German Court Upholds Flat-Rate Subsidy for Doctors' Online Payment System
A Stuttgart orthopedist has lost her legal challenge over a subsidy for Germany's telematics infrastructure (TI). The Baden-Württemberg State Social Court (LSG) ruled that the flat-rate payment of €3,150 did not need to cover all her costs for the online payments system. The decision overturned an earlier ruling by the Stuttgart Social Court (SG).
The doctor had contested her remuneration notice for the third quarter of 2018, arguing she was owed nearly €3,900 instead of the €3,150 subsidy for her health insurance expenses. She claimed the Association of Statutory Health Insurance Physicians (KV) should fully reimburse her expenses for connecting to the TI system.
The LSG disagreed, stating that flat-rate payments do not have to be cost-covering. While it recognised that a purely symbolic reimbursement could raise concerns, the current rates were deemed reasonable. The court also ruled that requiring providers to share in the TI's introduction costs was both fair and constitutionally permissible.
The TI system, managed by the Federal Ministry of Health (BMG), provides monthly subsidies to medical practices and pharmacies for their online payments. These payments, ranging from €237.78 to €323.90 per practice between July and December 2023, help cover installation and operational expenses for health insurance. The BMG oversees implementation, with input from the National Association of Statutory Health Insurance Physicians (KBV) and the GKV-Spitzenverband.
The ruling confirms that providers must contribute to the TI's costs, even if subsidies do not fully cover their expenses for health insurance. Medical practices and pharmacies will continue receiving fixed payments, set by the BMG, for connecting to the system. The decision sets a precedent for future disputes over TI funding.
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