Why psychologists file complaints against health insurance companies

The Swiss Federation of Psychologists (FSP) has lodged a complaint against one of the two umbrella organizations for health insurance, Santésuisse, with the supervisory body, the Federal Office of Public Health (OFSP). The subject of the dispute? Non-reimbursement of services provided by psychotherapists in training by certain health insurance companies that are members of Santésuisse. A showdown that has been going on for months and getting worse.

Why are we talking about it. Since 1 July 2022, psychotherapists can invoice their services directly without going through the supervision of a psychiatrist. The new legal framework defines quite clearly who can and cannot charge for psychotherapy sessions, but there is some ambiguity regarding professionals in training.

A breach that pressures the umbrella organization to deny reimbursement from compulsory health insurance and leaves around 1,500 psychologists in further training embarrassed and patients without a shrink. Explanations.

Also read: “More proximity and less waiting”: the new reimbursement system for shrinks

The causes of anger. We thought everything was finally settled: psychologists and psychotherapists recognized at the federal level went from the so-called delegation system to the so-called prescription system on July 1, 2022. It is clear that they can bill their services directly without being under supervision by a psychiatrist. A hard-won autonomy.

But when it was time to get down to business, namely to define a tariff, the relationship between Santésuisse and FSP deteriorated. In June 2022, a provisional tariff structure was established between the tariff partners with the same point value (the amount that each practitioner can charge depending on the canton in which he practises, ed. note.) has been approved by all the cantons.

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