Investigating human rights This large-scale equipment plan requires binding needs planning to control the quality and efficiency of medical care nationwide. This means that contracts for MRI or CT equipment outside of the large-scale equipment plan are not covered. Therefore, cost reimbursement is only possible for examinations with equipment that is included in the large-scale equipment plan. This has been confirmed by the case law of the Austrian Supreme Court. Long waiting times However, the AOB is continually confronted by patients’ complaints about waiting times for MRI and CT scans which may amount to several months. Due to the urgency of these examinations (e.g. for cancer diseases or upcoming, scheduled operations) the affected persons are often compelled to be examined as private patients, even though the health insurance carrier cannot pay any cost reimbursement then. Appointments are scheduled quickly for private patients Therefore, in its Annual Report for 2015 and on the ORF TV programme “BürgerAnwalt” the AOB has discussed specific individual cases involving this problem in order to achieve an improvement in this unsatisfactory situation. An important reason for the waiting times is the fee agreement between the Main Association of Austrian Social Security Institutions and the Association of Austrian Health Care Facilities (Austrian Economic Chambers). This agreement provides for limiting (capping) the total fee amount. The result is that facilities only examine as many patients as they receive corresponding fees for. Since private patients receive appointments much faster, it can be assumed that there is still available capacity, which has not been exhausted because of the cap on the total fee amount. Health insurance carriers take first measures The health insurance carriers have now reacted to this bottleneck in providing care ensuring that at least examinations which are urgently necessary can be conducted quickly at the expense of the public health insurance programme. Thus, in Lower Austria an “onco-CT” task force was established with representatives of the Lower Austrian Public Regional Health Insurance Office (NÖGKK), the Specialists’ Group on Health Care Facilities/Diagnostics of the Lower Austrian Economic Chamber, the Lower Austrian Patients and Care Advocates and the Land of Lower Austria. They agreed on measures to ensure that cancer patients receive appointments for urgently needed examinations quickly. This agreement is intended to help persons who have been diagnosed with cancer in a preliminary examination and need computer tomography for further therapy planning, but who cannot obtain a timely appointment from their CT providers. They will be allotted an appointment from a special quota offered by CT providers nationwide. Such models should be developed throughout Austria to ensure earlier appointments for examination. However, if an evaluation of such measures shows that patients still expect unreasonable waiting times, the existing agreement on the total fee amount for MRI and CT scans must be critically scrutinised. 56

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