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The Bundestag passed the Fair Competition Act and thus complied with the long-demanded reform on morbidity-oriented risk structure compensation (Morbi-RSA). The core of the law is the financial equalisation between the health insurance funds. To this end, new calculation and equalisation components are to be introduced so that, for example, cost differences in health care provision depending on the region are cushioned. A further innovation is that the allocation of the Morbi-RSA will take account of 300 diseases instead of 80 as previously. Furthermore, there is to be a high-risk pool with which very high treatment costs of individual insured persons can be covered. However, the disability pension will no longer be included in the calculation. In contrast to the Federal Ministry of Health (BMG), the SHI Board will not be reduced in size for the time being. Similarly, to the regret of parliamentary state secretary Thomas Gebhart, there will be no opening of the regional AOKs. The BMG’s plan failed due to the resistance of the SPD and the health ministers of the states.
In addition to the law, regulations will also be introduced that will make wholesalers and manufacturers subject to the obligation to report supply bottlenecks. In the course of this, the Federal Institute for Drugs and Medical Devices (BfArM) will be given additional powers, such as the demand for stocks of individual drugs and the establishment of an advisory board.
The health insurance companies are generally positive about the law and the reforms that have been initiated. The exception is the AOK, which criticises the introduction of the regional component in view of the oversupply in certain conurbations. Thomas Gebhart describes those insured by the statutory health insurance as „winners“ of the reform. Christoph Straub, chairman of the board of Barmer-Ersatzkasse, considers the new law to be a „groundbreaking reform“. The opposition from the Greens and the FDP criticize that the law does not set any prevention incentives. Likewise, the evaluation of the Morbi-RSA planned for 2023 with regard to the regional quota is too late.

Source: Ärzteblatt