Abstracts by key term: Section 25b SGB V
>> Mit § 25b SGB V hat der Gesetzgeber den Kranken- und Pflegekassen erlaubt, vorhandene Daten zum Schutz der Gesundheit ihrer Versicherten auszuwerten. Ziel ist es, Risiken früher zu erkennen und Versicherte auf passende Vorsorge- und Behandlungsangebote hinzuweisen. Damit ändert sich die Rolle von Sozialdaten. Sie dienen nicht mehr nur der Abrechnung oder der Dokumentation. Sie […]
05.10.2026
"We didn't use it." This is the succinct conclusion reached by the majority of health insurance funds regarding the implementation of Section 25b of the German Social Code (SGB V) in the current MVF survey (1). The SBK has so far seen no reason to invoke the legal basis. Techniker Krankenkasse, one of the driving forces behind the German Health Data Use Act (GDNG), has also only identified a single measure. The MVF survey has been running since February – even before the BfDI circular of April 1, 2025, on the information obligations of health and long-term care insurance funds regarding the right of objection, which significantly tightened the requirements for the funds and spoke of a "multiplicity of information measures" and "conceivable building blocks."
02.06.2025
Health and long-term care insurance funds can evaluate insured persons' data. Various information obligations can arise from the data evaluation. These obligations arise first when a specific health risk to the insured person is identified. This requires that there is a sufficient probability of health damage. Health and long-term care insurance funds must also provide information if their data evaluation reveals that there is a possibility (not probability) of illness or the need for care in the foreseeable future that arises from the individual (life) circumstances of an insured person. Whether these thresholds are reached in each case is ultimately determined by medical science and health services research. Health and long-term care insurance funds must always be able to provide a comprehensible justification for how they arrived at their results and why they made which information decisions. These legal requirements limit the use of artificial intelligence to the extent and as long as they cannot make their procedures and results transparent and comprehensible. Violations of these requirements can result in claims for information and damages against the health or long-term care insurance funds.