Chart of the Legal Status of the GBA

The diagram explains the legal status of the GBA (Federal Joint Committee) and its guidelines in the form of a pyramid with six levels:

  1. At the top of the pyramid is the federal legislation by the German Bundestag. This is followed by the regulation of the Federal Ministry of Health or other federal ministries if applicable.
  2. The directives of the GBA are below these two regulatory levels, i.e. they implement the law and the regulation.
  3. Below this level, the self-governing partners at the federal level (KBV, KZBV, DKG, GKV-SV) determine the further implementation of the GBA directives in contracts.
  4. Further regulatory requirements are specified by the self-governing partners at the state level (e.g. Association of Statutory Health Insurance Physicians, state federations of statutory health insurance providers) in their own contracts.
  5. At the bottom of the pyramid are the by-laws of the statutory health insurance providers and the Association of Statutory Health Insurance Physicians.
  6. Abbreviations: KBV = National Association of Statutory Health Insurance Physicians, KZBV = National Association of Statutory Health Insurance Dentists, DKG = German Hospital Federation, GKV-SV = National Association of Statutory Health Insurance Funds

GBA, November 2023