The Joint Federal Committee (G-BA), as the highest body of joint self-governance in the healthcare sector, has set out specific minimum requirements for emergency care in hospitals. The changes came into force on 20 June 2026.

In future, alongside the three established levels (basic, extended and comprehensive) of emergency care, there will also be a „non-participation“ level. Hospitals that do not meet all the minimum requirements for emergency care will be classified as non-participating and must expect financial penalties. The minimum requirements include, for example, that the hospital must either maintain a combination of specialist departments in the fields of surgery and internal medicine, or have a specific, independent specialist department such as ophthalmology or dermatology, which is able to treat emergencies within its specialist field independently as part of its care mandate. It is also required that medical and nursing staff employed by the hospital be available on site at all times to provide emergency care. Laboratory and diagnostic imaging services must also be available at all times.

The current changes stem, amongst other things, from a ruling by the Federal Social Court in the spring of 2025, which an ophthalmology clinic had successfully secured with the help of DOMBERT Rechtsanwälte. The court had criticised, on the one hand, the fact that under the previous regulations, non-participation in emergency care was not defined as a separate tier with specific conditions (Ref.: B1 KR 25/23 dated 2 April 2025). On the other hand, it had criticised the fact that it was not clear from the G-BA’s regulations what reduction in workload on the part of hospitals not participating in emergency care justified the discount.

„It is doubtful whether the G-BA has taken sufficient account of this criticism in its new regulations,“ says Rechtsanwalt Dr Maximilian Dombert. „In any case, hospital operators must now check whether their hospital meets the minimum requirements of the new guideline or not. As further legal disputes cannot be ruled out, any such findings in the budget agreements should, for the time being, be made subject to reservation.“