Non-emergency medical transport in Mecklenburg-Western Pomerania: VSPV sees an implementation deficit rather than a remuneration problem.

Since 1 April 2026, numerous taxi- and rental-car companies in Mecklenburg-Vorpommern have stopped providing patient transport services. The background is a failed remuneration dispute between the industry and the statutory health insurers. According to the Association of Private Commercial Road Passenger Transport in North Rhine-Westphalia, around 80 percent of the businesses derive the majority of their revenue from patient transport—with comparatively low nationwide remuneration rates. Particularly affected are chronically ill and mobility-impaired patients who rely on regular trips to dialysis, chemotherapy, or radiation therapy.

Expert opinion deems individual contracts inadmissible

The association submitted on 9 April 2026 an expert opinion to the Ministry of Economic Affairs, Infrastructure, Tourism and Labour as well as to the Ministry of Finance and Digitalisation of Mecklenburg-Vorpommern. The opinion, prepared together with the Professional Association for Passenger Transport North Rhine Taxi-Rental Cars, concludes that individual agreements between health insurance funds and individual taxi companies in the so-called mandatory-service area are legally impermissible.

According to the structure of § 51(2) of the Passenger Transport Act, special agreements may only be concluded by the local taxi industry as a majority or by a trade association representing the industry. Individual entrepreneurs or minorities would not be entitled to conclude such agreements. Otherwise, the level playing field desired by the legislature vis-à-vis economically powerful large customers such as health insurers would be lacking.

Obligations of the licensing authorities to review legality

Special agreements in the mandatory passenger transport area are also either subject to approval or to notification. In both cases the competent licensing authority must perform a legality check. In doing so, the provisions of § 39(2) of the Passenger Transport Act must be indirectly taken into account. This requires that transport fares be economically viable and enable an appropriate profit margin as well as investments.

If an expert opinion establishes a certain minimum remuneration below which services could not be provided in compliance with social standards and taking into account the statutory provisions, such special agreements would be illegal. In this case the approval must be refused or consent withdrawn. The criterion is the overall economic viability of the local transport market and not the situation of individual operators.

The association sees in practice of individual contracts an enforcement deficit of the competent authorities. The state government has been urged to remind the licensing authorities of their legal duties and to strengthen them accordingly.