport costs to the patient.

Considerations

The Federal Tribunal examines whether the separate invoicing of transport costs for patients in private wards is in accordance with Art. 44 para. 1 HIA on tariff protection. It considers that Art. 44 para. 1 HIA does not apply to services provided in the private ward of a hospital. The tariff regime for this ward is governed by cantonal law and not by the HIA. The hospital can therefore…