Wenn die Krankenkasse schwächelt – Mit der Auslandsbehandlung importierte Insolvenzrisiken

Abstract

Supranational and interstate law under certain conditions allows patients with statutory health insurance to benefit from medical treatment in other European member countries at the expense of their domestic health insurance carrier. The interstate billing and reimbursement of costs between the responsible health insurance carrier in the home country of the insured person and the ancillary health insurance carrier in the country of residence takes place via national contact points. The aim of this article is to illustrate the financial burden a German statutory health insurance carrier bears that arises from pre-financing treatment costs of foreign patients. As of now, the AOK Bavaria has open claims against foreign health insurance carriers amounting to more than 100 million EUR – receivables that are not interest-bearing. [1] As so called “competent institution” (Reg EC 883/2004 Art. 1 q) some foreign health insurance carriers in charge pay only
after years, others do not pay at all. In Germany, statutory health insurance carriers are legally obliged to cover costs from European guest patient treatment via advance
payments, although they have no dedicated means for that. Neither are they allowed to take out a loan on capital markets. As a corollary, foreign health insurance carriers that do not fully comply do not only carry liquidity problems but also real insolvency risks for the ancillary German health insurance carrier.