According to the decision of the traffic light coalition, the cultivation and possession of cannabis in Germany should soon be legal, provided the EU does not thwart the plans.

The first senate of the Federal Social Court (BSG) in Kassel rejected an anticipation of the project, specifically an extensive claim to the assumption of costs for cannabis products by health insurance companies.

Only seriously ill people could be prescribed cannabis in Germany and only after a thorough and careful examination by their doctor, emphasized Rainer Schlegel, the President of the BSG and at the same time the Presiding Judge of the Senate, in his oral verdict on Thursday.

If the high requirements for this assessment are met, the health insurance company may only check the result of the medical assessment if

Marcus Young

Editor in Business.

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In three cases, the highest German social court rejected the appeals of insured persons against the refusal to assume costs.

Only in the case of a lawsuit against the Betriebs-BKK did the Senate overturn an earlier judgment, here the Lower Saxony-Bremen State Social Court still has to clarify some open questions (Az. B 1 KR 28/21 R et al.)

According to an amendment to the law, it has been possible to prescribe medicinal cannabis, cannabis flowers or cannabis extracts on prescription in this country since 2017.

The active ingredient tetrahydrocannabinol (THC) brings good treatment successes, especially in chronically ill people.

In contrast to other (remedial) prescriptions, approval by the insured person's health insurance company is required for the first prescription.

It only covers the costs according to Section 31 Paragraph 6 of the Social Security Code V if there is a serious illness and other treatment methods, in particular recognized standard therapies, have already been exhausted.

In the cases now being negotiated, several patients, one of them through his supervisor, had applied to their health insurance companies for the supply of medical cannabis products and for the costs to be covered.

The plaintiffs suffer from epilepsy, ADHD, pain or mental illness.

The health insurance companies had refused the approval, among other things with reference to the previous drug consumption of the insured persons.

During the oral hearing, the Senate discussed controversial issues with the parties.

For example, when a “serious illness” is present and how much it affects participation in public life, work and family.

There was a lot of need for discussion about the medical justification for such a therapy - he had the feeling that cannabis had become a "cure-all" for some doctors, said a representative of the defendant AOK Baden-Württemberg.

The insurance companies also complained that many doctors would formulate their findings too briefly and with regard to the form of therapy too imprecisely.

More work for doctors

In the subsequent verbal justification of the verdict, the assessment of the patients by doctors played a central role.

In the future, it cannot simply be questioned by the health insurance companies.

However, the First Senate specified the expectations of the "reasonable assessment" and made high demands.

This must specifically contain the state of health, the clinical picture and the desired treatment goal.

In addition, doctors there have to describe tried and tested therapies, their results and possible side effects.

They should also consider the possible harmful consequences of cannabis use for their patients.

In return, health insurance companies may only check this assessment for its completeness and plausibility of the consideration.

In its decision, the BSG left open whether a previous addiction generally precludes a prescription.

The doctor must also carefully weigh these up in individual cases, it said in Kassel.