Hospitals in Germany are complaining about the growing frequency of inspections conducted by the Medical Service (MD) of health insurance funds. According to an evaluation published by the German Hospital Institute and reported by the “Rheinische Post”, approximately 4,000 full-time employees across the country are primarily involved in processing these MD inspections.
These inspection efforts incur substantial personnel costs; nationwide, the estimated total amounts to around €245 million. On average, each hospital dedicates roughly four full-time staff members to managing MD inspections, leading to average annual staffing expenses of nearly €236,000 per facility.
The industry is concerned that this volume of inspections will increase due to the health insurance reform, specifically the Contribution Rate Stabilization Act. The survey further revealed that 98% of all German hospitals anticipate that their inspection quotas will rise starting January 1, 2027. Already, over half of the hospitals (53%) have either hired or are planning to hire additional personnel in 2026 to handle the MD inspection workload.
Gerald Gaß, head of the German Hospital Association (DKG), has sharply criticized this trend, stating that the figures are “alarming.” He argues they demonstrate the extent to which a culture of distrust among health insurers is dominating the healthcare sector. Gaß asserts that the Medical Service is increasingly being misused by health insurers as an instrument for cost optimization. While he insists that actual fraud must be punished, he argues that extensive and highly granular regulation, resulting in constant inspection “orgies,” is counterproductive. Therefore, he advocates for deregulation as the most effective way to significantly reduce bureaucracy and inspection burdens.
