Bundestag adopts new regulations for the remuneration of home nursing care

On November 9, 2018, the Bundestag voted on the Nursing Staff Strengthening Act (PpSG). The law, which essentially aims to improve the situation for nursing staff in the care of the elderly and sick, also contains some interesting new regulations for home nursing care, some of which were only included in the law shortly before the end of the legislative process through amendments (Bundestag printed paper 19/5593).

Section 132a para. 1 sentence 4 no. 5 SGB V now stipulates that the framework recommendations of the umbrella organizations at federal level should not only regulate the principles of remuneration and its structures, including the transparency requirements for remuneration negotiations to prove the actual wages or salaries paid, but must now also regulate principles for the remuneration of longer travel times, especially in rural areas, by means of surcharges including outpatient care in accordance with Book Eleven for the first time by 30.06.2019. This is intended to counter the fact that health insurance funds often only want to pay for the pure care time in remuneration negotiations, but do not want to agree separate remuneration for the sometimes long journeys to the insured person.

In addition, the legal requirements for the remuneration agreements to be concluded between the care service and the health insurance fund have been supplemented. Section 132a (4) SGB V clarifies that the payment of salaries up to the level of collectively agreed remuneration and corresponding remuneration in accordance with church labor law regulations cannot be rejected as uneconomical. In addition, it is regulated that the principle of contribution stability regulated in Section 71 SGB V, which has often been used by health insurance funds to limit remuneration increases in remuneration negotiations, does not apply in this respect. It is also stipulated that the service provider is obliged to comply with the corresponding payment of employees at all times and to provide evidence of this at the request of a contracting party. The legislator is extending the existing regulation for the outpatient care sector (Section 89 (1) sentence 4 SGB XI) to include home nursing care and would like to use this as an incentive to pay employees accordingly.

All of the aforementioned legal changes are very welcome, as they should provide significant support for (intensive) care services in future remuneration negotiations. Due to the other provisions of the PpSG, which also create incentives for hospitals to remunerate nursing staff better and, in particular, to retain a sufficient number of nurses in hospitals, the battle for nursing staff is likely to intensify further. As a result of this market pressure alone, outpatient nursing services, which are also active in the area of home nursing care, will have to develop concepts to offer their employees attractive wages and working conditions, particularly in comparison to inpatient employers.

Date: 14. Nov 2018