Patient transport services on the brink of being scrapped: Dispute between taxi companies and health insurers escalates in MV

From 1 April 2026, numerous taxi companies will lack the billing basis for medical transports. Without a valid contract, rides under prescription – the so-called transport vouchers – can no longer be billed to the health insurance funds. The consequence: a significant portion of the industry announces that it will suspend these rides for the time being.

“We have done everything to gain a foothold and avoid an escalation. But we cannot go any further down,” says association spokesperson Maik Göricke.

The association has moved decisively — the health insurers have not

In fact, the association had significantly reduced its original demands according to its own statements – most recently an offer about 31 percent below the initial demand. Nevertheless, no agreement was reached. The economic situation of many companies is strained. For months, the association has pointed out that the offered remunerations are not cost-covering. A specially developed cost calculator for an average operation with four vehicles was supposed to prove this.

“Mathematical basic principles are regularly ignored,” says the association.

The companies had already made concessions – including a calculated owner’s wage at minimum-wage level.

Taxi companies under pressure

At the same time, the businesses report a structural problem: bankruptcies, closures of operations and withdrawals of even nonprofit providers from the field of patient transports are increasing. In Mecklenburg-Vorpommern, this sector is central for many companies – around 80 percent generate the majority of their revenue. The consequences are correspondingly severe if this business collapses.

For patients, this means concretely: In Schwerin, Rostock, Neubrandenburg, Stralsund as well as in the districts Mecklenburgische Seenplatte and Vorpommern-Rügen, significant restrictions threaten. Particularly affected are chronically ill and mobility-impaired people who regularly require dialysis, chemotherapy or radiation therapy. Discharge transports from hospitals or trips to outpatient treatments are also at risk.

Without a taxi (almost) no medical transports!

In the meantime, the taxi industry overall accounts for a large part of these transports. According to the Association of Substitute Health Insurance Funds, in Mecklenburg-Vorpommern nearly 80 percent of medical transports are carried out by taxi companies without medical accompaniment. A disruption cannot be compensated in the short term by the remaining operators or by the emergency medical service.

The statutory health insurers deny the accusations. They say they have presented a “clearly improved offer,” according to sources within their ranks. According to information from the negotiating circle, this amounted to an average increase of about ten percent. From the insurers' point of view, a defensible step — from the entrepreneurs' point of view, still insufficient. They demand alignment with the remuneration level of other federal states, where in some cases considerably higher rates are paid.

The option of individual contracts is, according to the state association, “no solution”

At the same time, the health insurers warn of the consequences of an exit by the companies. Such a step would jeopardize the care of seriously ill people. They appeal to the businesses not to participate in announced work stoppages. In parallel, the insurers offer individual contracts on the basis of the last offer. According to their own statements, about half of the companies have accepted this option.

However, the state association does not see this as a solution. The offered contracts are not negotiable and, in their structure, correspond to a “one-size-fits-all model” that conceals the economic reality of many businesses.

“We don't have a bad order book, but low remuneration,” says Göricke.

The utilization of the vehicles is high – the problem lies solely in financing. The dispute has a long history. For years the health insurers have used their bargaining power to push through low remuneration, the association criticizes. The fragmented structure of the industry has made it difficult to present a united front. Now resistance is forming: around a third of the companies, representing about 40 percent of the vehicle fleet, reject the current conditions.