Contribution Stabilization Act: VSPV sees an existential risk for the rural taxi trade.

The draft bill on GKV contribution stabilization from the Federal Ministry of Health provides for linking the remuneration for patient transports with taxis and rental cars to the base wage rate of the statutory health insurance, and to set this as a statutory upper limit as of January 1, 2027. The Association of Private Commercial Road Passenger Transport in North Rhine-Westphalia warns, according to its own analysis, of serious consequences for the taxi and rental-car trades, especially in rural areas.

High dependence on revenue from patient transports

According to the association, many businesses outside urban centers generate up to 80 percent of their total turnover with patient transports, for example to dialysis, chemotherapy, or rehabilitation treatments. While costs in the taxi and rental-car sector have cumulatively risen by 25 to 35 percent in recent years, the base wage rate has increased by around 15 percent in the same period. From 2027 it should also be reduced by one percentage point.

A remuneration tied to the base wage rate would, according to the association's assessment, lie below a cost-covering level. Companies would not be able to provide such journeys profitably in the long term.

Legal clash with the Passenger Transport Act

The association also points to legal hurdles. According to § 51(2) of the Passenger Transport Act, deviating remuneration agreements between health insurers and taxi companies require approval. The competent road traffic authority independently checks whether an agreement is cost-covering and adequate. If an agreement is not approved, the official taxi tariff applies.

At the same time, health insurers would have to reimburse medically necessary trips under § 60 of the Social Code Book V. The association assumes that the planned regulation would therefore in the taxi-mandated-ride area practically not take effect and would create additional bureaucracy.

Tax effects in the rental-car sector

Also for the rental-car sector, the association sees follow-on effects. Medical trips with rental cars are subject to a reduced VAT rate of seven percent, provided that a corresponding special agreement exists in the taxi sector. If this disappears, according to the association, the standard rate of 19 percent would apply. The difference of twelve percentage points would be borne by the health insurance funds under typical gross-price agreements.