Decision 9C_721/2023 of 15 February 2024

8 mars 2024 – In its decision of 15 February 2024, the Federal Supreme Court rejected the appeal of Birth Centre A. AG. The court decided that birth centres must charge for the phototherapy treatment of newborns in accordance with the Diagnosis Related Group (DRG) for birth centres.

Birth Centre A. AG invoiced the phototherapy treatment of two newborns according to the DRG for acute hospitals. The Hospital Authority of the Canton of Berne and the Directorate of Health, Social Affairs and Integration of the Canton of Berne rejected the invoices on the grounds that the DRG used was only approved for acute hospitals.

The dispute before the Administrative Court of the Canton of Berne had been which tariff should be used to calculate the canton's share of the treatment: the DRG for birth centres in the applicable Swiss DRG catalogue, or, as the appellant claimed for reasons of legal equality, the DRG for acute hospitals, which is assigned a higher cost weighting. The cantonal court confirmed the cantonal authorities' legal position. The cantonal court considered it justified to differentiate the cost weighting according to whether the treatment was provided in a birth centre or in an acute hospital, in part because of the different requirements for infrastructure and personnel. If birth centres were allowed to invoice according to the DRG for acute hospitals, they would systematically be overcompensated. The legal requirement to charge based on flat rates per case takes into account the entire course of treatment and not just individual treatment measures. Therefore, the cases in question cannot be invoiced according to a different DRG for birth centres.

The Federal Supreme Court held that the cantonal court’s decision did not violate federal law. The appeal was therefore rejected.

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