Summary

On May 20, 2026, the Federal Council commissioned the Federal Department of Home Affairs to develop a draft law amending the Federal Health Insurance Act (LAC) to enable cost coverage of medical services provided by Advanced Practice Nurses (APN) under mandatory health insurance (MHI). This measure aims to address the growing shortage of general practitioners, which cannot be solved solely through additional study places or foreign specialists due to increasing retirements and reduced working hours. The draft law is to be submitted for public consultation by the end of the first half of 2028.

Persons

Topics

  • Healthcare provision
  • Nursing professionals
  • Health insurance law
  • General practitioner shortage

Clarus Lead

The regulation of APNs marks a structural turning point in Swiss primary care: while demographic pressure (aging population, chronic diseases) increases demand for general practitioner services, supply simultaneously shrinks through retirements and reduced working hours. The integration of APNs as autonomous service providers into health insurance creates a new care logic: not replacing doctors, but distributing workload. The coordination with the ongoing revision of the Health Professions Act demonstrates that this solution is part of a larger system reform – the Nursing Initiative is thus translated into concrete service structures.

Detailed Summary

Advanced Practice Nurses are nursing professionals with a Master's degree in Advanced Practice Nursing who possess sound medical competencies and can provide certain services in collaboration with responsible physicians. The Federal Council prefers an employment model in which APNs work in ambulatory settings and provide services under their own professional responsibility but under medical coordination. Billing is conducted by the facility to the MHI, which requires APNs to be registered as new service providers under the LAC.

The Nursing Initiative has already led to an examination by the Federal Office of Public Health regarding which services meet the criteria for MHI coverage and how collaboration between service providers can be organized. The LAC amendment must be coordinated with the second phase of the Nursing Initiative, which will regulate APN training and professional practice in the Health Professions Act. The Federal Council expects that APNs will partially address the general practitioner shortage, reduce the workload of general practitioners, and promote professional development of nursing professionals.

Key Points

  • The Federal Council commissions the development of a LAC amendment draft to enable MHI cost coverage of APN services by the end of H1 2028.
  • Advanced Practice Nurses are to work in ambulatory settings under their own professional responsibility and medical coordination.
  • This measure addresses the structural general practitioner shortage through task-sharing rather than staff replacement.

Critical Questions

  1. Evidence Quality: What empirical data demonstrate that APNs working in collaboration with physicians achieve equal or better care quality in primary care compared to traditional general practitioner models?

  2. Conflicts of Interest: How will it be ensured that collaboration between APNs and physicians does not lead to under-care when financial incentives for cost savings exist?

  3. Causality of Bottlenecks: Is the general practitioner shortage actually a supply problem (too few doctors), or do causes also lie in workload, remuneration, or job satisfaction that APN integration will not solve?

  4. Implementation Risks: How will coordination between APNs and physicians be concretely regulated when APNs are employed – what liability and responsibility questions arise?

  5. Regulatory Gaps: Which specific services can APNs provide, and how will it be prevented that the definition becomes too broad or too narrow?

  6. Transition Phases: How long will it take until sufficient APNs are trained to provide measurable relief to general practitioners?

Sources

Primary Source: Federal Council – Press Release of May 20, 2026: "General Practitioner Shortage: Federal Council Commissions Development of LAC Amendment for Advanced Practice Nurses" – https://www.news.admin.ch/de/newnsb/BGwH1mELr9F7AkuXWDKJn

Supplementary Sources:

Verification Status: ✓ 20.05.2026

This text was created with the support of an AI model. Editorial Responsibility: clarus.news | Fact-Check: 20.05.2026