Germany coalition plans sick leave changes and doctor fee corrections

The German governing coalition is pursuing two major healthcare and labor policy shifts. First, the Union and SPD have reached an agreement to abolish the controversial 'fixed cost degression' for general practitioners and pediatricians. This measure, originally part of the GKV Contribution Rate Stabilization Act (BStabG), would have reduced reimbursements for practices that treated a high volume of patients. The correction aims to prevent a reduction in medical services and is expected to be finalized by October to take effect before January 1, 2027.

Second, the coalition is planning to tighten sick leave regulations by requiring a medical certificate (AU) starting from the first day of illness. Proposed by Chancellor Friedrich Merz to reduce economic disadvantages caused by absenteeism, the plan faces opposition. Labor Minister Bärbel Bas has expressed concerns regarding potential strain on medical practices and the practicalities of the requirement. While the policy aims to eliminate telephone-issued certificates, video consultations may remain an option, and certificates do not necessarily need to be submitted on the very first day of illness.