The Federal Administrative Court (BVerwG) has clarified that a university hospital cannot determine the scope of its care mandate itself. Rather, the hospital planning authority must make these determinations on its own responsibility (case reference: 3 C 3.24 of 4 December 2025). This is also compatible with the constitutionally protected freedom of research and teaching.

In this case, a university hospital wanted to be included in the Saxon hospital plan as a facility for specialised obesity treatment and as a centre for liver transplants. The clinic also justified this on the grounds of research and teaching. Its application was rejected on the grounds that care in these areas was already covered by other hospitals. The university hospital appealed against this - but without success.

As the Federal Administrative Court has now explained, in the case of university hospital care, the freedom of science „must be appropriately balanced with other fundamental rights and constitutionally protected interests, in particular the objectives of hospital planning“. First and foremost, hospital planning is orientated towards the best possible patient treatment. However, the freedom of science must also be taken into account when including university hospitals in hospital planning. In the opinion of the BVerwG, different interests were sufficiently taken into account in the present case.

Rechtsanwalt Dr Maximilian Dombert advises municipal and commercial hospital operators in Germany and welcomes the clarification: „The funding obligation of the federal states and the authorisation of hospitals to bill the statutory health insurance funds for services presupposes that the responsible state authorities carry out an overall assessment of demand, performance and cost-effectiveness. For this reason, an autonomous authorisation of the university hospitals to choose and determine their care provision would be alien to the system.“

Rechtsanwalt Prof. Dr Klaus Herrmann refers to the emphasis placed on research and teaching in hospital planning: „The particular challenge for university hospitals is to represent these concerns to hospital planning in such a way that they are understood and taken into account as comprehensively as possible.“