Table 1 Assessment approaches of the G-BA and resulting consequences for provision prior to and after 2012
| Â | Outpatient | Inpatient | |||
|---|---|---|---|---|---|
Until 2011 | Since 2012 a),b) | 2000-2011 | 2012-2016 a),b) | Since 2017 | |
Before evaluation | Not in benefit basket, i.e. provision not reimbursable | Not in benefit basket, i.e. provision not reimbursable | Provision allowed | Provision allowed | Provision allowed, unless method under § 137h |
After evaluation | |||||
 Proven benefit | Acknowledg-ment and inclusion in benefit basket | Acknowledg-ment and inclusion in benefit basket | Continued provision | Continued provision | Continued provision/ inclusion in benefit basket (§ 137h) |
 No proven benefit + no ‘potential’ | No acknowledge-ment, i.e. non-inclusion into benefit basket | No acknowledge-ment, i.e. non-inclusion into benefit basket | Exclusion from benefit basket | Exclusion from benefit basket | Exclusion/ non-inclusion (§ 137h) |
 No proven benefit, but clinical studies expected (= ‘potential’) | Suspension of the decision until studies available | Suspension of the decision until studies available | Suspension of the decision until studies available | Suspension of the decision until studies available | Trial implementation (under § 137e) |
 Insufficient evidence, indication of possible benefit, no clinical studies expected/ planned (= ‘potential’) | Approach not existent | Trial implementation (under § 137e) | Approach not existent | Trial implementation (under § 137e) | Trial implementation (under § 137e) |