There is a new draft bill from the BMG for a “Law to Strengthen Health Care in Municipalities (Health Care Strengthening Act – GVSG)”. Compared to its previous version, the current draft has been supplemented by a number of projects, the announcement of which has already been reported in the media.
The GVSG is an “omnibus law”. It combines several projects and also changes several laws. The GVSG is essentially about changes to the law on statutory health insurance, SGB V.
Probably the most important change for GKV finances that has been included in the GVSG draft is the de-budgeting of family doctor services. Lauterbach had recently promised it to the medical profession. This means that there are no longer any upper limits for these services and doctors no longer have to worry that their services will no longer be fully rewarded. As expected, specialists are also calling for their services to be de-budgeted.
The BMG’s plans to set up “health kiosks” as a low-threshold care offer, to promote the establishment of “primary care centers” – now linked to the health kiosks, and to promote “health regions” as networks were already included in the previous draft bill. These three projects are intended to strengthen health care in the community and gave the law its name. In addition, the GVSG makes it easier for municipalities to set up their own MVZs.
Health kiosks, primary care centers and health regions have great potential to improve prevention and care on site, but it is important to cleverly combine them with existing offers, not least the ÖGD, and not to set up parallel structures.
Perhaps the BIPAM, for whose establishment a draft law will soon be presented, can develop assistance for cooperation here.
The planned innovations for the Federal Joint Committee (G-BA) are also positive. At least nursing is finally given the right to make applications and consult on matters that affect the practice of the nursing profession. The rights of patient representatives are also being expanded slightly, as are the opportunities for scientific societies and other actors to participate.
It is also interesting that health and nursing care insurance companies will in future have to present data about the quality of their services, for example about approvals and rejections of services or about the processing time of applications. It will have to be seen whether this will actually result in more transparency regarding the quality of service provided by the health insurance companies, as intended.
In the future, the states will no longer just have a say in the admissions committees, but will also be allowed to have a say, which could give regional peculiarities a little more weight. Here too, it remains to be seen what impact this will actually have.
In addition, the GVSG draft contains a number of regulations that have so far received little attention from the public, from the exemption from contributions for orphans’ pensions for voluntary services to the area of medical aids to expanded audit rights of the Federal Audit Office, which will also be able to audit the associations of statutory health insurance physicians in the future. Nice too, the 21st century is moving forward: The law is intended to give the statutory health insurance associations and their federal associations, the G-BA and the evaluation committee the opportunity to hold hybrid or digital committee meetings. Until now, there have been reservations about, for example, the confidentiality and legality of votes.
The ban on allowing homeopathy to be financed by health insurance companies, which has been hotly discussed in the media and here in the blog in recent days, is also on the GVSG omnibus. Article 1 point 2 of the draft law states that the amendment to SGB V is as follows:
“The following sentence is added to § 11 paragraph 6:
Homeopathic and anthroposophical medicines as well as homeopathic services are excluded as additional statutory services within the meaning of this paragraph.”
The justification for this states:
“The possibility for health insurance companies to offer homeopathic and anthroposophic medicines as well as homeopathic services as additional statutory benefits will be deleted. There is insufficient scientific evidence for the effectiveness of corresponding drugs and services. The use of homeopathic medicines and anthroposophics as well as homeopathic services should therefore be based exclusively on the insured person’s own decision to finance these services and should not be borne by the group of insured persons of the health insurance company(s). With the reference to Section 11 Paragraph 6 contained in Section 140a Paragraph 2 Sentence 2, reimbursement of homeopathic and anthroposophic medicines as well as homeopathic medical services through contracts for special care in accordance with Section 140a is also excluded. However, the health insurance companies are free to provide for the possibility of arranging private supplementary insurance contracts for these services in accordance with Section 194 paragraph 1a in the statutes.
Of course, the draft bill still has to go through the Bundestag after the resolution has been passed in the cabinet. As is well known, “Struck’s Law” applies there, according to which no law leaves the Bundestag the same way it entered it. Struck’s law is, firstly, empirically wrong and, secondly, a bit strange, because if deliberations in the Bundestag did not lead to changes to bills, the Bundestag could be saved. Struck’s law could also trivially read: “The legislature (sometimes) does what it is supposed to do.” It will be interesting to see how the draft of the GVSG first leaves the cabinet and then the Bundestag.