Mecklenburg-Vorpommern: Conflict over patient transport continues to escalate
From the state association's point of view, an earlier push by the health insurers was already not viable. A one-time surcharge of two euros per ride, offered at the end of March, was mainly intended to prevent a planned demonstration in Schwerin. There were corresponding indications in writing, according to the association. In substance, the offer did not represent a lasting improvement.
Individual contracts boycott a solution
Instead of a nationwide framework contract, the health insurers continue to rely on individual contracts. This is exactly where the core of the conflict lies. In the association's view, such agreements are economically not feasible for taxi operators and legally questionable. Talks with the state government and licensing authorities are ongoing, but a clarification is pending. The association argues that the authorities must prohibit existing individual contracts, as they violate economic principles.
7 or 19 percent value-added tax?
There is also a tax-related aspect: Only a uniform framework agreement would enable the application of the reduced VAT rate of seven percent. Without this, car rental companies would have to remit 19 percent – a decisive difference given the already tight margins.
The reimbursement rates recently proposed by the health insurance funds are, from the industry's perspective, clearly below the necessary level. For 2026, 2.10 euros per kilometer were planned for admission or discharge trips, 1.90 euros for regularly occurring trips such as to dialysis or radiotherapy. For 2027, the rates were expected to rise slightly. The association regards these adjustments as insufficient, also in light of the planned increase in the minimum wage at the start of 2027.
Offering far from economic viability
For comparison, the industry points to existing taxi tariffs, for example in Rostock and in the Vorpommern-Greifswald district, where currently around 2.20 euros per kilometer apply – based on calculations that are already four years old. Assessments now assume a necessary price of about 2.90 euros in order to be able to operate economically. Many entrepreneurs offset the difference through long working hours and short rest periods.
The association sees this as a structural problem. Without adjustments, a creeping erosion of mobility offerings in the country threatens. Patient transports, school transports, or the transport of people with disabilities could in the medium term no longer be guaranteed to the usual extent.
Political pressure is growing
The Ministry of Economic Affairs has been urged to intervene with a decree and to remind the licensing authorities of their duties. These should examine whether existing individual contracts are actually permissible. The association calls for a clear signal from the state government to the health insurers.
At its core, it is about more than tariff issues. The dispute touches on the question of how reliable provision in rural Mecklenburg-Vorpommern can be organized. Without viable economic foundations, this system would hardly be sustainable.
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