According to research by NDR, WDR and Süddeutsche Zeitung, health insurance companies waste money of their insured for additional services of radiologists if they buy certain drugs such as X-ray contrast media cheaply from pharmaceutical companies and settle expensive bills with the health insurance companies of the insured. Numerous German states, including Bavaria, North Rhine-Westphalia, Hamburg, and Lower Saxony, have reacted to this and ordered cuts in the lump-sum payments. Lucrative additional earnings of up to 100,000 euros per tomograph and year were the rule for radiologists. The contrast agents allow for the improvement of image quality in numerous examinations in magnetic resonance imaging (MRI) and computer tomography (CT). However, the potential gains from the contrast media billing also provided an incentive for radiologists to use more contrast media than necessary, which led to outrage in the political debate, as the agents are allergenic in individual cases and can lead to serious side effects. Invoices from pharmaceutical companies and delivery notes to doctors‘ surgeries brought to light the high additional earnings of these specialists. There are now cuts in the lump sum in some federal states. The AOK Westfalen-Lippe speaks of halving the flat rate for MRI examinations for these contrast media. There will soon be calls for tenders to ensure that the cheapest provider is awarded the contract. In Hamburg and Lower Saxony, the flat rates have already been reduced by 30 to 35 percent. The most consistent line is being taken by the state of Bavaria, which was the first to cut the flat rates drastically in October 2019. Since then, one litre of contrast medium costs only 970 euros for MRI examinations. Previously, the AOK paid an impressive sum of 3900 euros. The CT contrast agent flat rate has also been reduced from 470 euros to 110 euros per litre. However, according to research experts, radiologists still earn enough from administering these drugs. The health insurance companies have savings of 50 million euros per year. Some experts even estimate the cost savings to be much higher, because health insurance companies of some German states refer to „business and trade secrets“. Politicians are therefore also calling for more transparency in order to reveal the damage to the general public.
