Doctors in private practice receive a flat rate of 2,300 euros for the replacement of the connectors for their “digital equipment”. According to the decision of the Federal Arbitration Office for contract medical care, the statutory and private health insurance companies will provide a total of 400 million euros for the practices. The decision was preceded by negotiations between the National Association of Statutory Health Insurance Physicians and the Central Association of Health Insurance Funds.
So far it was unclear who should pay for the replacement of the particularly secure router. In the past, doctors have repeatedly had to pay part of the costs in connection with the telematics infrastructure – on average, each practice has paid around 9000 euros, as the most recent representative meeting of the National Association of Statutory Health Insurance Physicians (KBV) shows.
Expiring certificates create electronic waste
The connectors connect the practices to the telematics infrastructure, which is intended to network all players in the healthcare system. The prerequisite for the exchange is that the term of the security certificate in the connector is only six months or less. There should also be other flat rates, including for a necessary update that should enable the use of the electronic patient file.
Safety certificates not permanently installed
Only recently c’t found out in an investigation that the security certificates are not permanently installed, contrary to the information provided by the manufacturer CGM. When asked, CGM and Gematik could not name any technical reasons that would make a complete replacement of the hardware unavoidable. Likewise, connectors from the manufacturers RISE and Secunet are to be replaced, although they support software updates.
According to the National Association of Statutory Health Insurance Funds, the connector exchange is necessary because “the built-in security certificates are expiring and in the future the crypto processes will have to be converted to newer processes in accordance with the specifications of the Federal Office for Information Security”. In fact, new requirements for longer security keys will apply from 2025 – but these requirements could also be met by replacing the device-specific Security Module Cards (gSMC-K cards), since the complete crypto calculations take place on the cards. The exchange campaign could result in insurance premiums rising even further. The health insurance companies are currently short of about 17 billion euros. Among other things, Karl Lauterbach wants to ask the insured to pay for this.
KBV demands complete financing
According to information from the German medical news service, the KBV is dissatisfied with the decision. It is true that the amount is higher than the health insurance companies wanted to pay. “Nevertheless, the result does not meet our demand for full financing of the costs, which was based on the price charged by the manufacturer,” criticized Thomas Kriedel, member of the KBV board. “Doctors and psychotherapists are legally obliged to have their practices connected to the telematics infrastructure. They are not responsible for the fact that the connectors have to be gradually replaced from autumn onwards. The replacement must be fully financed.”
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