In its decision of 14 April 2026, the Federal Supreme Court declined to enter into the appeal of two industry associations (Verband A. and Verband B.) challenging the Canton of St. Gallen's decision not to increase the maximum rates for nursing home financing and supplementary benefit daily flat rates as of 1 January 2026.

The Canton of St. Gallen's Ordinance on Nursing Financing (kantonale Verordnung über die Pflegefinanzierung vom 14. Dezember 2010, PFV) sets maximum rates per care level, which the cantonal government is required to review every three years under cantonal law. Following a review in September 2025, the St. Gallen government had decided not to increase the rates for 2026, citing cantonal budget consolidation measures, while indicating that it would revisit the matter in 2027. The two associations had challenged the underlying resolution (Beschluss, RRB 2025/651), requesting the Federal Supreme Court to annul it and order the government to adjust the maximum rates in line with federal law. The Federal Supreme Court held that the appeal was inadmissible. The Court found that RRB 2025/651 did not constitute a cantonal legislative act (kantonaler Erlass) subject to abstract judicial review under art. 82 lit. b of the Federal Supreme Court Act (Bundesgerichtsgesetz, BGG), as the resolution merely instructed the competent departments to inform affected parties of the decision by letter, without any normative content. The Court further held that art. 2 PFV, which had last been amended in early 2023, remained in force in its existing form and could not be challenged given the statutory time limit under art. 101 BGG. The associations' alternative argument – that the government had failed to fulfil its legislative mandate, giving rise to a denial of justice under art. 94 BGG – was equally rejected: the Court held that such a claim would require a sufficiently clear and specific legislative duty under federal or international law, which the associations had failed to identify. In particular, the Court noted that art. 25a para. 5 of the Federal Health Insurance Act (KVG) affords cantons a wide margin of discretion in regulating residual nursing cost financing, and thus does not give rise to a sufficiently determinate obligation to act.

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