19. Juli 2024 – In its decision of 12 June 2024, the Federal Administrative Court ruled on the appeal by the Vaud Society of Medicine (Société vaudoise de médecine, SVM) against a decree of the Cantonal Council of the Canton of Vaud. The case concerned the extension of the 2020 tariff for the reimbursement of outpatient services. The main legal question was whether the Cantonal Council was obliged to establish a framework tariff pursuant to Art. 48 of the Federal Health Insurance Act (Bundesgesetz über die Krankenversicherung, KVG) instead of extending the previous year’s tariff agreement for 2021 in line with Art. 47 para. 3 KVG).

The Cantonal Council had extended the 2020 tariff agreement by one year and set the TARMED tax point (Taxpunkt) at CHF 0.95. SVM argued that this extension violated federal law, which would require the Cantonal Council to establishment a framework tariff. The Cantonal Council argued that extending the previous year’s tariff agreement was within its discretion.

The Federal Administrative Court ruled that the Cantonal Council was free to choose one of the options provided for in Art. 47 and 48 KVG in the absence of a tariff agreement. However, if associations of doctors are parties to the tariff agreements to be approved, it was obliged to set a framework tariff when approving them, which will enter into force if no new agreement is reached in the following year. The Federal Administrative Court upheld SVM's appeal and annulled the decree by the Cantonal Council to extend the 2020 tariff agreement. It ordered the Council to set the framework tariff for 2021.

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