WG: Press release from the BMG: More time for patients in the hospital, support for obstetrics, pediatrics and midwives: Bundestag passes hospital care relief law
02.12.2022 15:09
And here is a news email with PDF attachment (should also be uploaded)
Peter Stegmaier Editor-in-Chief MVF
eRelation AG – content in health eRelation AG Kölnstraße 119 53111 Bonn Germany T$ +49 228 76 38 280 – 0 F$ +49 228 76 38 280 – 1 [email protected]: BMG press office <>eRelation AG – Content in Health
Registration court: Bonn District Court / Registration number: 19 HRB 9392
Chairman: Peter Stegmaier
The content of this email is intended exclusively for the designated addressee. Any form of knowledge, publication, reproduction or distribution of the contents of this email by unauthorized third parties is prohibited. We ask that you contact the sender of the email if you are not the recipient of the email and delete the material from your computer.
This e-mail and any attachments are confidential and intended solely for the addressee. The perusal, publication, copying or dissemination of the contents of this e-mail by unauthorized third parties is prohibited. If you are not the intended recipient of this e-mail, please delete it and immediately notify the sender. Sent: Friday, December 2, 2022 2:36 p.m. Subject: BMG press release: More time for patients in the hospital, support for obstetrics, pediatrics and midwives: Bundestag passes hospital care relief law
Press release Berlin, December 2, 2022
More time for patients in the hospital, support for obstetrics, pediatrics and midwives: Bundestag passes hospital care relief law. Nursing staff get more time for patients. The existence of hospitals with a specialist department for obstetrics and inpatient care for children and young people will be secured. Financing for midwives will be improved and outpatient treatment will be promoted. These are the contents of the “Law on the assessment of nursing staff in hospitals and on the adaptation of other regulations in the hospital system and in digitalization” (Hospital Care Relief Act, KHPflEG), which was passed by the German Bundestag today.
Federal Health Minister Prof. Karl Lauterbach explains: “With the first hospital law, we are sending important signals. In the future, medical necessity should no longer decide on treatment in clinics. Children's hospitals and obstetric wards will be relieved first. Patients should be able to rely on the fact that they will be treated and looked after by qualified staff at all times and that they will only have to stay overnight in the hospital if it is really necessary. Treatments should also increasingly be possible in hospitals on an outpatient basis. This reduces the burden on care and prevents complications.”
The content of the law in detail:
Nursing staffing in hospitals The law is intended to improve the nursing situation in hospitals in the medium term. For this purpose, ideal staffing for the stations is calculated and implemented. For this purpose, a personnel measurement instrument (PPR 2.0) is used, which was developed by all those involved as part of the Concerted Care Campaign. The introduction of PPR 2.0 will take place in three stages:
The testing phase starts on January 1, 2023 with a practical test. The test phase takes place in a representative selection of hospitals. On this basis, hospitals are given guidelines for staffing in a legal regulation. From 2025, staffing will be sharpened and sanctioned.
Hospital day treatment and special sector-level remuneration Not every inpatient treatment requires the patient to spend the night in the hospital. In order to reduce the burden on hospital staff and to enable patients who want to spend the night in familiar surroundings, day hospital treatment is being introduced. The decision on this is made by mutual agreement between doctors and patients. In order to achieve these goals, the documentation requirements for day-care treatment should be limited to the minimum required. In the past, whether treatment was inpatient or outpatient was often a cost issue. The different remuneration for inpatient services (case flat rates) and outpatient treatment (EBM) led to inpatient treatment being carried out that was also possible without hospitalization. In order to avoid unnecessary overnight stays in hospital for patients, sector-level remuneration will be introduced for certain treatments. This remuneration lies between the outpatient (EBM) and inpatient levels (DRG). By March 31, 2023, health insurance companies and hospitals should jointly determine a catalog of operations that can be performed on an outpatient basis and the corresponding remuneration.
Funding for obstetrics and pediatrics In order to support obstetrics departments in hospitals, the federal states receive additional financial resources according to the Königstein key. When determining the specific amount per hospital location, the availability of a specialist department for pediatrics, a specialist department for neonatology, a certain proportion of vaginal births, the number of births and the possibility of carrying out the practical part of the midwifery course must be taken into account. This is intended to maintain a comprehensive supply of obstetric care locations. 120 million euros are available for this purpose for the years 2023 and 2024.
For the inpatient care of children and young people, the revenue volume provided before the pandemic in 2019 is largely guaranteed regardless of the services actually provided. To avoid false incentives, however, a hospital must accept discounts if it generates less than 80 percent of its 2019 revenue volume for the care of children and young people. The revenue volume from 2019 will also be carried forward to the present and increased by an additional 300 million euros for each of 2023 and 2024 - a total of 600 million euros. The guarantee of the revenue volume ensures that the care of children and young people is secured compared to the performance-oriented logic of the per-case flat-rate system. Special facilities can charge a surcharge for the care of children and young people. The funds are earmarked for the care of children and young people.
To finance the additional funds for obstetrics and pediatrics, around 380 million euros will be taken from the health fund's liquidity reserve for the years 2023 and 2024. In addition, private health insurance also contributes to the financing.
Safe midwifery care From 2025, the personnel costs of midwives will be fully taken into account in the care budget. This means that the personnel costs incurred by midwives for caring for pregnant women, those giving birth and those who have recently given birth are fully refinanced and the employment of midwives in the delivery rooms is equated with direct patient care in bedside wards.
Further regulations for the hospital sector In addition, the draft law provides for the following regulations in particular in the hospital sector:
· Budget negotiations for hospitals will be accelerated. Deadlines are set for various procedural steps and automatic action by the arbitration board.
· The structural review of hospitals by the medical services, the process for transmitting hospital data to the Institute for the Hospital Remuneration System (InEK) and the application process for the Hospital Future Fund are also being further developed.
· The hospitals' liquidity situation will be improved by increasing the provisional care fee value.
· Telemedical services are promoted by agreeing fees for appropriate remuneration.
· The hygiene funding program will be continued as an infectious diseases funding program and extended by three years, so that the staffing in infectious diseases will be financially supported.
· It is guaranteed that the costs of training in nursing assistance and assistance at the hospital are financed in a legally secure manner.
Digital healthcare The law also contains regulations to improve digital applications in the area of medical and nursing care. The main aim is to strengthen user-friendliness and increase distribution. This makes prescription data usable in the supply process or enables simple identification procedures in pharmacies. At the same time, hurdles that currently exist due to restrictions imposed by providers and manufacturers of information technology systems within the telematics infrastructure will be reduced.
Further regulations
· In order to improve the care situation for those affected by Long COVID, the Federal Joint Committee must make regulations for cross-professional, coordinated and structured care.
· The equal participation of women on the boards of statutory health insurance associations and federal associations will be strengthened.
· There will be exceptions to the extended price moratorium for immunoglobulins of human origin.
· With the suspension of monthly contributions to the long-term care provision fund and the provision of the funds in an annual installment in December 2023, as well as with the extension of the federal government's ability to reimburse pandemic-related costs for one year, regulations are being created to stabilize the financial situation of social long-term care insurance in the short term.
· The mandate of the Health Advisory Council will be explicitly expanded to include the area of nursing and the frequency of reports will be made more flexible in order to make scientific policy advice more timely and tailored in the future.
· Air rescue services are included in the direct distribution channel for blood supplies and can be supplied directly by the blood donation services. This is intended to contribute to improving emergency care for patients.
The law is still being discussed by the Federal Council and will come into force the day after it is announced.
Peter Stegmaier Editor-in-Chief MVF
eRelation AG – content in health eRelation AG Kölnstraße 119 53111 Bonn Germany T$ +49 228 76 38 280 – 0 F$ +49 228 76 38 280 – 1 [email protected]: BMG press office <>eRelation AG – Content in Health
Registration court: Bonn District Court / Registration number: 19 HRB 9392
Chairman: Peter Stegmaier
The content of this email is intended exclusively for the designated addressee. Any form of knowledge, publication, reproduction or distribution of the contents of this email by unauthorized third parties is prohibited. We ask that you contact the sender of the email if you are not the recipient of the email and delete the material from your computer.
This e-mail and any attachments are confidential and intended solely for the addressee. The perusal, publication, copying or dissemination of the contents of this e-mail by unauthorized third parties is prohibited. If you are not the intended recipient of this e-mail, please delete it and immediately notify the sender. Sent: Friday, December 2, 2022 2:36 p.m. Subject: BMG press release: More time for patients in the hospital, support for obstetrics, pediatrics and midwives: Bundestag passes hospital care relief law
Press release Berlin, December 2, 2022
More time for patients in the hospital, support for obstetrics, pediatrics and midwives: Bundestag passes hospital care relief law. Nursing staff get more time for patients. The existence of hospitals with a specialist department for obstetrics and inpatient care for children and young people will be secured. Financing for midwives will be improved and outpatient treatment will be promoted. These are the contents of the “Law on the assessment of nursing staff in hospitals and on the adaptation of other regulations in the hospital system and in digitalization” (Hospital Care Relief Act, KHPflEG), which was passed by the German Bundestag today.
Federal Health Minister Prof. Karl Lauterbach explains: “With the first hospital law, we are sending important signals. In the future, medical necessity should no longer decide on treatment in clinics. Children's hospitals and obstetric wards will be relieved first. Patients should be able to rely on the fact that they will be treated and looked after by qualified staff at all times and that they will only have to stay overnight in the hospital if it is really necessary. Treatments should also increasingly be possible in hospitals on an outpatient basis. This reduces the burden on care and prevents complications.”
The content of the law in detail:
Nursing staffing in hospitals The law is intended to improve the nursing situation in hospitals in the medium term. For this purpose, ideal staffing for the stations is calculated and implemented. For this purpose, a personnel measurement instrument (PPR 2.0) is used, which was developed by all those involved as part of the Concerted Care Campaign. The introduction of PPR 2.0 will take place in three stages:
The testing phase starts on January 1, 2023 with a practical test. The test phase takes place in a representative selection of hospitals. On this basis, hospitals are given guidelines for staffing in a legal regulation. From 2025, staffing will be sharpened and sanctioned.
Hospital day treatment and special sector-level remuneration Not every inpatient treatment requires the patient to spend the night in the hospital. In order to reduce the burden on hospital staff and to enable patients who want to spend the night in familiar surroundings, day hospital treatment is being introduced. The decision on this is made by mutual agreement between doctors and patients. In order to achieve these goals, the documentation requirements for day-care treatment should be limited to the minimum required. In the past, whether treatment was inpatient or outpatient was often a cost issue. The different remuneration for inpatient services (case flat rates) and outpatient treatment (EBM) led to inpatient treatment being carried out that was also possible without hospitalization. In order to avoid unnecessary overnight stays in hospital for patients, sector-level remuneration will be introduced for certain treatments. This remuneration lies between the outpatient (EBM) and inpatient levels (DRG). By March 31, 2023, health insurance companies and hospitals should jointly determine a catalog of operations that can be performed on an outpatient basis and the corresponding remuneration.
Funding for obstetrics and pediatrics In order to support obstetrics departments in hospitals, the federal states receive additional financial resources according to the Königstein key. When determining the specific amount per hospital location, the availability of a specialist department for pediatrics, a specialist department for neonatology, a certain proportion of vaginal births, the number of births and the possibility of carrying out the practical part of the midwifery course must be taken into account. This is intended to maintain a comprehensive supply of obstetric care locations. 120 million euros are available for this purpose for the years 2023 and 2024.
For the inpatient care of children and young people, the revenue volume provided before the pandemic in 2019 is largely guaranteed regardless of the services actually provided. To avoid false incentives, however, a hospital must accept discounts if it generates less than 80 percent of its 2019 revenue volume for the care of children and young people. The revenue volume from 2019 will also be carried forward to the present and increased by an additional 300 million euros for each of 2023 and 2024 - a total of 600 million euros. The guarantee of the revenue volume ensures that the care of children and young people is secured compared to the performance-oriented logic of the per-case flat-rate system. Special facilities can charge a surcharge for the care of children and young people. The funds are earmarked for the care of children and young people.
To finance the additional funds for obstetrics and pediatrics, around 380 million euros will be taken from the health fund's liquidity reserve for the years 2023 and 2024. In addition, private health insurance also contributes to the financing.
Safe midwifery care From 2025, the personnel costs of midwives will be fully taken into account in the care budget. This means that the personnel costs incurred by midwives for caring for pregnant women, those giving birth and those who have recently given birth are fully refinanced and the employment of midwives in the delivery rooms is equated with direct patient care in bedside wards.
Further regulations for the hospital sector In addition, the draft law provides for the following regulations in particular in the hospital sector:
· Budget negotiations for hospitals will be accelerated. Deadlines are set for various procedural steps and automatic action by the arbitration board.
· The structural review of hospitals by the medical services, the process for transmitting hospital data to the Institute for the Hospital Remuneration System (InEK) and the application process for the Hospital Future Fund are also being further developed.
· The hospitals' liquidity situation will be improved by increasing the provisional care fee value.
· Telemedical services are promoted by agreeing fees for appropriate remuneration.
· The hygiene funding program will be continued as an infectious diseases funding program and extended by three years, so that the staffing in infectious diseases will be financially supported.
· It is guaranteed that the costs of training in nursing assistance and assistance at the hospital are financed in a legally secure manner.
Digital healthcare The law also contains regulations to improve digital applications in the area of medical and nursing care. The main aim is to strengthen user-friendliness and increase distribution. This makes prescription data usable in the supply process or enables simple identification procedures in pharmacies. At the same time, hurdles that currently exist due to restrictions imposed by providers and manufacturers of information technology systems within the telematics infrastructure will be reduced.
Further regulations
· In order to improve the care situation for those affected by Long COVID, the Federal Joint Committee must make regulations for cross-professional, coordinated and structured care.
· The equal participation of women on the boards of statutory health insurance associations and federal associations will be strengthened.
· There will be exceptions to the extended price moratorium for immunoglobulins of human origin.
· With the suspension of monthly contributions to the long-term care provision fund and the provision of the funds in an annual installment in December 2023, as well as with the extension of the federal government's ability to reimburse pandemic-related costs for one year, regulations are being created to stabilize the financial situation of social long-term care insurance in the short term.
· The mandate of the Health Advisory Council will be explicitly expanded to include the area of nursing and the frequency of reports will be made more flexible in order to make scientific policy advice more timely and tailored in the future.
· Air rescue services are included in the direct distribution channel for blood supplies and can be supplied directly by the blood donation services. This is intended to contribute to improving emergency care for patients.
The law is still being discussed by the Federal Council and will come into force the day after it is announced.
2022-12-02_Press release-KHPlfEG.pdf