Facts
The Federal Court had to decide according to which tariff the health insurance must reimburse the nursing services provided by an approved home care organization to residents of a disability home. The lower instance had decided that the services are to be reimbursed according to the tariff for outpatient service providers (Art. 7a para. 1 HIBO) and not according to the tariff for nursing homes (Art. 7a para. 3 HIBO). The health insurance filed a complaint against this judgment.Considerations
The Federal Court dismissed the complaint. It stated that the wording, the purpose and the systematic context of the relevant provisions in the Health Care Benefits Ordinance (HIBO) clearly indicate that the applicable tariff is determined by the formal classification of the service provider. Since the respondent is an approved home care organization, its services must be reimbursed according to Art. 7a para. 1 HIBO and not according to the nursing home tariff. The Federal…