German Doctor ID Cards Expire This June, Threatening E-Prescriptions and Sick Leave Signatures

A clock is ticking for thousands of German medical practices. Electronic health professional cards (eHBA) issued with a specific chip version — known as generation 2.0 — will stop working at the end of June 2026. Without a replacement card, physicians will no longer be able to produce legally valid digital signatures for e-prescriptions and electronic sick notes.

The warning comes from the German Federal Chamber of Dentists, but the impact stretches far beyond dental offices. The cards are the backbone of a digital health system that has rapidly replaced paper. Since July 2022, doctor’s offices have been transmitting sickness notifications directly to health insurance funds. The electronic sick note (eAU) has largely supplanted its paper predecessor.

Employers have been required to fetch eAU data electronically from insurers since the start of 2023. For most statutory-insured employees, that means no more paper certificates. The duty to report illness promptly, however, remains unchanged. A medical certificate must be submitted no later than the fourth calendar day of absence, and companies can demand proof earlier if they choose.

The eHBA expiry adds a layer of vulnerability. If a practice fails to exchange its card in time, it cannot legally sign any digital health document. That would force the clinic to fall back on paper forms — or halt digital processes altogether.

Alongside this technical deadline, a separate legal development is tightening the rules around sick notes. The Schleswig-Holstein State Labour Court ruled that a certificate of incapacity loses its evidentiary value if it covers exactly the duration of an employee’s notice period. In such cases, employers may refuse continued wage payment, and the worker must prove they were genuinely ill.

When doubts arise, companies can request the Medical Service (MD) to review a case. In 2024, the MD recommended ending a sick leave immediately in only 6.3 percent of examined cases. Industry experts also point to a less scrupulous practice: some health insurers try to shorten sickness benefit payments by phoning patients to discuss their condition. Insured persons are under no legal obligation to participate in such calls.

Financial parameters have shifted, too. Since 1 January 2026, the contribution assessment ceiling for sickness benefits rose to €5,812.50 per month, lifting the maximum daily rate to €135.63. The benefit itself remains 70 percent of gross earnings, capped at 90 percent of net pay, and can be claimed for up to 78 weeks within three years for the same illness.

These changes come against a backdrop of climbing sick leave. The average number of days off per employee reached 17 in 2025, compared to 13 in 2021. A study by Pronova BKK also suggests that roughly 60 percent of workers have at some point called in sick even though they felt fit to work.

Parallel to health-care digitisation, other municipal services are also going digital. In Mainz, a pilot phase for a daycare app began in February 2026, allowing parents to check their children out digitally. After the summer holidays, the system is expected to roll out to all city-run facilities.

For medical practices and employers alike, the message is clear: check the expiry date on eHBA cards now. Without a valid digital signature, the entire chain of e-prescriptions and electronic sick notes risks breaking — just as the rules around those sick notes are becoming stricter.

en | boerse | 69563067 |