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At least 14 public health insurance funds will sue Morbi-RSA. The reason for this is a systematic error in the allocation calculation.

Among the claimants are eleven regional associations of local health insurance, including Bahn BKK, Deutsche BKK and DAK-Gesundheit. The funds will feel deprived of an annual amount equivalent to hundreds of millions.

The calculation for the funds‘ internal financing mechanism has long been the subject of criticism. Recently, several experts had analysed the methodology and its consequences and thus fuelled the calls for reform of the allocation of compensation.

 

Commentary: The criticisms are that funds such as Techniker Krankenkasse (TK) have benefitted unfairly due to its overly young and healthy members as a result of the Morbi-RSA erroneous methods. This is leading to the current uproar over excessive allocations from the main health fund.

The local funds argue that a 30-year-old insured member would have on average 104 percent of expenses covered by the fund. The coverage ratio falls with the increasing age of the insured. Thus, funds with higher proportions of older people are at a disadvantage – as is the case with the AOK.

During the introduction of the Morbi-RSA in 2009, there has been much discussion. Due to the financial implications of the list among scientists, the BVA and the cash is controversial. There are currently 80 diseases on the list of the Morbi-RSA.

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