Facts
On June 20, 1995, the Kantonalverband Thurgauischer Krankenkassen (KTK) terminated the agreement with Klinik [B. AG] of April 1, 1993, regarding the treatment and benefits of the insured. The Klinik requested an extension of the agreement, which was granted by the Regierungsrat of the canton of Thurgau until December 31, 1996. The KTK filed an appeal with the Federal Council, which was rejected on September 23, 1996.
The Klinik [B. AG] then invoiced the insurers, including Wincare Versicherungen, for an additional amount for the services provided in 1996 due to a higher tax point rate. Wincare refused to pay, arguing that the applicable tax point rate was lower. The Klinik then seized the cantonal arbitration tribunal of the canton of Thurgau, which was composed of a neutral president and representatives of the insurers and healthcare providers.
Wincare requested the recusal of one of the members of the arbitration tribunal, Dr. G., due to his connections with Klinik [B. AG] and other private healthcare establishments in the canton of Thurgau. The arbitration tribunal rejected this request, and Wincare filed an appeal with the Federal Insurance Tribunal.
Considerations
The Federal Insurance Tribunal examined the admissibility of the appeal and found that the decision of the cantonal arbitration tribunal was subject to appeal. It then examined the grounds for appeal and found that the decision of the cantonal arbitration tribunal was not flawed in form or substance.
The Federal Insurance Tribunal also examined the question of whether the cantonal arbitration tribunal could be composed of members who are not…