German court rules doctors must share telematics infrastructure costs
A recent ruling by the Baden-Württemberg State Social Court (LSG) has clarified the financial responsibilities around Germany's telematics infrastructure (TI). The case centred on an orthopedist from Stuttgart who contested a €3,150 subsidy for TI connection costs, arguing it failed to cover her full expenses. The court's decision now sets a precedent for how medical practices and pharmacies are reimbursed for integrating with the system.
The dispute began when the orthopedist received her remuneration notice for the third quarter of 2018. Alongside her usual payments, the notice included a €3,150 subsidy for connecting to the TI—a digital network linking healthcare providers across Germany. Unhappy with the amount, she demanded an additional €3,900 from the Association of Statutory Health Insurance Physicians (KV) to cover the remaining costs of operating the system.
The Stuttgart Social Court (SG) initially ruled in her favour. However, the LSG later overturned this decision, stating that the law does not require flat-rate payments to fully cover all expenses. While the court acknowledged that an excessively low, purely symbolic reimbursement could be problematic, it found the current rates reasonable.
The LSG also confirmed that requiring healthcare providers to contribute to the TI's introduction costs is both fair and constitutionally valid. The ruling did not specify total state investments in the infrastructure, though gematik GmbH—the federal agency overseeing its implementation—remains responsible for its rollout.
Medical practices and pharmacies in Germany have long received subsidies to offset TI connection costs. This case, however, clarifies that these payments do not need to match every expense incurred by providers.
The decision means that healthcare providers must accept the existing subsidy structure without guaranteed full reimbursement. The LSG's ruling reinforces the legal framework for TI funding, ensuring that the system's financial burden is shared between the state and medical professionals. No further appeals on this matter have been announced.
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