German Statutory Health Insurance Savings Package to Be Expanded
Germany is planning further measures to bolster savings within its statutory health insurance system. Proposed changes are to be incorporated into legislation reforming emergency medical services.
German governing parties are preparing to expand the recently enacted Stabilization of Contribution Rates in Statutory Health Insurance Act (GKV-Beitragssatzstabilisierungsgesetz) with additional financial and structural measures. A draft from the Federal Ministry of Health proposes implementing these changes via amendments to the law reforming emergency medical services. The aim is to further enhance savings and implement structural adjustments across various healthcare sectors.
Key areas targeted by the proposed changes include digital health applications (DiGA), for which new fee reductions are planned based on user dropout rates within the first four weeks of use. For cytostatics and medical aids, provisions allowing special price agreements with pharmacies and health insurance funds may be reintroduced. Similar regulations were previously in place but led to considerable supply chain disruptions. The possibility of conducting tenders for medical aids will also be reinstated.
Furthermore, regulations concerning cannabis-based medicines will be adjusted. The previously mandatory therapeutic trial period for these drugs will become more flexible, at the discretion of the prescribing physician and limited to approved indications. Oversight of cross-sectoral healthcare facilities (süV) will also be tightened, with quality performance potentially impacting reimbursement and non-compliance leading to billing bans. The tasks of the Institute for Quality and Efficiency in Health Care (IQWiG) will be expanded.
For ambulatory care and psychotherapy, the removal of fixed cost deductions for certain physician groups is planned. Reimbursement for psychotherapy services, particularly for children and adolescents and for urgent acute treatments, is set to be expanded beyond current budgetary limits. These measures are part of a broader effort to balance the finances of the German statutory health insurance system.