In its judgment of 2 June 2026, the Federal Supreme Court (the Court) dismissed a physician's appeal against a judgment of the Arbitration Tribunal for Insurance Matters of the Canton of Vaud (Tribunal arbitral des assurances du canton de Vaud) of 8 April 2025, and partially upheld a cross-appeal by a group of health insurers. At issue was whether the physician could bill certain TARMED positions without holding the required specialist qualification, and whether his broader billing practice for 2016 and 2017 had been economical.

The Arbitration Tribunal had ordered the physician to repay CHF 366,957 for billing TARMED positions reserved for specialists in internal medicine, pediatrics, or general medicine, despite holding only the title of general practitioner during the relevant years. The Court confirmed this order, holding that the concept of qualifying intrinsic value predated the physician's practice in Switzerland and that his specialist title, recognised only in 2024, had no retroactive effect on his billing rights for 2016 and 2017.

The Arbitration Tribunal had also declined, for lack of reliable statistics, to examine the insurers' separate claim that the physician's practice as a whole had been non-economical. On the insurers' appeal, the Court held that the Arbitration Tribunal's inquisitorial duty under the Federal Act on Health Insurance (HIA) required it to seek corrected statistics rather than simply declining to examine that claim, and remanded the matter for further findings. Court costs of CHF 15,000 were imposed on the physician.

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