SURVEY: GP-2025/9: AOK-BV

The end of the traffic light coalition on November 6 also meant the end of numerous legislative proposals from the Ministry of Health. Although the Hospital Care Improvement Act (KHVVG) was finally passed, it has yet to be implemented. Other proposals, such as the Health Care Strengthening Act (GVSG) and the emergency reform, are likely to be suspended.

We assess the draft laws recently planned by the BMG as follows::

1. Health Care Strengthening Act (GVSG)

In principle, we see an urgent need for action to strengthen local healthcare, particularly in rural and structurally weak areas.

Unfortunately, the draft GVSG was stripped of its healthcare content during the legislative process.

We therefore advocate that, in a renewed attempt to introduce a pension law, Primary care centers, health kiosks etc. again to focus onto sustainably improve care.

However, proposals such as the introduction of a flat-rate and very high de minimis threshold for cost-effectiveness audits for medically prescribed services or the de-budgeting of specialist groups are not effective and should therefore be rejected.

2. Nursing Competence Act (PKG)

The Act to Strengthen Nursing Competence could have set important course for strengthening the autonomy of professional nursing and for the structural development of nursing care insurance.

At least the following suggestions should therefore be implemented:

• Regarding the Transfer of (auxiliary) tasks of health and nursing care funds to third parties Based on two BSG rulings, legal clarity must be created so that the health and nursing care funds can carry out their tasks in an economical manner without jeopardising the trust of the insured in the functioning of the social insurance system.
• Through the planned Recognition of nursing as a medical profession and the representation of reserved nursing tasks in the benefit and contract law of statutory health and long-term care insurance Given the shortage of skilled workers, the nursing skills of nurses can be used efficiently to ensure health and nursing care.
• The planned Strengthening the role of local authorities Particularly in the case of municipal care structure planning (Caring Communities), this is an important measure to secure local care and support structures.
• The proposed regulation allowing those in need of care to use half of their entitlement to day care benefits for low-threshold group care services should also be implemented. This would compensate for the structural lack of day care services.

3. Reform of emergency care (NotfallG)

A reform of emergency care is urgently needed, but it cannot be implemented in a short-term or fragmented manner, as the state health departments and the state interior ministries must also be involved. The next federal government must urgently make the modernization of emergency care one of its priorities.

4. Health Digital Agency Act (GDAG)

The plans outlined in the GDAG to improve the digital arrangement of doctor's appointments are sensible. However, in our view, it is essential to also to enable digital appointment scheduling by health insurance companies. In addition, there is an urgent need for regulation regarding the agreements for providers of digital appointment scheduling platforms: It should be clarified that only such appointment scheduling platforms for arranging appointments in the statutory health insurance may be used, who have demonstrated that they meet the requirements to be defined.

The proposal made in a non-specialist amendment to the GDAG to Use of insured data to train artificial intelligence We believe that health insurance companies make sense.

5. Pharmacy Reform Act (ApoRG)

The pharmacy reform was intended to initiate important changes that would contribute to improving healthcare.

These include the planned regulations to facilitate access to the German labor market and the establishment of pharmacies for foreign skilled workers, to open up prospects for part-time employees to become branch managers, and, in addition, to further develop the career prospects of pharmaceutical technical assistants and to outline opportunities for advancement.

We also believe that the proposed reduction in bureaucracy and increased flexibility are important for facilitating community-based pharmacy care. Appropriate regulations can help make pharmacy care in structurally weak areas more robust and sustainable. Likewise, the adjustment of remuneration planned with the reform pursues the right goal of better supporting nationwide care.

6. Bureaucracy Reduction Act

Under the pretext of "debureaucratization," legislators have in the past abolished key elements for compliance and monitoring of cost-effectiveness in healthcare. Bypassing joint self-administration, new services have been introduced whose benefits for patients have not been proven.

A reduction in bureaucracy, for example through the Strengthening the “case dialogue” This allows for direct communication between hospitals and health insurance companies in the event of disputed billing issues, based on the relevant patient records. This avoids both audit procedures by the Medical Service and legal proceedings before the social courts, thus relieving the burden on the overburdened social courts. Instead of continuing to weaken such elements at the policy level, health insurance companies must be provided with effective tools.

7. Healthy Heart Act (GHG)

The draft law met with widespread criticism from healthcare stakeholders and is entirely unnecessary. The radical restructuring of disease management programs it proposes jeopardizes the care of chronically ill patients, overburdens physicians' practices, and burdens the finances of statutory health insurance funds. The draft law undermines proven, certified, and quality-tested preventive services. Prevention must not be limited to preventive medicine—even in the future. Rather, a comprehensive public health strategy is needed to improve the health of people in Germany.