German Bundestag Approves Revised Health Care Strengthening Law

The Bundestag has officially approved the revised Health Care Strengthening Act (GVSG), spearheaded by Federal Minister of Health Karl Lauterbach. This legislation, endorsed by the former coalition government, aims to enhance the remuneration structure for general practitioners (GPs) in Germany.

One of the key changes introduced by the GVSG is the removal of the cap on remuneration for GPs. From now on, every service provided by a GP will be compensated, which is expected to incentivize physicians to accept more patients. The Federal Ministry of Health (BMG) anticipates that this will lead to additional costs for health insurance funds, estimated to be in the lower triple-digit million range. Tensions had arisen among medical associations regarding the potential redistribution of funds as a result of these changes.

In addition to the changes in remuneration, the legislation introduces a new 'care flat rate' for patients with mild chronic conditions who require minimal oversight. This initiative aims to reduce the frequency of appointments solely for billing purposes and increase flexibility in patient care, allowing GPs to bill for a comprehensive annual flat rate rather than per appointment. Moreover, practices meeting certain criteria can qualify for an additional 'retention flat rate,' which supports home visits and extends consultation hours, including evenings.

Minister Lauterbach emphasized that these measures would enable GPs to better fulfill their role as healthcare navigators while reducing bureaucratic burdens. This, in turn, is expected to lower overall costs by decreasing unnecessary specialist appointments.

As of the end of 2023, there were 51,389 GPs registered in Germany, representing an increase of 75 since the end of 2022. However, this figure reflects a decrease from the 52,262 GPs recorded a decade earlier, with a significant proportion--37%--being over the age of 60.

Another significant modification in the GVSG pertains to emergency contraception. Women will now have access to emergency contraceptive pills without age restrictions when there are indications of sexual assault or rape, as the previous age limit of 22 has been eliminated.

Furthermore, the reimbursement for various wound treatment products has been extended until December 2025. This extension aims to provide legal clarity surrounding an expired transitional regulation in the Social Code Book V, allowing stakeholders--including the Joint Federal Committee (G-BA) and manufacturers--additional time to conduct necessary consultation processes. Previously, the expiration of this transitional period had caused confusion in pharmacies, although some health insurance providers had assured they would not contest claims under the old regulations.

Pharmacies had hoped that the issue of discounts (skonto) could also be resolved within the framework of the GVSG. However, SPD health policy spokesperson Heike Baehrens noted that an agreement with the FDP was not reached. She indicated that the FDP had insisted on a stripped-down version of the GVSG, focusing primarily on the removal of budget caps for GPs.