In its judgment of 21 August 2026, the Federal Administrative Court (FAC, the Court) declined to enter into the appeal of prio.swiss, the association of Swiss health insurers, against the 2025 hospital list for acute somatic care of the Canton of Schwyz. At issue was whether health insurance associations could challenge a cantonal hospital list as a whole under the right of appeal introduced on 1 January 2024.

The Government Council of the Canton of Schwyz had adopted the 2025 hospital list for acute somatic care and rehabilitation by resolution of 3 June 2025. The association challenged the acute somatic care list in its entirety, claiming that it was based on hospital planning in breach of federal law, in particular the requirement of intercantonal coordination. It argued that art. 53 para. 1^bis of the Federal Act of 18 March 1994 on Health Insurance (HIA) granted it a right of appeal in the public interest which, according to the legislative materials, was intended to allow the review of entire hospital lists.

The Court rejected this view. Under its established case law, a hospital list constitutes a bundle of individual rulings, each concerning a performance mandate, and cannot be challenged as such. Interpreting art. 53 para. 1^bis HIA, the Court held that neither its wording, which mirrored art. 53 para. 1 HIA, nor the legislative materials indicated an intention to depart from this case law. The parliamentary debates had focused on whether to introduce the right of appeal, not on its object. Moreover, a challenge to the hospital list in its entirety would delay the implementation of the hospital planning and the service mandates (Leistungsaufträge) and create legal uncertainty for hospitals and patients.

The Court emphasised that standing and the object of appeal had to be assessed separately. Associations could challenge any or all individual performance mandates and invoke deficiencies in the underlying planning. However, they had to specify which mandates were affected, explain why these required correction, and demonstrate a current and practical interest arising from a concrete threat to the interests of compulsory health insurance. Specific requests had to be submitted already when exercising the right to be heard in the cantonal hospital planning process, as new requests were inadmissible before the Court.

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