On March 6, 2026, the German Bundestag passed the Hospital Reform Adjustment Act (KHAG), thereby readjusting key elements of the hospital reform. Three points are particularly relevant for hospital reimbursement and market access:
- Firstly, the number of medical service groups will be reduced (61 instead of 65). Quality criteria with minimum requirements will remain in place, but exceptions to the allocation will be expressly permitted. In oncological surgery, the German Federal Joint Commitee G-BA can also set lower case number limits for specific indications in order to ensure regional care provision.
- Secondly, the pre-reimbursement is being postponed: 2026 and 2027 are considered budget-neutral, 2028 and 2029 are considered a convergence phase, and full financial effect is expected from 2030 onwards. This extends the transition phase in hospitals in parallel with the DRG logic.
Thirdly, the transformation fund will be strengthened financially and financed differently: federal funds from the special infrastructure and climate neutrality fund will be channeled into the transformation fund; the federal share and the tranches for the years 2026 to 2029 will be adjusted accordingly.
In addition, the J-FC (G-BA) will take over the hospital transparency register in future.
For international medtech manufacturers, the following still applies: CE-market authorization enables distribution, but does not replace the reimbursement and market-access logic in hospitals.
Especially in the highly regulated German market, such framework conditions should be incorporated into pricing, evidence and go-to-market planning at an early stage.
Healthcare Heads supports international medtech companies with reimbursement and market access strategies, including scenarios, data evaluations.
Please contact us to schedule an initial meeting to discuss the relevance of the KHAG for your technology.
Get in touch now and start with a reimbursement analysis.
Author: Healthcare Heads GmbH
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