Download Bilag 7b - Region Syddanmark

Framework Agreement on Treatment for Danish Cancer Patients
Preamble
Under Danish law, life-threatening cancer patients shall be offered a treatment within
four weeks. The Danish Regional Councils, who are responsible for the public hospital
and health service, hereunder the cancer treatment program, has declared a 7-Point
plan, effective from October the 1st, 2007, to shorten the gap between suspicion until
treatment of life-threatening cancer. Within 48 hours, patients shall be informed of time
and place for the examination and treatment. The purpose of the Agreement is that
cancer patients who cannot be offered treatment at a Danish hospital within 48 hours,
shall receive an offer to be treated at HELIOS Privatkliniken GmbH in Schwerin. The
HELIOS Group is a leading private German hospital group with 58 hospitals, mainly
operating as public service hospitals, providing prestationary examination, full treatment
programs and ambulant as well as rehabilitation programs. The HELIOS Group is wholly
owned by the public listed Fresenius Group SE.
1. Parties of the Agreement
This Agreement has been made between
Region Syddanmark
Damhaven 12
DK - 7100 Vejle
(herafter RSD)
and
HELIOS Privatkliniken GmbH
Friedrichstrasse 136
D – 10117 Berlin
(hereafter HPK)
2. Target Group of the Agreement
(1) The target group of the Agreement shall be breast cancer, lung cancer, colorectal
cancer and head-and-neck cancer patients.
(2) According to this Agreement, other types of cancer can be treated upon prior
agreement between the RSD and HPK.
(3) The Agreement shall not apply to research, experimental or alternative treatment.
(4) Basically, the patients shall be referred to inpatient treatment. At the visitation,
Page 1
importance will be attached to the patient’s ability to handle transport to treatment
at the HPK.
(5) The patients shall meet the general conditions for cost-free hospital treatment
pursuant to Danish law and granted by the RSD according to this agreement.
(6) This agreement can be extended to other regions in Denmark, where RSD has
the overall responsibility to be contact between HPK and the actual region.
3. General Provisions on Treatment at HPK and Quality of the Treatment
(1) The patients shall be treated in accordance with the outcome and results of a
joint commission pointed out by HPK and RSD, who has setup common rules
and procedures that apply to German and Danish standards of treatment and
quality (referred to Appendix V.).
(2) On special request by the Region South Denmark or the Danish National Board
of Health, HPK shall be obliged to:
a. Describe examination and treatment principles, including treatment
experience, professional qualifications, resources, standard of the equipment,
quality development and initiatives;
b. Give an account of compliance with the latest developments in medicine, any
professional reference programmes for treatments, that are relevant to this
Agreement (given that they are considered medically advisable by HPK);
c. Provide information about waiting time for treatment; and
d. Provide a template of the declaration of consent.
(3) Upon request HPK shall be obliged to inform the RSD or the Danish National
Board of Health of the average waiting time in the respective to HELIOS
Hospitals for the concrete treatments included in this Agreement.
(4) HPK may in isolated cases, for reasons of capacity, medical reasons or
professionalism, refuse treatment of a patient who has been referred in
accordance with this Agreement. If a patient is turned down, RSD and the patient
shall, without undue delay, be notified of the reason.
(5) HPK will not use subcontractors for examination or treatment in accordance to
this agreement, outside the HELIOS Hospital Group.
Page 2
4. Referral for Treatment etc.
(1)
A prerequisite for HPK treating a patient according to this Agreement is the
existence of a written referral from the RSD
(2)
The referral, RSD, shall make sure, that the patients referred meet the
conditions, cf. clause 3.
(3)
The referral shall be made according to the referral used from RSD and followed
by a “cost transfer declaration” for the payment of the treatment. This form
states date of referral, patient data, information about the desired treatment and
contact data of the MD making the referral as well as payment instructions.
(4)
It is the responsibility of the patients MD without undue delay to forward relevant
case notes, including X-ray pictures to HPK. The relevant information will be
provided in Danish
(5)
It is the responsibility of the RSD to ensure that the patient has
received the required and statutory information about treatment and that the
patient has given his/her consent to the information mentioned in sub clauses (3)
and (4) being sent to HPK. Furthermore, the referral shall be conditional on the
patient agreeing to HPK, upon completion of the treatment, sending all the
relevant information about the treatment back to the RSD for payment purposes
and any continued treatment.
(6)
After completion of treatment, HPK shall send a letter of discharge in German
and English. All the other relevant information (case notes, any image
diagnostics and other medical information) can be send in German to the RSD.
(7)
Any subsequent control (post inpatient) in connection with the treatment will take
place at the RSD; HPK is not responsible for any such subsequent controls.
(8)
If any complications occur at the intervals between the individual treatments,
HPK has to make an agreement with RSD about whether the patient shall be
treated at HPK or at a hospital in Denmark. The patient’s wishes should be
included in the decision.
(9)
If any complications occur after completion of treatment, the patient shall decide
to continue the treatment at HPK or to be treated at a hospital in Denmark.
5. Patient Information and Communication
(1) The MD or RSD shall inform the patient, based on information made by HPK, of
HELIOS Hospitals, the environment, procedures (according to Appendix III. and
IV) and the time of treatment at HPK
Page 3
(2) The referral department shall give the patient a brochure on purpose and scope
of treatment, on practicalities regarding the stay at HPK and information on
complaints and damages. Patient material in Danish shall be prepared jointly by
the RSD and HPK including names, contact data, etc.
(3) HPK ensures that patients are generally admitted by a person who speaks
Danish and who can act as a liaison to the other Danish cancer patients.
(4) In general HPK will employ Danish-speaking hospital staff. In special cases of
absence of such Danish speaking hospital staff, HPK may ask for an interpreter
in connection with the patient’s first visit. Should there be a need for further
assistance from an interpreter as regards information and treatment of the
patient, the required interpreting services can be made available as soon as
possible. The RSD reserves the right to prepare guidelines for requisition of an
interpreter. HPK shall specify the costs for interpretation in connection with
invoicing of the treatment etc., cf. clause 8 in this Agreement
(5) The patient shall also have a contact person at the RSD.
6. Transport and Accommodation
(1) The RSD shall be responsible for the patient's transportation to and from HPK,
and it shall pay the costs involved. The same applies if the patient needs to be
brought home in an ambulance or if the patient dies. In these cases HPK shall
participate in the practical arrangements.
(2) HPK shall undertake the practical tasks in connection with reservations for the
patients and any relatives at a location close to the hospital of treatment and
shall otherwise assist the patients with practical matters. HPK shall also be
prepared to pay allowances to the patients. Any allowance paid through HPK will
be refunded by the RSD. The specific model for the cooperation regarding
patient accommodation and allowances is included in Appendix II and shall be
finally agreed upon by RSD and HPK.
7. Services and Prices
(1) Payment for treatment of patients at HPK pursuant to this Agreement shall rest
upon the RSD.
(2) Prices for the individual examinations and treatments are based on the German
DRG and GOÄ Systems.
(3) Payments for the medical service shall, comply with the current German DRGPage 4
System (general accounting system for inpatient treatment) or the GOÄ
(Gebührenordnung für Ärzte, general accounting system for outpatient treatment)
rates.
(4) In case of the patient's failure to appear at HPK for examination or treatment,
HPK is payed a reduced price of the full price corresponding to HPK's costs per
week, by the RSD cf. Appendix II.
(5) If the patient needs to be admitted for observation during an outpatient treatment
period, or if the patient is admitted due to complications, RSD shall be contacted.
Payment for treatment of complications in connection with HPK’s treatment of a
patient in accordance with this Agreement shall comply with the above stated and
current German DRG and GOÄ rates.
(6) The range of services included in Appendix II may be amended upon negotiation
between the parties of this Agreement. The prices agreed upon may be changed
at a notice of six months.
8. Payment
(1) For the initial setup cost in connection with the terms and obligations in this
agreement, RSD shall pay HPK a one time fee of € 15.000,00 after signing the
agreement.
(2) To be prepared to examine Danish cancer patients within 48 hours and
eventually treatment, the RSD shall pay HPK a monthly fee € 10.000,00 in
advance.
(3) Payment shall be made on the basis of an invoice for each patient sent to the
RSD in German with reference to the referral received from the RSD prior to the
admission of the patient. Invoices submitted before the end of a month shall be
paid not later than the end of the following month.
The invoice shall include the patient's name, address, civil reg. no., MD, referral
date, continued treatment recommended, date(s) of examination/treatment and the
treatment provided by HPK specified in accordance with the terms stipulated in
clause 7:
a. If the patient has been admitted to HPK for general observation, date of
admission and discharge shall be stated.
b. If the patient has been treated for complications, the type of treatment shall
be stated.
c. If assistance by an interpreter has been required, this should also be
specified on the invoice.
Page 5
HPK shall, concurrently with the invoice to the RSD, send a letter of discharge.
9. Rules of Damages and Complaints
(1) Patients who are treated at HPK pursuant to this Agreement shall be subject to
the German law.
The RSD or MD shall be obliged to advise patients who have been referred for
treatment pursuant to this Agreement on complaints options regarding the health
professional treatment, the service and the Danish patient insurance scheme.
HPK shall be obliged to inform RSD in writing of any complaints and patient
insurance cases raised in connection with HPK's treatment of patients. HPK
shall be obliged to disclose any information to the Patient Insurance Association
that the Patient Insurance Association deems important for case processing
under the Act on Right of Appeal and Compensation within the Health Service.
(2) HPK is liable in case of gross negligence and intent only.
(3) HPK shall have the required insurance to cover any damages occurring in
connection with treatment of referred patients performed by HPK's employees or
associated staff.
(4) HPK shall at any time be able to document adequate insurance coverage in
accordance with German law.
10.
Disputes
(1) The Parties shall agree on mutually and as soon as possible to try to resolve any
questions of doubt regarding the individual provisions in the Agreement and in
the Appendices of the Agreement.
(2) This contract is subject to German law only. The court of jurisdiction is Schwerin,
Germany.
11.
Breach
In case of breach of this Agreement, the other Party shall be informed
immediately in writing of any measures taken to remedy the situation. In repeated
cases of a material breach, the other Party may demand that the Agreement be
terminated at one month's notice, alternatively demand a re-negotiation of the
Agreement.
Page 6
12.
Commencement, Duration, Termination
(1) This Agreement shall enter into force on October the 1st, 2007 and apply at
least 12 month until it is terminated, cf. sub clause (3), cancelled or amended, cf.
sub clause (2).
(2) The Agreement may be terminated by either Party at six months' notice to the
first of a month. If the Parties agree, the Agreement may be terminated at a
shorter notice.
Vejle, 1st of December, 2007
Region Syddanmark
Berlin, 1st of December, 2007
HELIOS Privatklinik GmbH
Claus Toftgaard
Silvio Rahr
Chief Medical Officer
Chief Executive Officer
Page 7