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 	  	  Index:	  	                                                                                                         ...
 	  A	  summary	  of	  the	  legal	  and	  regulatory	  situation	  for	  chiropractic	  in	  Europe.	  Norway:	  Licensed...
 	  A	  chiropractic	  education	  has	  been	  established	  under	  the	  medical	  faculty	  at	  the	  University	  of...
 	                                                LEGAL	  REGULATIONS	  RELATING	  TO	  CHIROPRACTIC	                     ...
 	  ninth	  covering	  a	  further	  19	  professions.	  An	  over-­‐arching	  regulator,	  the	  Council	  for	  Healthca...
 	  There	  is	  no	  specific	  law	  for	  chiropractic.	  Chiropractors	  are	  primary	  caregivers,	  responsible	  f...
 	  Dansk	  Kiropraktor	  Forening	  	                                                                                    ...
 	  The	  DCA	  and	  the	  National	  Health	  Insurance	  negotiate	  the	  agreement	  every	  3	  years.	  The	  Danis...
 	  Chiropractic:	  the	  UK	  legislative	  position	                                                                    ...
 	  	                    Norwegian	  Law:	  Extracts	  concerning	  the	  practise	  of	  chiropractic	  and	  chiropracto...
 	  	  	  	  	  	  	  	  The	  right	  to	  authorisation	  upon	  application	  is	  granted	  to	  anyone	  who:	  	    ...
 	            	  2.	                                	  	  OF	  2000-­‐12-­‐21	  no	  1385:	  Regulations	  concerning	  pa...
 	  3.	  	                                              	  	   Act	  relating	  to	  Social	  Insurance	  (Social	  insura...
 	  Amended	  by	  Act	  of	  19	  June	  1997	  no.	  87	  (in	  force	  1	  July	  1998	  under	  Decree	  19	  June	  1...
 	          A	  doctor’s	  certificate	  must	  be	  submitted	  no	  later	  than	  eight	  weeks	  from	  the	  commence...
 	                                  	  	   Act	  relating	  to	  Patients’	  Rights	  (Patients’	  Rights	  Act).	  	     ...
 	  In	  order	  to	  be	  able	  to	  refer	  to	  a	  specialist	  doctor	  and	  physiotherapist	  and	  to	  be	  able...
 	  K4.	  Telephone	  conversations/written	  communications	  about	  individual	  patients	  with	  doctors,	  physiothe...
 	                      	  	  FOR	  2003-­‐12-­‐19	  no	  1728:	  Regulation	  on	  the	  cover	  of	  the	  cost	  of	  t...
 	  Physiotherapists	  wishing	  to	  certify	  incapacity	  to	  work	  must	  have	  authorisation	  under	  the	  Healt...
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  1. 1.               EUROPEAN CHIROPRACTORS´ UNION The Glasshouse 5a Hampton Hill Road Hampton Middlesex TW12 1JN     Page  |  1  
  2. 2.      Index:     Page  No    Summary  of  the  legal  and  regulatory  situation  for  Chiropractic  in  Europe 3-­‐4  Legal  regulations  relating  to  Chiropractic   5-­‐7  Legal  regulation  of  Chiropractors  in  Denmark   8-­‐9  Legal  regulation  of  Chiropractors  in  Great  Britain   10  Legal  regulations  in  Norway   11-­‐27  Legal  regulations  in  Sweden   28  Legal  regulations  in  Switzerland   29  European  Chiropractors’  Union  Constitution   30-­‐35  ECCE  Constitution   37-­‐45  Bylaws  of  the  European  Academy  of  Chiropractic   46-­‐49  Institutions  holding  Accredited  status  with  the  ECCE   50-­‐53  Letter  from  the  ENQA  to  President  of  the  ECCE   54-­‐55 Page  |  2  
  3. 3.    A  summary  of  the  legal  and  regulatory  situation  for  chiropractic  in  Europe.  Norway:  Licensed  as  an  independent  health  profession  since  1988  Title  protection.  All  patients  are  partially  reimbursed  by  the  state  Chiropractors  have  the  legal  right  to  take  their  own  x-­‐rays.  Chiropractors  can  refer  patients  for  x-­‐rays,  MRI,  CT  scans,  ultrasound  diagnostic.  Chiropractors  can  refer  patients  to  a  medical  specialist.  Chiropractors  can  refer  patients  to  physiotherapy.  Chiropractors  can  sick  leave  their  patients  up  to  12  weeks.  The  patient’s  right  to  have  reimbursed  travel  expenses  when  going  for  chiropractic  treatments,  are  regulated  by  law.  The  Government  has  established  a  fund  for  post  graduate  education  for  chiropractors.  The  Government  gives  financial  support  for  the  infrastructure  of  chiropractic  research.  Most  insurance  companies  fully  reimburse  chiropractic  treatment.    Sweden:  Licensed  as  an  independent  health  profession  since  1989  Title  protection  All  patients  who  seek  a  chiropractor  with  care  contract  are  reimbursed.    Denmark:  Licensed  as  an  independent  health  profession  since  1991  Title  protection  Chiropractors  have  the  legal  right  to  take  their  own  X-­‐rays.  Chiropractors  have  full  rights  with  respect  to  diagnostic  ultrasound.  Some  regions  give  chiropractors  permission  to  refer  to  MR  and  CT  by  special  agreement.  All  patients  are  partially  reimbursed  by  the  state.  Most  insurance  companies  fully  reimburse  chiropractic  services.  The  Government  has  established  a  fund  for  post  graduate  education  for  chiropractors.  The  Government  support  chiropractic  research.   Page  |  3  
  4. 4.    A  chiropractic  education  has  been  established  under  the  medical  faculty  at  the  University  of  Southern  Denmark  in  Odense.    United  Kingdom:  Licensed  and  regulated  as  an  independent  health  profession  since  1994.  Title  protection  Chiropractic  is  one  of  only  eight  independently  regulated  health  professions  in  the  UK  Chiropractors  have  the  legal  right  to  take  their  own  x-­‐rays.  Chiropractic  education  is  provided  by  the  University  of  Bournemouth  (Angle  European  College  of  Chiropractic),  the  University  of  Glamorgan  (Welsh  Institute  of  Chiropractic)  and  the  McTimoney  College  of  Chiropractic.    Switzerland:  Licensed  as  an  independent  health  profession.  Licensed  as  one  of  five  medical  professions.  (Medicine,  dentistry,  veterinary  medicine,  pharmacy  and  chiropractic)  Title  protection  All  patients  are  partially  reimbursed  by  the  state  Chiropractors  have  the  legal  right  to  take  their  own  x-­‐rays.  Chiropractors  have  limited  prescription  rights.  (Painkillers  and  anti-­‐inflammatory  drugs)  Chiropractors  can  refer  patients  for  x-­‐rays,  MRI,  CT  scans,  ultrasound  diagnostic.  Chiropractors  can  refer  patients  to  a  medical  specialist.  Chiropractors  can  refer  patients  to  physiotherapy.  Chiropractors  can  sick  leave  patients.  Most  insurance  companies  fully  reimburse  chiropractic  treatment.  A  chiropractic  education  has  been  established  under  the  medical  faculty  at  the  University  of  Zürich.         Page  |  4  
  5. 5.     LEGAL  REGULATIONS  RELATING  TO  CHIROPRACTIC   Denmark¸  Great  Britain,  Norway,  Sweden,  Switzerland      DENMARK  Authorization  Chiropractors  have  been  authorized  in  Denmark  since  1991.    Chiropractors  are  granted  authorization  from  the  National  Board  of  Health  after  completing  a  five-­‐year  Master’s  Degree.  The  authorization  gives  the  right  to  practice  in  subordinate  positions  in  hospitals  or  clinics  under  the  supervision  of  a  chiropractor  with  authorization  to  practice  independently.  Authorization  to  practice  independently  is  issued  by  the  National  Board  of  Health  after  an  additional  one-­‐year  practical  training  (internship).  The  Law  of  autorisation:  (Bekendtgørelse  af  lov  om  autorisation  af  sundhedspersoner  og  om  sundhedsfaglig  virksomhed)  https://www.retsinformation.dk/Forms/R0710.aspx?id=121913#Kap12    The  Law  of  Permission  to  Practice  Independently  as  a  Chiropractor:    (Bekendtgørelse  om  tilladelse  til  selvstændigt  virke  som  kiropraktor)  https://www.retsinformation.dk/Forms/R0710.aspx?id=125562    National  Board  of  Health  http://www.sst.dk/English/Education%20and%20authorization/Chiropractor.aspx  Practicing  in  Denmark  The  Law  that  regulates  chiropractic  in  Denmark  is  called  ‘Bekendtgørelse  om  kiropraktorvirksomhed’:  https://www.retsinformation.dk/Forms/R0710.aspx?id=46331  In  Denmark  there  is  direct  access  for  patients  to  chiropractors  so  there  is  no  need  for  a  medical  referral  prior  to  this.  The  right  of  direct  access  for  patients  is  regulated  through  the    National  Law  of  Health  (Sundhedsloven):  https://www.retsinformation.dk/forms/r0710.aspx?id=130455&exp=1    Chiropractors  have  the  right  to  diagnose  patients  independently  and  no  medical  referral  is  required  as  a  condition  for  grants  from  the  National  Health  Service.    Through  their  training  chiropractors  achieve  competences  within  the  medical  imaging  field,  and  all  practicing  chiropractors  have  access  to  X-­‐ray  facilities.    Some  regions  give  chiropractors  permission  to  refer  to  MR  and  CT  by  special  agreement.  Chiropractors  have  full  rights  with  respect  to  diagnostic  ultrasound  (take  and  read).    National  Health  Insurance  According  to  the  Act  on  National  Health  Insurance  patients  are  reimbursed  for  some  of  their  expenses  in  connection  with  chiropractic  examination  and  treatment  through  the  National  Health  Insurance.    In  average  the  patients  pay  approximately  80%  of  the  expenses  for  chiropractic  treatment  and  have  20%  of  the  expenses  reimbursed  by  the  National  Health  Insurance.    GREAT  BRITAIN  The  Chiropractors  Act  1994  is  the  relevant  legislation  in  the  UK.  Prior  to  this,  the  chiropractic  profession  was  self-­‐regulated  but  the  passing  of  the  Act  provided  for  the  establishment  of  a  statutory  regulator,  the  General  Chiropractic  Council,  which  is  responsible  for  regulating  and  developing  the  chiropractic  profession.  The  GCC  publishes  a  Code  of  Practice  and  Standard  of  Proficiency  which  sets  out  the  standards  of  conduct  and  practice  required  for  safe  and  competent  practice.    Legislation  for  chiropractors  in  the  UK  means  that  it  is  a  criminal  offence  for  anyone  to  call  themselves  a  chiropractor  unless  they  are  registered  with  the  GCC.  Chiropractic  is  one  of  one  of  only  eight  independently  regulated  health  professions  in  the  UK,  the   Page  |  5  
  6. 6.    ninth  covering  a  further  19  professions.  An  over-­‐arching  regulator,  the  Council  for  Healthcare  Regulatory  Excellence,  oversees  the  performance  of  the  UK  health  regulators.    The  UK  legislation  on  chiropractic  largely  mirrors  that  for  other  UK  statutorily-­‐regulated  professions.  It  is  regarded  as  sound  legislation,  but  in  keeping  with  all  other  regulators  it  will  be  subjected  to  review  within  the  next  few  years.  There  is  a  Law  Commission  inquiry  looking  at  all  regulators  and  their  relative  fitness  for  purpose;  reform  is  likely  as  part  of  the  current  Government’s  agenda  for  change.    It  is  mandatory  for  chiropractors  to  undertake  a  minimum  of  30  hours  continuing  professional  development  each  year.  This  is  regularly  audited  by  the  GCC.  The  Department  of  Health  has  indicated  that  it  will  be  asking  the  regulators  to  introduce  a  scheme  of  revalidation  as  part  of  its  reform  of  the  UK  Health  Service.    Chiropractic  education  in  the  UK  is  delivered  by  three  GCC-­‐accredited  educational  providers:  the  Anglo-­‐European  College  of  Chiropractic,  the  Welsh  Institute  of  Chiropractic  and  the  McTimoney  College  of  Chiropractic,  all  of  whom  deliver  Masters  level  awards.  The  first  two  of  these  institutions  also  enjoy  fully  accredited  status  with  the  European  Council  on  Chiropractic  Education,  the  quality  assurance  agency  for  chiropractic  education  in  Europe.    The  British  Chiropractic  Association  is  the  largest  member  of  the  European  Chiropractors’  Union  and  has  around  1350  members.  There  are  in  total  approximately  2700  registered  chiropractors  in  the  UK,  the  balance  being  represented  by  three  other  associations.  Its  President  is  Richard  Brown,  who  is  also  the  Secretary  of  the  European  Chiropractors  Union.  The  BCA  is  a  stakeholder  in  the  CEN  standardisation  process  currently  developing  a  standard  for  the  services  of  chiropractors.      NORWAY  Chiropractors  have  been  authorised  in  Norway  since  1989.  A  new  law  was  passed  in  1999,  Act  of  2.  July  1999,  no  64  relating  to  Health  Personnel  etc.  (The  Health  Personnel  Act)  that  applies  to  all  groups  of  authorized  health  professions  including  chiropractors.  Title  protection  follows  with  authorization  as  stated  in  §  74.  English  translation  Authorization  requirements  are  defined  in  the  same  act  (§  48.)  and  is  education  from  an  ECCE/CCEI-­‐accredited  institution  followed  by  a  one  year  internship  (§  76.).  Rules  and  regulations  for  the  internship  year  are  given  in  FOR  2000-­‐12-­‐21  nr  1382  from  the  Department  of  Health  and:  IK-­‐10/2001  from  the  Norwegian  Board  of  Health  Supervision.  The  chiropractors  are  responsible  for  their  own  diagnosis  and  treatment  based  on  the  general  principle  of  responsible  conduct  as  defined  in  the  Act  §4.  All  patients  are  entitled  to  partial  reimbursement  for  chiropractic  care  (limited  to  14  treatments  per  year)  and  can  seek  care  directly  (no  medical  referral  necessary).  Chiropractors  can  prescribe  sick  leave  (up  to  twelve  weeks  and  limited  to  musculoskeletal  conditions),  and  refer  to  hospitals,  medical  specialists,  physiotherapy  and  diagnostic  imaging  including  CT-­‐  and  MRI-­‐scans.  All  services  referred  to  above  within  the  national  health  system  are  reimbursed  on  equal  terms  as  medical  referrals.      The  regulations  and  requirements  for  the  chiropractor  to  execute  the  rights  above  are  defined  in  FOR  2005-­‐12-­‐21  nr  1668.  Chiropractors  are  also  allowed  to  take  their  own  x-­‐rays,  but  National  Insurance  does  not  reimburse  this.  This  activity  is  regulated  by  the  National  Radiation  Protection  Agency.  Patient  safety  and  protection  is  regulated  by  law  and  chiropractors  were  included  together  with  all  other  authorized  private  practitioners  by  revision  Pasientskadeloven  from  2009  and  at  the  same  time  included  in  the  National  patient  accident  insurance  pool  (NPE).        SWEDEN  Chiropractors  have  been  licensed  in  Sweden  since  1989.    All  authorised  health  personnel  today  adhere  to  one  law.  The  law  on  patient  safety  passed  in  2010.  The  law  includes  a  title  protection  for  chiropractors.   Page  |  6  
  7. 7.    There  is  no  specific  law  for  chiropractic.  Chiropractors  are  primary  caregivers,  responsible  for  diagnosis  and  treatment  and  should  like  all  other  licensed  health  professionals  adhere  to  evidence  based  care  according  to  the  law.  The  law  on  patient  safety:  http://www.riksdagen.se/webbnav/index.aspx?nid=3911&bet=2010:659  The  National  Agency  for  Health  and  Social  Welfares  Directive  on  patient  safety,  Patientsäkerhetsförordningen  (2010:1369),  regulates  the  required  professional  qualification  for  chiropractors.  The  minimum  requirement  is  a  four  year  degree  and  one  year  practical,  supervised  training  according  to  4§  chapter  3.  See  Patientsäkerhetsförordningen  (2010:1369),  3  Kap  4§:  http://www.notisum.se/rnp/sls/lag/20101369.htm    Tobias  Lauritsen  President,  Swedish  Chiropractic  Association      SWITZERLAND  The  Chiropractic  profession  is  regulated  on  a  federal  and  a  cantonal  level.    Federal  legislation  Federal  law  on  education,  postgraduate  and  continuing  education  and  professional  activity  of  the  MDs,  the  dentists,  the  DCs,  the  pharmacists  and  the  veterinarians  (MedBG/LPMéd).    http://www.admin.ch/ch/d/sr/c811_11.html    Chiropractic  treatments  are  reimbursed  by  the  social  insurances.  Sickness  insurance:  http://www.admin.ch/ch/d/sr/c832_10.html  Accident  insurance  http://www.admin.ch/ch/d/sr/c832_20.html  Radioprotection:  http://www.admin.ch/ch/d/sr/c814_50.html    Cantonal  legislation  There  are  26  cantons;  each  canton  has  its  own  regulation.       Page  |  7  
  8. 8.    Dansk  Kiropraktor  Forening      LEGAL  REGULATION  OF  CHIROPRACTORS  IN  DENMARK  Authorization  Chiropractors  have  been  authorized  in  Denmark  since  1991.  Chiropractors  are  granted  authorization  from  the  National  Board  of  Health  after  completing  a  five-­‐year  Master’s  Degree.  The  authorization  gives  the  right  to  practice  in  subordinate  positions  in  hospitals  or  clinics  under  the  supervision  of  a  chiropractor  with  authorization  to  practice  independently.  Authorization  to  practice  independently  is  issued  by  the  National  Board  of  Health  after  an  additional  one-­‐year  practical  training  (internship).  The  Law  of  autorisation:      (Bekendtgørelse  af  lov  om  autorisation  af  sundhedspersoner  og  om  sundhedsfaglig  virksomhed)  https://www.retsinformation.dk/Forms/R0710.aspx?id=121913#Kap12  The  Law  of  Permission  to  Practice  Independently  as  a  Chiropractor:  (Bekendtgørelse  om  tilladelse  til  selvstændigt  virke  som  kiropraktor)  https://www.retsinformation.dk/Forms/R0710.aspx?id=125562  National  Board  of  Health  http://www.sst.dk/English/Education%20and%20authorization/Chiropractor.aspx  Practicing  in  Denmark  The  Law  that  regulates  chiropractic  in  Denmark  is  called  ‘Bekendtgørelse  om  kiropraktorvirksomhed’:  https://www.retsinformation.dk/Forms/R0710.aspx?id=46331  In  Denmark  there  is  direct  access  for  patients  to  chiropractors  so  there  is  no  need  for  a  medical  referral  prior  to  this.  The  right  of  direct  access  for  patients  is  regulated  through  the  National  Law  of  Health  (Sundhedsloven):  https://www.retsinformation.dk/forms/r0710.aspx?id=130455&exp=1  Chiropractors  have  the  right  to  diagnose  patients  independently  and  no  medical  referral  is  required  as  a  condition  for  grants  from  the  National  Health  Service.  Through  their  training  chiropractors  achieve  competences  within  the  medical  imaging  field,  and  all  practicing  chiropractors  have  access  to  X-­‐ray  facilities.  Some  regions  give  chiropractors  permission  to  refer  to  MR  and  CT  by  special  agreement.  Chiropractors  have  full  rights  with  respect  to  diagnostic  ultrasound  (take  and  read).  National  Health  Insurance  According  to  the  Act  on  National  Health  Insurance  patients  are  reimbursed  for  some  of  their  expenses  in  connection  with  chiropractic  examination  and  treatment  through  the  National  Health  Insurance.  In  average  the  patients  pay  approximately  80%  of  the  expenses  for  chiropractic  treatment  and  have  20%  of  the  expenses  reimbursed  by  the  National  Health  Insurance.  The  Law  that  regulates  the  subsidy  to  chiropractic  treatment  is  called  ’Bekendtgørelse  om  tilskud  til  kiro-­‐  praktisk  behandling  i  praksissektoren’:  http://www.danskkiropraktorforening.dk/Global/DKF-­‐  dokument-­‐  er/Praksisomr%c3%a5det/Bekendtg%c3%b8relse%20om%20tilskud%20til%20kiropraktisk%20behandling%20i%20pra  ksissektoren.mht   Page  |  8  
  9. 9.    The  DCA  and  the  National  Health  Insurance  negotiate  the  agreement  every  3  years.  The  Danish  Chiropractic  Education  at  University  of  Southern  Denmark  The  University  of  Southern  Denmark  is  the  only  educational  institution  in  the  Nordic  countries  with  a  graduate  program  in  clinical  biomechanics  (chiropractic).  The  full  study  program  consists  of:  •      a  3  year  bachelor  program  •      a  2  year  graduate  program  (following  the  BA  program)  •      a  house  year  (following  the  graduate  program)  About  half  of  the  students  come  from  Denmark  while  the  other  half  come  from  the  other  Nordic  countries.  The  education  enjoys  fully  accredited  status  with  the  European  Council  on  Chiropractic  Education,  the  quality  assurance  agency  for  chiropractic  education  in  Europe.  The  Danish  Chiropractic  Education  at  University  of  Southern  Denmark:  http://www.sdu.dk/en/Uddannelse/kandidat/klinisk_biomekanik  The  Danish  Chiropractic  Association  (DCA)  The  DCA  was  established  in  1925.  Today  the  association  represents  almost  700  members  who  are  working  as  chiropractors  in  Denmark  or  are  studying  chiropractic.  Since  2006  the  chairman  of  the  board  of  the  DCA  has  been  Peter  Kryger-­‐Baggesen.   Page  |  9  
  10. 10.    Chiropractic:  the  UK  legislative  position      The  Chiropractors  Act  1994  is  the  relevant  legislation  in  the  UK.  Prior  to  this,  the  chiropractic  profession  was  self-­‐regulated  but  the  passing  of  the  Act  provided  for  the  establishment  of  a  statutory  regulator,  the  General  Chiropractic  Council,  which  is  responsible  for  regulating  and  developing  the  chiropractic  profession.  The  GCC  publishes  a  Code  of  Practice  and    Standard  of  Proficiency  which  sets  out  the  standards  of  conduct  and  practice  required  for  safe  and  competent  practice.    Legislation  for  chiropractors  in  the  UK  means  that  it  is  a  criminal  offence  for  anyone  to  call  themselves  a  chiropractor  unless  they  are  registered  with  the  GCC.  Chiropractic  is  one  of  only  eight  independently  regulated  health  professions  in  the  UK,  the  ninth  covering  a  further  19  professions.  An  over-­‐arching  regulator,  the  Council  for  Healthcare  Regulatory  Excellence,  oversees  the  performance  of  the  UK  health  regulators.    The  UK  legislation  on  chiropractic  largely  mirrors  that  for  other  UK  statutorily-­‐regulated  professions.  It  is  regarded  as  sound  legislation,  but  in  keeping  with  all  other  regulators  it  will  be  subjected  to  review  within  the  next  few  years.  There  is  a  Law  Commission  inquiry  looking  at  all  regulators  and  their  relative  fitness  for  purpose;  reform  is  likely  as  part  of  the  current  Government’s  agenda  for  change.    It  is  mandatory  for  chiropractors  to  undertake  a  minimum  of  30  hours  continuing  professional  development  each  year.  This  is  regularly  audited  by  the  GCC.  The  Department  of  Health  has  indicated  that  it  will  be  asking  the  regulators  to  introduce  a  scheme  of  revalidation  as  part  of  its  reform  of  the  UK  Health  Service.    Chiropractic  education  in  the  UK  is  delivered  by  three  GCC-­‐accredited  educational  providers:  the  Anglo-­‐European  College  of  Chiropractic,  the  Welsh  Institute  of  Chiropractic  and  the  McTimoney  College  of  Chiropractic,  all  of  whom  deliver  Masters  level  awards.  The  first  two  of  these  institutions  also  enjoy  fully  accredited  status  with  the  European  Council  on  Chiropractic  Education,  the  quality  assurance  agency  for  chiropractic  education  in  Europe.    The  British  Chiropractic  Association  is  the  largest  member  of  the  European  Chiropractors’  Union  and  has  around  1350  members.  There  are  in  total  approximately  2700  registered  chiropractors  in  the  UK,  the  balance  being  represented  by  three  other  associations.  Its  President  is  Richard  Brown,  who  is  also  the  Secretary  of  the  European  Chiropractors  Union.  The  BCA  is  a  stakeholder  in  the  CEN  standardisation  process  currently  developing  a  standard  for  the  services  of  chiropractors.       Page  |  10  
  11. 11.       Norwegian  Law:  Extracts  concerning  the  practise  of  chiropractic  and  chiropractors.       Act  Relating  to  Health  Personnel  etc.  (Health  Personnel  Act).  DATE:   ACT-­‐1999-­‐07-­‐02-­‐64    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  Services)    ENTRY  INTO  FORCE:  2001-­‐01-­‐01,  Royal  decree,  2000-­‐04-­‐14    LAST  AMENDED:   ACT-­‐2003-­‐08-­‐29-­‐87  of  2003-­‐09-­‐01    AMENDING:    ABBREVIATION:   Health  Personnel  Act  -­‐  hlspl.      Chapter  9.  Conditions  for  authorisation,  licensing  and  certificate  of  completion  of  specialist  training  §  48.  Authorisation                  The  authorisation  system  under  this  act  covers  the  following  categories  of  health  personnel:     a)  Emergency  medical  technician   b)  Pharmaceutical  technician   c)  Audiologist   d)  Medical  laboratory  technician   e)  Occupational  therapist   f)  Pharmacist     g)  Chiropodist   h)  Physiotherapist   i)  Medical  secretary   j)  Auxiliary  nurse   k)  Midwife     l)  Chiropractor   m)  Clinical  nutritionist     n)  Doctor   o)  Care  worker   p)  Optician   q)  Prosthetist   r)  Orthoptist     s)  Perfusionist   t)  Psychologist   u)  Radiographer   v)  Nurse   w)  Dental  secretary   x)  Dentist   y)  Dental  nurse   z)  Dental  technician   æ)  Social  educator   Page  |  11  
  12. 12.                  The  right  to  authorisation  upon  application  is  granted  to  anyone  who:     a)  has  passed  the  examination  in  the  relevant  subject  at  a  Norwegian  university,  technical  college  or  advanced  occupational   training,     b)  Has  completed  the  practical  training  laid  down  by  the  Ministry  in  the  regulations,     c)  is  under  the  age  of  75,  and   d)  Who  is  not  unfit  for  the  profession?                  The  right  to  authorisation  upon  application  is  also  granted  to  anyone  who:     a)  Has  a  foreign  examination  qualification  which  is  recognised  as  equivalent  to  the  corresponding  Norwegian  examination,     b)  Has  a  foreign  qualification  which  is  recognised  under  an  agreement  on  reciprocal  approval  under  §  52,  or     c)  Has  otherwise  demonstrated  that  he/she  possesses  the  necessary  skills.     The  Ministry  may  in  its  regulations  specify  that  the  categories  of  health  personnel  that  are  not  covered  under  section  1  may   be  granted  authorisation  on  application.  The  decision  will  place  particular  emphasis  on  considerations  of  patient  safety,  the   content  and  purpose  of  training,  the  extent  to  which  the  profession  is  practiced  independently  and  considerations  of   harmonisation  with  other  countries.     The  Ministry  may  in  its  regulations  specify  additional  requirements  for  the  authorisation  of  individual  groups  of  health   personnel,  for  example  that  the  requirements  shall  also  apply  to  those  who  already  have  authorisation  or  official  certification   at  the  time  the  regulations  come  into  force.    Amended  by  Act  of  21  Dec  2000  no.  127  (in  force  1  Jan  2001  pursuant  to  Decree  of  21  Dec  2000  no.  1359).    §  49.  Licence       Health  personnel  who  are  not  entitled  to  authorisation  under  §  48,  may  be  granted  a  licence  on  application.  Licences  may   only  be  granted  to  health  personnel  that  are  considered  suitable  with  regard  to  the  type  and  scope  of  the  licence.                Licences  may  also  be  granted  to  health  personnel  with  foreign  qualifications  which  are  recognised  under  the  agreement  on   reciprocal  approval  pursuant  to  §  52.                  The  licence  may  be  restricted  in  time,  to  a  specific  position,  to  certain  types  of  health  care  or  otherwise.                The  Ministry  may  set  more  specific  requirements  for  obtaining  a  license  and  the  conditions  attached  to  it,  including  a   provision  that  the  requirements  shall  apply  to  those  already  holding  a  license  at  the  time  these  regulations  come  into  force.    §  50.  Border  license     Public  employees  and  authorised  health  personnel  in  Sweden  and  Finland  working  along  the  border  with  Norway  may   practice  their  profession  in  Norwegian  local  authorities  along  the  border  without  Norwegian  authorisation  or  licensing  under   §§  48  and  49.    §  51.  Conditions  governing  the  certificate  of  completion  of  specialist  training                The  Ministry  may  stipulate  requirements  concerning  the  conditions  for  approval  of  authorised  health  personnel  as  specialists   within  a  defined  section  of  the  specialist  health  area,  including  a  provision  that  the  requirements  shall  apply  to  those  who   already  hold  a  certificate  of  completion  of  specialist  training  when  these  regulations  come  into  force.    §  52.  International  agreements     On  the  basis  of  mutual  approval  agreements  with  other  countries,  authorisation,  licenses  and  certificates  of  completion  of   specialist  training  may  be  granted  to  foreign  citizens.     The  Ministry  may  in  its  regulations  make  further  provisions  to  supplement  section  1,  and  may  in  this  connection  set  special   conditions  for  approval  which  are  necessary  in  order  to  comply  with  international  agreements.         Page  |  12  
  13. 13.      2.      OF  2000-­‐12-­‐21  no  1385:  Regulations  concerning  patient  records  DATE:  FOR-­‐2000-­‐12-­‐21-­‐1385    DEPARTMENT:HOD  (Ministry  of  Health  and  Care  Services)    DEPT/OFFICE:  Health  department    PUBLISHED:In  2000  3107  (Comments)    ENTRY  INTO  FORCE:2001-­‐01-­‐01    LAST  AMENDED:  FOR-­‐2003-­‐02-­‐25-­‐232  of  2003-­‐03-­‐03    AMENDING:  VALID  FOR:  Norway    AUTHORITY:  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§40,  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§42,  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§43,  ACT-­‐1999-­‐07-­‐02-­‐64-­‐§45,  ACT-­‐1999-­‐07-­‐02-­‐61-­‐§3-­‐2,  ACT-­‐1982-­‐11-­‐19-­‐66-­‐§1-­‐3a,  ACT-­‐1983-­‐06-­‐03-­‐54-­‐§1-­‐3a,  ACT-­‐1999-­‐07-­‐02-­‐63-­‐§5-­‐1  Provisions  concerning  patient  records.  §  4.  (Record  system)    Practices  where  healthcare  is  provided  must  set  up  a  patient  record  system.  The  system  must  operate  in  a  way  which  ensures  that  requirements  established  in  or  in  support  of  the  law  can  be  met,  including  rules  on:     a)  right  to  view  records  cf.  Health  Personnel  Act  §  41  and  Patients’  Rights  Act  §  5-­‐1,     b)  Access  to  and  disclosure  of  records,  cf.  Health  Personnel  Act  §  25  and  §  45  and  the  Patients’  Rights  Act  §  5-­‐3,     c)  Reporting  obligations  and  obligation  of  information,  cf.  Health  Personnel  Act  Chapter  6  and  7,     d)  Drafting  of  the  record,  cf.  Health  Personnel  Act  §  39  Section  2,     e)  Correction  and  deletion,  cf.  Health  Personnel  Act  §  42,  §  43  and  §  44  and     f)  Security  against  access  by  unauthorised  persons,  cf.  Health  Personnel  Act  Chapter  5,  including  secure  safekeeping,  cf.   Health  Personnel  Act  §  21.         Page  |  13  
  14. 14.    3.         Act  relating  to  Social  Insurance  (Social  insurance  Act).      DATE:   ACT-­‐1997-­‐02-­‐28-­‐19    DEPARTMENT:   AID  (Ministry  of  Labour  and  Social  Inclusion)    PUBLISHED:    ENTRY  INTO  FORCE:  1997-­‐05-­‐01    LAST  AMENDED:   ACT-­‐2005-­‐12-­‐21-­‐127  of  2006-­‐01-­‐01    AMENDING:    ABBREVIATION:   Social  insurance  law  -­‐  ftrl.    Chapter  5.  Benefits  in  health  services                    Provisions  concerning     -­‐  Aims  are  in  §  5-­‐1     -­‐  Membership  in  §  5-­‐2     -­‐  Upper  expenditure  limit  for  individual  contribution  in  §  5-­‐3     -­‐  Cover  for  cost  of  examination  and  treatment  in  §§  5-­‐4  to  5-­‐12     -­‐  Support  for  birth  outside  institutions  in  §  5-­‐13     -­‐  Cover  for  expenditure  on  medication  etc.  in  §  5-­‐14     -­‐  Cover  for  the  costs  of  important  drugs  which  are  also  used  in  hospital,  in  §  5-­‐15     -­‐  Fixed  salary  subsidy  are  in  §  5-­‐21     -­‐  Contributions  in  §  5-­‐22     -­‐  Exceptions  for  military  personnel  in  §  5-­‐23     -­‐  Benefits  for  health  services  abroad  in  §  5-­‐24     -­‐  Benefit  in  the  event  of  occupational  injury  in  §  5-­‐25     -­‐  Benefits  for  sickness  which  arose  in  the  period  during  which  there  was  no  right  to  benefit,  in  §  5-­‐26.    Amended  by  acts  of  14  June  2002  no.  22,  28  June  2002  no.  52  (in  force  1  July  2002  under.  Decree  28  June  2002  no.  692),  20  Dec.  2002  no  100  (in  force  1Jan  2003  under.  Decree  20  Dec  2002  no.  1804),  20  June  2003  no.  45  (in  force  1  July  2003  under.  Decree  20  June  2003  no.  712),  28  Nov  2003  no.  96  (in  force  1  Jan  2004),  21  Dec  2005  no.  127  (in  force  1  Jan  2006).    §  5-­‐8.  Physiotherapy     The  insurance  system  pays  benefit  to  cover  the  cost  of  examination  and  treatment  by  physiotherapists.     Benefits  for  physiotherapy  are  only  granted  if  the  physiotherapist  has  an  agreement  on  operating  subsidies  with  the  local   authority,  see  Municipal  Health  Services  Act  §  5-­‐1.     The  right  to  benefit  is  conditional  upon  the  member  being  referred  by  a  doctor,  chiropractor  or  manual  therapist.  The   referral  requirement  does  not  apply  to  examination  and  treatment  by  a  manual  therapist.  The  treatment  must  be  of   considerable  importance  for  the  member’s  illness  and  ability  to  function.                  The  benefit  is  paid  on  the  basis  of  fixed  rates.     The  Ministry  establishes  regulations  concerning  benefits  pursuant  to  this  paragraph,  including  regulations  governing   contributions  for  combined  measures  by  physiotherapists,  and  it  may  in  its  provisions  make  exceptions  which  widen  the   circle  of  physiotherapist  under  Section  2.     Page  |  14  
  15. 15.    Amended  by  Act  of  19  June  1997  no.  87  (in  force  1  July  1998  under  Decree  19  June  1997  no.  617),  21  Dec  2001  no.  118,  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under  Decree  21  Dec  2005  no.  1606).    §  5-­‐9.  Treatment  by  chiropractors                The  insurance  system  provides  benefit  to  cover  the  cost  of  examination  and  treatment  by  chiropractors.                The  treatment  must  be  of  considerable  importance  to  the  member’s  ability  to  function.                The  benefit  is  paid  on  the  basis  of  fixed  rates.                The  Ministry  establishes  regulations  concerning  benefits  pursuant  to  this  paragraph,  including  regulations  governing   contributions  for  combined  measures  by  chiropractors.    Amended  by  Act  of  19  Dec  2003  no.  135  (in  force  1  Jan  2004),  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under  Decree  21  Dec  2005  no.  1606).    Chapter  8.  Sickness  benefit        Provisions  concerning   -­‐  Aims  are  in  §  8-­‐1     -­‐  General  conditions  for  the  right  to  sickness  benefit  in  §§  8-­‐2  to  8-­‐9     -­‐  The  basis  for  sickness  benefit  in  §  8-­‐10     -­‐  Sickness  benefit  days  in  §§  8-­‐11  and  8-­‐12     -­‐  Scaled  sickness  benefit  in  §  8-­‐13     -­‐  Subsidies  for  work-­‐related  travel  in  §  8-­‐14     -­‐  Sickness  benefits  for  employees  in  §§  8-­‐15  to  8-­‐33     -­‐  Sickness  benefits  for  self-­‐employed  traders  are  in  §§  8-­‐34  to  8-­‐37     -­‐  Sickness  benefits  for  freelancers  in  §§  8-­‐38  and  8-­‐39     -­‐  Sickness  benefits  for  members  with  combined  incomes  in  §§  8-­‐40  to  8-­‐43     -­‐  Sickness  benefits  for  special  groups  in  §§  8-­‐44  to  8-­‐47     -­‐  The  relationship  with  other  social  insurance  payments,  etc,  in  §§  8-­‐48  to  8-­‐52     -­‐  Sickness  benefit  during  a  stay  in  an  institution  in  §§  8-­‐53  and  8-­‐54     -­‐  Sickness  benefits  in  the  event  of  occupational  injury  in  §  8-­‐55.    §  8-­‐1.  Aim   The  aim  of  sickness  benefit  is  to  compensate  professionally  active  members  who  are  unable  to  work  because  of  sickness  or   injury,  for  loss  of  occupational  earnings.    §  8-­‐7.  Documentary  evidence  of  incapacity  to  work     To  qualify  for  sickness  benefit  the  member  must  have  his  incapacity  to  work  supported  by  a  doctor’s  certificate.  This  does   not  apply  during  the  qualifying  period  covered  by  the  employer,  when  the  employee  is  entitled  to  use  self-­‐certification,  see   §§  8-­‐18,  8-­‐19  and  8-­‐23  to  8-­‐27.     The  doctor’s  certificate  cannot  be  accepted  for  the  period  before  the  member  was  examined  by  the  doctor  (time  reported   sick).  A  doctor’s  certificate  for  the  period  before  the  member  consulted  a  doctor  may  nevertheless  be  accepted  if  the   member  has  been  prevented  from  consulting  a  doctor  and  it  is  agreed  that  he  or  she  has  been  unfit  for  work  from  an  earlier   date.     The  assessment  of  incapacity  to  work  shall  be  based  on  a  functional  assessment.  The  doctor  shall  in  all  cases  assess  whether   the  member  can  go  to  work  or  engage  in  a  work-­‐related  activity.  The  doctor  and  other  health  personnel  undertake,  in   collaboration  with  the  employee  and  if  applicable  the  employer,  to  provide  a  detailed  assessment  of  the  employee’s  ability   to  function.     Page  |  15  
  16. 16.     A  doctor’s  certificate  must  be  submitted  no  later  than  eight  weeks  from  the  commencement  of  the  period  of  incapacity  to   work  during  which  the  member  has  not  performed  any  work-­‐related  activity.    In  order  for  the  member  to  receive  payment  of   sickness  benefits  the  doctor’s  certificate  must  demonstrate  that  there  are  medical  reasons  preventing  performance  of  a   work-­‐related  activity.  The  statement  must  contain  a  report  of  the  future  treatment  programme  and  an  assessment  of  the   likelihood  of  the  person  being  able  to  resume  his  previous  job  or  do  other  work.     Sickness  benefit  may  however  be  paid  without  a  doctor’s  certificate  referred  to  in  section  four     a)  If  the  member  has  been  admitted  to  a  health  institution,     b)  If  the  suffering  is  so  serious  that  the  member  cannot  be  expected  to  be  fit  for  work  again,  or     c)  If  the  member  is  expected  to  be  pronounced  fit  within  a  short  period.                  For  a  member  without  an  employer  to  continue  to  qualify  for  payment  of  sickness  benefit,  the  local  national  insurance  office   th must,  no  later  than  the  end  of  the  12  week  of  incapacity  to  work,  assess  whether  the  medical  conditions  for  entitlement  to   sickness  benefit    have  been  met,  and  whether  there  is  a  need  for  medical,  occupational  or  other  action.  In  such  a  case  the   local  national  insurance  office  must  make  a  decision  in  writing  concerning  the  continued  right  to  sickness  benefit.  Exceptions   to  these  provisions  may  be  made  in  the  cases  referred  to  in  section  5.                  As  soon  as  possible  and  no  later  than  12  weeks  from  the  commencement  of  the  period  of  incapacity  to  work,  during  which   an  employee  who  is  registered  sick  has  not  performed  any  work-­‐related  activity,  the  local  national  insurance  office  shall   obtain  a  follow  up  plan,  except  when  such  a  plan  is  accepted  to  be  clearly  unnecessary,  cf.  §  25-­‐2  and  Working  Environment   Act  §  4-­‐6  Section  3.                  The  local  national  insurance  office  shall  as  soon  as  possible  assess  whether  occupational  rehabilitation  is  to  be  provided  if   internal  company  measures  are  not  forthcoming,  or  if  the  member  does  not  have  employment.  An  assessment  of  this  nature   shall  be  completed  by  the  end  of  the  period  of  sickness  benefit  at  the  latest.                  The  Ministry  may  establish  regulations  concerning  exceptions  to  the  condition  for  a  doctor’s  certificate  in  Section  1  for  a   limited  period,  if  evidence  of  the  incapacity  to  work  has  been  provided  by  a  statement  from  other  health  personnel.    Amended  by  Acts  of  22  March  2002  no.  7  (in  force  1  July  2002),  19  Dec  2003  no.  135  (see  III  thereof,  in  force  1  Jan  2004),  18  June  2004  no.  41  (in  force  1  July  2004),  17  June  2005  no.  62  (in  force  1  Jan  2006  under  Decree  17  June  2005  no.  609),  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under  Decree  21  Dec  2005  no.  1606).         Page  |  16  
  17. 17.         Act  relating  to  Patients’  Rights  (Patients’  Rights  Act).      DATE:   ACT-­‐1999-­‐07-­‐02-­‐63    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  Services)    ENTRY  INTO  FORCE:   2001-­‐01-­‐01,  2001-­‐07-­‐01    LAST  AMENDED:   ACT-­‐2005-­‐12-­‐21-­‐125  from  2006-­‐01-­‐01    AMENDING:    ABBREVIATION:   Patients’  Rights  Act  -­‐  pasrl.      Chapter  2.  Right  to  healthcare  and  transport    Heading  amended  by  Act  28  Nov  2003  no.  96  (in  force  1  Jan  2004).    §  2-­‐2.  Right  to  assessment     Patients  who  are  referred  to  a  hospital  or  specialist  outpatients’  department  covered  by  §  2-­‐4,  are  entitled  to  have  their   health  condition  assessed  within  30  working  days  from  when  the  referral  is  received.    The  need  for  healthcare  must  be   assessed  and  information  must  be  provided  about  when  provision  of  the  treatment  can  be  expected.     An  assessment  must  be  made  as  to  whether  the  patient  has  a  right  to  specialist  health  services  referred  to  in  §  2-­‐1  section  2   and,  if  applicable,  a  time  limit  should  be  set  as  referred  to  in  the  second  point  of  the  same  section.  Patients  who  have  such  a   right  must  be  informed  of  this  and  the  time  limit.  In  the  notification  the  patient  must  also  be  given  details  about  right  of   appeal,  appeal  time  limits  and  details  of  the  appeals  procedure.  The  referring  authority  must  also  be  informed.     The  assessment  must  be  conducted  on  the  basis  of  the  referral.  If  necessary  supplementary  information  shall  be  obtained  or   the  patient  shall  be  called  in  for  examination.     If  a  serious  or  life-­‐threatening  illness  is  suspected,  the  patient  has  the  right  to  an  earlier  assessment.    Amended  by  acts  12  Dec  2003  no.  110  (in  force  1  Sep  2004  under.  Decree  19  March  2004  no.  540),  21  Dec  2005  no.  125  (in  force  1  Jan  2006  under.  Decree  21  Dec  2005  no.  1606).    ·∙                Regulation  21.12.2005  concerning  benefit  to  cover  of  the  cost  of  treatment  by  chiropractors  (NY).  Regulation  concerning  benefit  to  cover  of  the  cost  of  treatment  by  chiropractors    Laid  down  by  the  Ministry  of  Health  and  Care  Services  21.  December  2005  pursuant  to  the  act  of  28.  February  1997  no.  19  on  social  insurance  §  5-­‐9  section  4,  §  22-­‐2  section  2.  Chapter  I  Regulations  §  1.  The  insurance  system  pays  benefit  to  cover  the  cost  of  examination  and  treatment  by  a  chiropractor  for  illnesses,  injury  or  disability  which  entitles  the  member  to  benefit  under  the  Social  Insurance  Act,  Chapter  5.  The  treatment  must  be  of  considerable  importance  to  the  member’s  ability  to  function.  §  2    Benefit  is  only  granted  if  the  treating  person  has  authorisation  as  a  chiropractor  under  the  Act  of  2.  July  1999  no.  64  concerning  health  personnel  etc.  §  48,  or  approval  under  previous  regulations,  cf.  health  personnel  act  §  76  section  2  or  an  internship  (turnus)  licence  as  a  chiropractor  in  accordance  with  the  regulation  of  21.  December  2000  no.  1382  concerning  practical  training  (internship)  for  health  personnel  Chapter  1  and  6.   Page  |  17  
  18. 18.    In  order  to  be  able  to  refer  to  a  specialist  doctor  and  physiotherapist  and  to  be  able  to  provide  documentary  evidence  of  incapacity  to  work  up  to  8  weeks,  it  is  a  condition  that  the  chiropractor  or  the  holder  of  an  internship  licence  as  a  chiropractor  has  the  necessary  skills  in  social  insurance  subjects  etc.  The  Ministry  will  establish  specific  requirements  regarding  the  content  and  scope  of  training.  §  3    The  insurance  system  pays  benefit  for  treatment  by  chiropractors  according  to  the  rates  in  §  7.  Benefit  is  paid  for  up  to  14  treatments  per  patient  per  treatment  year.  §  4  If  the  member  is  unable  to  get  to  the  place  of  treatment  on  account  of  his  condition  of  health  the  local  authority  will  cover  the  chiropractor’s  travel  expenses  under  the  Act  of  19.  November  1982  no.  66  on  Municipal  health  services  §  5-­‐1  sections  3  and  4.  §  5  The  insurance  service  may  enter  into  an  agreement  with  chiropractors  concerning  direct  settlement  with  the  insurance  scheme,  cf.  Social  Insurance  Act  §  22-­‐2  section  2.  The  benefit  is  then  paid  direct  to  the  chiropractor,  who  is  not  then  entitled  to  charge  the  member  for  parts  of  the  fee  covered  by  the  insurance  system.  The  National  Insurance  Administration  has  established  specific  rules  concerning  direct  settlement.  §  6    The  claim  for  benefit  to  cover  the  cost  of  treatment  by  a  chiropractor  must  be  accompanied  by  a  receipted,  itemised  invoice  from  the  chiropractor.  As  well  as  the  diagnosis  for  the  treatment  carried  out,  the  invoice  must  also  contain  all  the  information  which  is  required  to  decide  the  claim.  The  chiropractor  must  issue  the  invoice  on  a  form  stipulated  by  the  National  Insurance  Administration.  Claims  submitted  electronically  must  be  structured  in  accordance  with  the  file  format  set  by  the  National  Insurance  Administration.  §  7  Rates  K1.  Examination  upon  commencement  of  a  course  of  treatment     100  kroner.    K2.  Treatment  by  a  chiropractor,  per  time         50  kroner  Notes  to  rates  K1  and  K2:    Rate  K1  and  K2  may  not  be  combined  in  the  same  consultation.  Rate  K1  may  only  be  applied  once  per  series  of  treatment.  Series  of  treatment  means  the  number  of  consultations  which  are  required  for  the  same  illness/injury/disability.  The  rates  may  be  activated  a  total  of  14  times  per  patient  per  treatment  year.  K3a.  Indemnification  for  consultations  including  travel  time  when  the  chiropractor  works  in  conjunction  with  other  health  and  social  services  staff  as  part  of  a  treatment  or  rehabilitation  programme  for  individual  patients,  including  working  in  the  base  team.  The  rate  also  covers  practice  costs.  The  rate  cannot  be  used  in  conjunction  with  internal  collaboration  in  inter-­‐disciplinary  medical  centres  etc.  The  rate  cannot  be  used  as  payment  for  regular  collaboration  meetings,  unless  the  collaboration  relates  to  actual  patients.  Collaboration  may  include  diagnosis,  charting  of  rehabilitation  requirements,  drawing  up  and  following  of  the  rehabilitation  schedule,  assessment  of  level  of  function,  adaptation  of  the  environment  etc.  The  rate  is  calculated  for  the  entire  consultation/travel  time,  not  per  patient.  Reimbursement  of  travel  can  be  also  claimed  under  the  regulation  concerning  cover  of  transport  costs  of  health  personnel  in  connection  with  travel  to  conduct  an  examination  or  treatment.  The  rate  may  also  be  applied  when  the  consultation  is  conducted  over  the  telephone.    The  consultation  must  be  scheduled.  Per  half  hour  commenced       240  kroner  K3b.  Later  per  half  hour  commenced         240  kroner       Page  |  18  
  19. 19.    K4.  Telephone  conversations/written  communications  about  individual  patients  with  doctors,  physiotherapists  in  specialist  health  services,  chiropractors  in  specialist  health  services,  community  health  and  social  services  and  company  health  services.  The  rate  may  not  be  used  for  communication  with  the  referring  therapist  upon  commencement  of  the  series  of  treatment.                                                     40  kroner  §  8  Grant  for  common  use  by  chiropractors  The  insurance  system  pays  a  grant  corresponding  to  1.5  per  cent  of  the  insurance  scheme  expenditure  on  treatment  with  chiropractors  to  the  fund  for  further  and  subsequent  training  of  chiropractors.  The  grant  is  paid  by  the  National  Insurance  Administration  to  the  Norwegian  Chiropractors  Association  for  an  appropriate  amount  every  quarter  with  a  final  settlement  at  the  end  of  the  year.  §  9  Entry  into  Force  The  regulation  comes  into  effect  on  1.  January  2006.  As  from  the  same  date  the  regulation  of  18.  April  1997  no.  331  concerning  benefit  to  cover  the  cost  of  treatment  by  chiropractors  is  revoked.       Page  |  19  
  20. 20.        FOR  2003-­‐12-­‐19  no  1728:  Regulation  on  the  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  an  examination  or  treatment.  DATE:   FOR-­‐2003-­‐12-­‐19-­‐1728    DEPARTMENT:   HOD  (Ministry  of  Health  and  Care  services)    DEP/OFFICE:   Health  service  Department.    PUBLISHED:   In  2003  volume  18    ENTRY  INTO  FORCE:   2004-­‐01-­‐01    LAST  AMENDED:    AMENDING:   FOR-­‐1997-­‐03-­‐11-­‐215    VALID  FOR:   Norway    AUTHORITY:   ACT-­‐1982-­‐11-­‐19-­‐66-­‐§5-­‐1,  ACT-­‐1999-­‐07-­‐02-­‐61-­‐§2-­‐1a  CONTENTS  Regulation  concerning  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  examinations  and  treatment.            §  1.  Scope            §  2.  Conditions  of  cover          §  3.  Ambulatory  health  service  in  Finnmark            §  4.  Calculation  of  cover  of  cost  of  transport            §  5.  Fixed  transport  supplement            §  6.  Entry  into  force    Regulation  concerning  the  cover  of  the  cost  of  transport  of  health  personnel  etc.  in  connection  with  travel  to  conduct  examinations  or  treatment.    Laid  down  by  the  Ministry  of  Health  19.  December  2003  pursuant  to  the  act  of  19.  November  1982  no.  66  on  municipal  health  services  §  5-­‐1  section  4  and  the  act  of  2.  July  1999  no.  61  on  specialist  health  services  etc.  §  2-­‐1a  section  4    §  1.  Scope                The  Local  Authority  covers  the  transport  costs  of  health  personnel  when  health  personnel  have  to  travel  to  patients  to  conduct  examinations  or  treatment  for  which  benefit  is  granted  under  the  Social  Insurance  Act  Chapter  5.  This  does  not  however  apply  to  the  transport  costs  of  specialists  who  have  operational  agreements  with  regional  health  authorities  cf.  section  2.  The  local  authority  will  also  cover  the  cost  of  transport  if  the  treatment  is  given  by  employees  of  the  local  authority  health  service,  including  home  nursing,  first  aid  clinic  and  family  welfare  office.                  The  regional  health  authority  covers  transport  costs  for  health  personnel  employed  by  the  regional  health  authority,  including  specialists  who  have  operational  agreements  with  the  regional  health  authority  cf.  Social  Insurance  Act  §  5-­‐4  and  §  5-­‐7.    Provision  concerning  exceptions  from  the  condition  for  a  doctor’s  certificate  when  chiropractors  and  manual  therapists  certify  incapacity  to  work  in  a  statement  Laid  down  by  the  Ministry  of  Labour  and  Social  Affairs  21.  December  2005  by  virtue  of  the  law  of  28.  February  1997  no.  19  concerning  Social  Insurance  §  8-­‐7  section  9  §  1  Right  to  certify  incapacity  to  work  Chiropractors  wishing  to  certify  incapacity  to  work  must  have  authorisation  under  the  Health  Personnel  Act  §  48  or  approval  under  former  regulations,  cf.  Health  Personnel  Act  §  76  section  2.  Those  holding  an  internship  license  as  a  chiropractor,  cf.  regulation  of  21.  December  2000  no.  1382  concerning  practical  training  (internship)  for  health  personnel  Chapter  1  and  6,  may  also  certify  incapacity  to  work.     Page  |  20  
  21. 21.    Physiotherapists  wishing  to  certify  incapacity  to  work  must  have  authorisation  under  the  Health  Personnel  Act  §  48  or  approval  under  former  regulations,  cf.  Health  Personnel  Act  §  76  section  2,  and  a) Have  passed  an  examination  in  clinical  master  study  in  manual  therapy  for  physiotherapists  at  a  Norwegian  university  or   equivalent,  or  b) Be  approved  for  use  of  A8  tariff  -­‐  Manual  therapy  -­‐  and  have  passed  an  examination  in  differential  diagnostics,  laboratory   analysis  and  training  in  radiology  equivalent  to  Norwegian  master  training.  Physiotherapists  who  certify  incapacity  to  work  are  referred  to  as  manual  therapists  in  the  regulation.  Chiropractors  and  manual  therapists  wishing  to  certify  incapacity  to  work  must  have  completed  training  in  insurance  related  subjects  etc.  the  Ministry  of  Health  and  Care  Services  will  establish  more  specific  rules  concerning  the  scope  of  the  training.  §  2  Declaration  of  incapacity  to  work  The  condition  in  the  Social  Insurance  Act  §  8-­‐7  concerning  a  doctor’s  certificate  for  the  right  to  sickness  benefit  does  not  apply  if  the  incapacity  to  work  is  certified  by  a  statement  from  a  chiropractor  or  manual  therapist.  An  equivalent  exception  is  made  t o  the  condition  for  a  certificate  from  a  doctor  in  §  8-­‐4  section  2,  b).  Nos.  1  and  2  only  apply  to  illness  or  injuries  which  are  directly  connected  to  the  muscle  and  skeleton  system.  The  regulations  in  the  Social  Insurance  Act  §  8-­‐7  section  2  and  3  apply  accordingly  to  declarations  from  chiropractors  and  manual  therapists.  The  declaration  referred  to  in  section  1  may  not  continue  for  a  continuous  period  of  more  than  eight  weeks  from  the  first  day  of  sick  leave.    With  the  consent  of  the  member  a  copy  of  the  declaration  issued  in  accordance  with  section  1  is  sent  to  the  member’s  doctor  at  the  same  time  as  to  the  local  national  insurance  office.  If  a  member  is  unfit  for  work  for  more  than  six  weeks,  the  chiropractor  or  manual  therapist  shall  inform  the  member  that  incapacity  for  work  for  more  than  eight  weeks  must  be  certified  by  a  doctor.  In  such  cases  the  chiropractor  or  manual  therapist  shall,  after  obtaining  the  member’s  consent,  send  the  details  of  the  treatment  performed  to  the  member’s  doctor.    The  Social  Insurance  Act  §  21-­‐4  section  2,  no.  3  on  the  obligation  of  information  in  the  doctor’s  certificate  concerning  sick  leave,  where  an  illness  or  injury  may  have  a  connection  with  the  work  situation  and  §  25-­‐7,  concerning  exemption  from  issuing  doctor’s  certificates,  applies  accordingly  for  chiropractors  and  manual  therapists.  §  3  Supplementary  guidelines  The  National  Insurance  Administration  may  issue  specific  guidelines  for  the  implementation  of  the  regulation,  including  the  illnesses  and  injuries  which  fall  under  §  2  section  1,  no.3,  and  the  application  of  §  2  section  1  in  the  event  of  a  member’s  repeated  incapacity  for  work.  §  4  Entry  into  force  The  regulation  comes  into  force  on  1.  January  2006.         Page  |  21  

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