Three federal states are complaining: there is a threat of bottlenecks in the care of premature babies!

Three federal states are complaining: there is a threat of bottlenecks in the care of premature babies!

On August 12, 2025, the states of Saxony-Anhalt, Baden-Württemberg and Schleswig-Holstein filed a lawsuit with the Federal Constitutional Court. They object to the nationwide guidelines of the Federal Joint Committee (G-BA) on hospital planning. The point of contention particularly concerns the care of very small premature babies whose birth weight is less than 1,250 grams. This regulation stipulates that from 2024 clinics will only be reimbursed by health insurance companies if they can prove that they treat at least 25 cases of such patients annually. Previously, this value was 20 cases and only 14 cases in previous years, as MDR reports.

The Thuringian Health Minister Petra Grimm-Benne (SPD) expressed concerns about the compatibility of these requirements with the state responsibility for hospital care. The federal states fear that the new regulations will lead to supply bottlenecks. Health Minister Manne Lucha from Baden-Württemberg also emphasizes the need for the lawsuit to protect the state's responsibility. In addition to the criticized minimum amount for the care of premature babies, there are also requirements for allogeneic stem cell transplants, where the required number is increased from 25 to 40 transplants per year. Requirements for staffing in psychiatry and psychosomatics are also sharply criticized, as only half of the facilities met the requirements in 2023.

The fears of the countries

The states are concerned that the G-BA guidelines limit the states' responsibility for hospital care. They argue that exceptions to the minimum quantity requirements are difficult to obtain and that this could lead to unjustified supply pressure. The debate about the constitutionality of these regulations is likely to have far-reaching consequences, especially since a nationwide hospital reform is being discussed in parallel with this lawsuit. This reform stipulates minimum retention figures for 61 performance groups, which creates additional uncertainty in the industry.

The Institute for Quality and Efficiency in Health Care (IQWIG) is commissioned to develop a methodology for determining these minimum retention numbers. In addition, it is expected that a separate legal regulation will be drawn up for occasional care in clinics, the deadline for which will now be extended to December 12, 2026, according to reports Ärzteblatt is reported.

Outlook and discussion

The entire topic will continue to be discussed intensively. A G-BA legal symposium planned for June 2024 in Berlin is intended to help analyze the effects of the new regulations and discuss measures to improve inpatient care. Topics such as quality assurance and the rights of self-government are the focus, as highlighted on the official website of the G-BA.

In summary, it is clear that the outcome of this lawsuit is not only important for the three federal states affected, but could have far-reaching consequences for the entire hospital landscape in Germany. It remains to be seen whether the states' concerns will be taken seriously or whether the central requirements of the G-BA will remain in place.