projetos

Beihilfe for implant-based dental prostheses

BVerwG 2 B 122/09, 2 B 122/09 (2 C 46/10)Bverwg / Divisão 216 de ago. de 2010Granted

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Extraído pela Omnilex

Resumo Omnilex

The Federal Administrative Court upheld the complaint against non-admission in a beihilfe dispute over implant-based dental prostheses. It held that the revision may clarify the statutory and regulatory requirements for reimbursement, in particular whether the existence of a non-preservable residual dentition that is to be removed only after the implants have healed bars beihilfe coverage.

Sumário Omnilex

§ 15 Abs. 1 BBhV; § 6 Abs. 1 Nr. 1 BhV; Anlage 2 Nr. 4c BhV; beihilfe for implant-based dental prostheses. A complaint against non-admission is well founded where the proposed revision raises a clarifiable question of law concerning the scope and prerequisites of beihilfe coverage. In particular, the case may warrant clarification whether a residual dentition that is not worth preserving and is scheduled for removal only at the end of the implant osseointegration phase excludes reimbursement. The decisive point is the need for appellate clarification of the legal criteria governing implant-supported dental treatment (consid. 1).

Texto completo

BVerwG — 2 B 122/09, 2 B 122/09 (2 C 46/10), Beschluss

Entscheidungsdatum: 2010-08-16

Aktenzeichen: 2 B 122/09, 2 B 122/09 (2 C 46/10)

Dokumenttyp: Beschluss

Normen: § 15 Abs 1 BBhV, § 6 Abs 1 Nr 1 BhV, Anl 2 Nr 4c BhV

Vorinstanz: vorgehend Oberverwaltungsgericht Rheinland-Pfalz, 2. Oktober 2009, Az: 10 A 10519/09, Urteil

Spruchkörper: 2. Senat

Titelzeile

Beihilfe für implantologische Leistung

Gründe

1 Die Beschwerde ist begründet. Das Revisionsverfahren kann Gelegenheit geben, die Anforderungen an die Gewährung von Beihilfen für implantatbasierten Zahnersatz (§ 6 Abs. 1 Nr. 1 BhV i. V. m. Anlage 2 Nr. 4 c BhV in der Fassung der Bekanntmachung vom 1. November 2001, § 15 Abs. 1 Nr. 5 BBhV vom 13. Februar 2009) zu präzisieren. Insbesondere wird zu prüfen sein, ob das Vorhandensein eines nicht erhaltungswürdigen Restzahnbestands, der nach dem Behandlungsplan erst am Ende der Einheilphase der Implantate entfernt werden soll, einer Beihilfegewährung entgegen steht.

Palavras-chave

beihilfedental prosthesesimplantsnon-admission complaintrevisionappellate review

Extraído pela Omnilex

Questões jurídicas principais extraídas pela Omnilex

Questão jurídica principal

Whether the non-admission complaint should be upheld and revision allowed in a beihilfe case concerning implant-based dental prostheses.

Decisão extraída

Yes. The complaint is well-founded because the revision may clarify the requirements for granting beihilfe for implant-based dental prostheses, including the relevance of a non-preservable residual dentition to be removed only after osseointegration.

Fundamentação extraída

The case raises a clarifying legal question under the cited beihilfe provisions, so appellate review is warranted.

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