Criminal defense for Disziplinarverfahren der Kassenärztlichen Vereinigung (§ 81 SGB V) in Bonn

In brief: Disciplinary measures of the SHI association for breaches of contract-physician duties. The sentencing range is Warning, reprimand, fine up to €50,000, suspension of licence up to 2 years (§ 81 Abs. 5 SGB V). What matters is the evidence – we assess it after obtaining the case file.

Legal Basis

§ 81 Abs. 5 SGB V

Sentencing Range

Warning, reprimand, fine up to €50,000, suspension of licence up to 2 years

Summary

Disciplinary measures of the SHI association for breaches of contract-physician duties.

Disciplinary Proceedings of the Association of SHI Physicians (Section 81 SGB V)

Contract physicians who breach their contract-physician duties must expect disciplinary proceedings by their Association of Statutory Health Insurance Physicians (KV). The basis is Section 81(5) SGB V. The measures range from a warning through a reprimand and a fine of up to €50,000 to the suspension of the licence for up to two years. We represent doctors nationwide in these proceedings.

When disciplinary measures apply

The trigger is a culpable breach of contract-physician duties – for example persistent inefficiency, breaches of billing and documentation rules, or disregard of duties of presence and emergency service. In North Rhine-Westphalia (NRW) there are two associations – the KV Nordrhein and the KV Westfalen-Lippe – each with its own disciplinary regulation.

Available measures

Section 81(5) SGB V provides an exhaustive catalogue that cannot be restricted or extended by statute: warning, reprimand, fine up to €50,000, and suspension of the licence or of contract-physician participation for up to two years. Several measures may be combined; the suspension is the most severe as it temporarily removes participation in SHI care.

How we defend

We examine whether a duty was actually breached and culpably so, insist on proportionality, use procedural errors (inadequate hearing, defects in reasoning, errors of discretion), and seek interim legal protection where a suspension threatens the practice. We coordinate the defence with any parallel criminal or professional-court proceedings. Legal recourse lies to the social courts.

This overview is general in nature. Decisive are Section 81(5) SGB V and the disciplinary regulation of the respective association. We act nationwide.

Summons or accusation of Disziplinarverfahren der Kassenärztlichen Vereinigung (§ 81 SGB V)? What matters now

Two things matter immediately: say nothing to the police about the allegation – you are never obliged to – and have your defense obtain the investigation file first. In detail: your rights as an accused person, responding to a police summons.

Possible discontinuation of proceedings

Not every case ends in a trial. Depending on the evidence and any prior record, the proceedings may be discontinued for lack of sufficient suspicion (§ 170 II StPO), for triviality (§ 153 StPO) or subject to conditions (§ 153a StPO). Often a penalty order without a public trial can be achieved.

Victim-offender mediation and restitution

In many cases, victim-offender mediation or making good the damage (§ 46a StGB) can significantly reduce the sentence or enable a discontinuation. Whether this is advisable in your case is something we assess based on the file.

What we do after reviewing the file

We assess the evidence, look for procedural errors and negotiate with the prosecution about a discontinuation.

Available 24/7: +49 228 504 463 36

This information does not replace a review of the individual case. In criminal proceedings, the defense strategy depends substantially on the case file, the specific allegation and the evidence.