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Non-emergency medical transport services look ahead to 2027 with concern - GKV-BStabG could significantly restrict reimbursement leeway.
For many companies that conduct non-emergency patient transport for those insured under statutory health insurance, this is about more than a legal technicality. It concerns the economic basis of a business field that has been facing rising costs for years. The core of the problem lies in the GKV Contribution Rate Stabilization Act (GKV-BStabG), which the Bundestag adopted in the summer of 2026. The aim of the law is to stabilize the finances of statutory health insurance and to curb the rise of health insurance contributions. To this end, reimbursement increases in numerous service areas will be more strongly limited in the future. For the years 2027 to 2029 there is a special rule: The permissible remuneration development is tied to the base wage rate, albeit with a deduction of one percentage point.
Precisely to this regulation, the vdek-Landesvertretung Nordrhein-Westfalen refers in a letter to a service provider. There it says:
“The legislator prescribes in the Contribution Rate Stabilization Act that the base wage sum, with a deduction of 1%, is permissible as the maximum remuneration increase.”
Changes beyond this are not possible, since this
“would effectively amount to circumventing the legal framework”
would represent.
For the VdKBf NRW, this formulation is a warning signal. The association sees in it an indication that the statutory health insurers could in the future also critically review or reject structural adjustments to remuneration agreements if these would lead to higher increases in remuneration.
Cost-saving law reaches the transport sector
Indeed, the law is not limited to doctors or hospitals. The legislative materials explicitly refer to patient transport services. The Federal Ministry of Health expects substantial savings for the statutory health insurance funds there. For 2027 alone, reduced expenditures of around 300 million euros are projected, which could rise to about 1.6 billion euros by 2030.
Thus, it becomes clear that patient transport is by no means at the margins of reform. Rather, it belongs to the areas where policy explicitly aims to curb costs. From the perspective of the statutory health insurers, this step is understandable. The statutory health insurance has been grappling for years with rising expenditures and structural financing problems. The Federal Ministry of Health quantifies the expected deficits at billions and justifies the reform with the aim of a more revenue-oriented expenditure policy.
Costs are rising faster than the reimbursements
For companies in medical and disability transportation, however, the situation is different. Their costs are not aligned with political austerity targets, but with collective bargaining agreements, vehicle prices, insurance premiums, workshop invoices, and energy costs.
Especially in the area of specialized transport of people with disabilities or mobility impairments, the requirements are high. Vehicles must be barrier-free, personnel require special qualifications, and the effort per trip is often significantly higher than that of conventional transport services. If reimbursements are allowed to rise only to a limited extent in the future, while actual costs grow more rapidly, margins come under pressure. Particularly affected would be companies whose revenue largely comes from trips for those with statutory health insurance. The VdKBf NRW openly expresses this concern.
„For companies that derive a substantial portion of their revenue from patient transports for those with statutory health insurance, the economic outlook could become dramatic from 2027,” states the letter to members.
Dispute over the interpretation
What is remarkable is that the debate is already sharpening months before the new regulations come into force. While the health insurers refer to the statutory provisions, providers fear that the leeway for negotiations could effectively disappear.
The vdek itself had explicitly welcomed the Contribution Rate Stabilization Act. In a statement the association spoke of a necessary return to a “income-oriented spending policy” and supported the limitation of remuneration increases to the base wage rate minus one percentage point. Thus the conflict line for the coming years is already taking shape: On the one hand are health insurers who, under political pressure, are supposed to save. On the other hand are transport companies that can only offer their services on a cost-covering basis if rising expenses are at least partly reimbursed.
Action Day in Ahlen Gains New Urgency
Against this background, the action day organized by VdKBf NRW on 19 September in Ahlen takes on a new significance. Originally planned as an information and industry meeting, the event is now likely to become primarily a discussion about the economic consequences of the Contribution Rate Stabilization Act.
The association is therefore actively promoting participation and has extended the registration deadline to 17 September (here is the contact for the VdKBf NRW). The message is clear: Those offering ambulance rides for people with statutory health insurance should engage early with the new framework conditions. Because regardless of how the first reimbursement negotiations in 2027 will actually proceed, one thing is certain: The phase of generous refinancing commitments is over. For patient transport services, this marks a time when business planning, political advocacy, and contract negotiations are likely to be more tightly intertwined than before.
Content automatically translated.
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