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Bundeskartellamt opens up competition among ophthalmologists from different federal states in Germany

Date of issue: 02.07.2013

The Bundeskartellamt has concluded a cartel administrative proceeding against the Brandenburg ophthalmologists cooperative "Augenärztegenossenschaft Brandenburg" and the health insurance fund AOK Nordost. Participation in two selective contracts and membership in the Brandenburg ophthalmologists cooperative has up to now only been allowed to those ophthalmologists who have an accreditation in Brandenburg to provide health care services within the statutory health insurance scheme. Competition from ophthalmologists accredited in other federal states was consequently excluded. The Brandenburg ophthalmologists cooperative and AOK Nordost will now open up the contracts and cooperative membership to ophthalmologists accredited in another federal state, who are legitimately active in Brandenburg.

Andreas Mundt, President of the Bundeskartellamt: "Selective contracts which make participation dependent upon in which federal state a doctor is officially accredited, limit the local competition in efficiency and quality between the doctors. This is to the detriment of the patients. The Bundeskartellamt will therefore rigorously follow up such regulations."

The selective contracts between the Brandenburg ophthalmologists cooperative and AOK Nordost apply to cataract operations (cataract contract) and the treatment of a wet form of age-related macular degeneration (IVI contract). The Bundeskartellamt criticises the current practice which makes participation in these contracts conditional on accreditation as a statutory health insurance practitioner in the federal state of Brandenburg. Participation in the IVI contract as well as participation as a non-operating ophthalmologist in the cataract contract is also dependent on membership in the Brandenburg ophthalmologists cooperative. According to the cooperative's rules, membership in the cooperative is, on the other hand, only available to ophthalmologists who are accredited in Brandenburg. Ophthalmologists who perform surgery and do not belong to the cooperative are only able to participate in the cataract contract on payment of a one-off compensation fee. In the Bundeskartellamt's view, the contracts and rules of the Brandenburg ophthalmologists cooperative therefore restrict competition. Ophthalmologists, especially those in Berlin, who are authorised to invoice their services in Brandenburg but are only active in a branch practice or as a member of a joint practice, cannot participate in the contracts.

The AOK Nordost and the Brandenburg ophthalmologists cooperative have offered commitments to redress the situation. Under these commitments the selective contracts and rules of the Brandenburg ophthalmologists cooperative will be amended to allow ophthalmologists from outside Brandenburg to participate in the contracts and become cooperative members in future. Future contracts will not be limited to ophthalmologists accredited in Brandenburg.

The Bundeskartellamt has declared the commitments offered as binding. The decisions are not yet final.

More than 75 percent of the ophthalmologist practices in Brandenburg are members of the Brandenburg ophthalmologists cooperative. AOK Nordost is the largest health insurance fund in Brandenburg, serving around 28 percent of statutorily insured persons in the federal state.

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