Germany: Hospitals demand back pay for intensive care beds and file dozens of lawsuits

A total of 46 lawsuits have been filed by German hospitals against four state governments over funding for newly created intensive care beds during the coronavirus pandemic. That’s according to a survey of the federal states’ health ministries by the editors of the German daily WELT.

The largest number of lawsuits has been filed in NRW

The situation is most striking in North Rhine-Westphalia: A total of 27 lawsuits are involved, eleven of which have been concluded. The value of the litigation in the still open cases amounts to about 6.4 million euros.

A spokesman for the Ministry of Health reports that hospitals have typically complained about “partial or denied notifications” from the state government in the context of funding intensive care beds. “The identification of a specific increase in treatment capacity in intensive care is often questioned.” Simply put, this means that hospitals are unable to prove that they actually purchased some of the approved intensive care beds with the appropriate equipment – and are now suing because they are not being reimbursed for the claimed costs.

Background: In March 2020, the federal government passed the so-called COVID Assistance Act-19. Among other things, it provides that hospitals will receive a bonus of €50,000 for each additional intensive care bed they create or convert from an existing one. This should prevent possible bottlenecks in intensive care units. This money is financed from the liquidity reserve of the health fund.

Have the beds ever been set up?

Between mid-March and the end of September, the competent Federal Social Security Administration transferred 686.1 million euros to the states for this purpose. In purely mathematical terms, this means 13,722 new intensive care beds. However, it is not known whether all of these beds have been set up at all and whether they were properly equipped. This funding expired in September 2020.

Twelve hospitals in Thuringia have also filed a lawsuit against the health ministry there. According to the health ministry, the state demanded “documents from the hospitals justifying the payments showing that investments were made.” So far, an out-of-court settlement has been reached with five hospitals: The hospitals have submitted the required documents justifying the payment and have received payments as a result.

The state of Hesse has also been sued in one case for approving three additional intensive care beds; the amount in dispute is €150,000. Lower Saxony is in the process of checking the hospitals’ documents regarding the installed ventilators, according to the Ministry of Health. As things stand, 26 lump sums, equivalent to 1.3 million euros, are in dispute.

In Bavaria, six lawsuits by hospitals are currently pending in various administrative courts, totaling €1.6 million.

Again, the Ministry of Health claims that the plaintiff hospitals did not want to provide proof of the investment costs incurred for the purchase of ventilators: they are of the opinion that the relevant law does not provide for such an obligation and that the payment should be regarded as a “bonus independent of investment costs”.


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