In its decision of 10 September 2024, the Federal Supreme Court dismissed the appeal of a hospital operator challenging the decision of the Arbitration Court for Social Security Disputes (Schiedsgericht in Sozialversicherungsstreitigkeiten) of the Canton of Bern regarding the obligation to disclose certain documents related to invoicing practices for computed tomography (CT) scans.

The main question addressed by the court was whether the health insurance providers could compel the disclosure of certain radiological reports and medical referrals associated with 55 invoices to assess the economic efficiency and appropriateness of the CT scans performed by the appellant. The court emphasized the importance of statistical methods for economic control within the health insurance sector, arguing that these methods are essential for comparing the appellant's billing practices with those of other medical facilities.

The court noted that despite the existence of case management agreements between the appellant and various health insurance providers, these agreements did not limit the statutory obligations to disclose information. It established that the requirement for transparency and data sharing exists independently of these agreements, particularly in the context of examining general treatment practices.

The court acknowledged that a lack of diagnostic information often hampers the effectiveness of statistical comparisons, which are crucial for evaluating the appropriateness of medical procedures. However, it concluded that the requested documents could still provide valuable insight into potential inefficiencies in the appellant's billing practices, particularly if discrepancies between medical indications and billed procedures were identified.

Ultimately, the court ruled that the request for the release of documents was permissible and necessary for the ongoing assessment of economic efficiency and appropriateness within the healthcare system. The court upheld the decision by the cantonal arbitration court, confirming that the health insurance providers had the right to access the relevant documents to fulfill their oversight responsibilities.

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