Schiedsverfahren

A pharmazeutische Dienstleistung does not arrive with its conditions and its fee written into the law. Both come out of a contract negotiated between the pharmacists' national negotiating body and the umbrella body of the statutory health insurers. When the two sides cannot agree, the matter goes to arbitration, and that route is the Schiedsverfahren. An arbitration body decides, and its decision stands in place of the agreement the parties failed to reach.

The composition of that body, how it is convened, who may bring a matter to it and what happens while a decision is pending are procedural questions set out in the guidance from the ABDA and the Landesapothekerkammer rather than in anything a pharmacy owner reads day to day. At the level of a single pharmacy the mechanism is simpler.

The fee for a service is a negotiated and contestable number. It was arrived at by two parties with opposed interests, it can be renegotiated, and it can be sent to arbitration and come back changed. That is a different kind of number from a price fixed by regulation. It means that any euro figure a pharmacy sees quoted for a service is a figure as at a date, and that quoting it without the date is how a business case ends up built on a number that has since moved. The same applies to the Impfhonorar, which has been changed more than once by exactly this route.

Two practical consequences follow. The first is documentary. When a service is billed, the fee that applied on the day of the service is the one that belongs on the Sonderbeleg, and a pharmacy that has not kept track of when a rate changed will find the reconciliation harder than it needed to be. The second is about planning. A calculation that only works at the current fee is fragile, because the fee is one of the inputs least under the pharmacy's control. Anyone modelling a service through the Apothekenreform should know which figures in the model are set by negotiation and be able to say what happens to the result if one of them moves.