The Berlin-Brandenburg Higher Administrative Court (OVG) has declared the rescue service fee statutes of the Teltow-Fläming district invalid (judgement of 28 January 2026, ref.: 6 A 13/25). A total of eleven health insurance companies had filed a complaint against the fact that so-called empty journeys, i.e. journeys where patients are not taken to hospital, were not shown separately in the ambulance service fee calculation and that these journeys were therefore cross-financed by the health insurance companies.

According to the OVG, these empty journeys did not constitute services that directly benefited the fee debtors, which is why they did not have to bear the costs. The previous regulation in the rescue service fee statutes „is not in line with the general principle of service and cost proportionality enshrined in law“, according to the court's press release.

This ruling has fatal consequences for the districts, says Rechtsanwalt Dr Maximilian Dombert, who represents the district of Teltow Fläming together with Rechtsanwalt Michael Jessen-Lieberum. The districts would not only have to fear repayments to the health insurance companies, but would also have to reckon with annual deficits in the millions, as the legislator in Brandenburg had assumed that the fees for using the rescue service would cover the costs in full, according to Dombert. The state is now called upon to close this funding gap if it is to avoid the rescue services only being able to perform to a limited extent. 

The problem of how to finance empty journeys is currently occupying several districts and cities, not only in Brandenburg but also in North Rhine-Westphalia. In Essen, the city council recently decided that patients would have to pay part of the costs of ambulance journeys themselves. However, it then abandoned this plan again following public pressure.