Accounting of „over performance” in the Light of the latest Supreme Court jurisprudence.

Supreme court has made several statements in the scope of accounting health benefits provided over the limited resulting from the contract with the payer.
Regardless of the above the line of jurisprudence on this matter has been evolving recently.
Supreme Court, in the verdict of 27 August 2015, reference symbol of files III CSK 455/14 (“Verdict”) stated that  “ providing benefits in case of emergency is a statutory obligation of the benefit provider, which has an unconditional nature and the cost of performing a benefit, not accounted for by the contract due to its kind or exhausting the limit, can burden neither a benefit provider nor a beneficiary”. 

The verdict has been based on the following factual state; a claimant runs a healthcare facility. After exhausting the limit resulting from the contract with the payer it provided health benefits to newly admitted patients. The facility claimed benefits provided over the limit.
It is worth emphasizing, that supreme court assumed in the verdict that the entity which concluded the agreement and performs benefits in emergency cases over the limit agreed for in the contract with the payer, can claim only the reimbursement  of justified costs of performing those benefits and not remuneration based on stipulated fees. 

The discussed verdict may raise concerns regarding the initiation of new line of jurisprudence. 

The verdict is available in the : http://www.sn.pl/orzecznictwo/SitePages/Najnowsze_orzeczenia.aspx