In its ruling of 10 April 2025, the Federal Administrative Court dismissed the appeals filed by the State of Baden-Württemberg and a hospital operator on the fundamental issue of whether a hospital should be reimbursed for actual personnel costs incurred in connection with binding staffing requirements.
The matter specifically concerned how to interpret the financing rules of the National Ordinance on Hospital Rates (Bundespflegesatzverordnung) in light of the requirements set out in the Psychiatry and Psychosomatics Staffing Guideline (Personalausstattung-Psychiatrie- und Psychosomatik-Richtlinie). The statutory health insurers had – following a decision by the Baden-Württemberg State arbitration board that went against them and was approved by the State – already successfully argued before Karlsruhe Administrative Court that the obligation to implement staffing requirements did not include any specification of the costs at which staff should be employed. The Federal Administrative Court confirmed that financing based on actual costs is to be ruled out unless explicitly laid down by law, thereby significantly strengthening the negotiating position of statutory health insurers in budget negotiations nationwide.
The following Gleiss Lutz team advised the Verband der Ersatzkassen e.V. and the Baden-Württemberg BKK/IKK working group in these proceedings: Dr. Reimar Buchner (partner, Berlin), Dr. Lenke Wettlaufer, Dr. Jan-Peter Spiegel (of counsel), Dr. Julia Hornung (all Public Law/Healthcare & Life Sciences, all Berlin).
Gleiss Lutz regularly assists statutory health insurers in hospital financing disputes and had already advised and represented the clients in connection with the introduction of the statutory regulation by way of a legal opinion as well as in the arbitration and approval proceedings.
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