Mandatory Health Insurer Not Obligated to Cover Narcotics Control Fee Without Explicit Statutory Inclusion

The case concerns a dispute over an insurance provider's obligation to cover the costs of a "control fee for narcotics according to ALT" related to medical treatment. The insured party sought reimbursement for these costs from their mandatory health insurer. The court reasoned that the specific regulation cited, which covers the fee for monitoring controlled substances, must be read in conjunction with the underlying legal framework defining covered medical services; absent a clear stipulation within the mandatory health insurance law or its implementing ordinances that explicitly includes this specific administrative control fee as a reimbursable benefit, the insurer was not obligated to cover the expense, despite its potential necessity for administering prescribed medication.