Terugbetaling van de kosten van grensoverschrijdende medische behandeling: inbreukprocedure tegen Spanje, Frankrijk, Luxemburg en Portugal (en)
The European Commission has decided to bring actions before the European Court of Justice against Portugal and France and to send reasoned opinions to Spain and Luxembourg with regard to cases where the cost of medical treatment received in another Member State has not been reimbursed. The Court of Justice has on several occasions expressed its opinion on the reimbursement of medical expenses incurred in another Member State and recognised patients’ rights not granted in these countries.
France and Portugal
The Court takes the view that, under Article 49 of the EC Treaty, Member States should no longer require non-hospital treatment in another Member State to be subject to prior authorisation. The Commission believes that, given the continued existence of prior authorisation for the reimbursement of non-hospital treatment in Portugal and of certain types of non-hospital treatment in France, these two Member States are restricting patients’ rights under Article 49 of the EC Treaty as recognised by the Court.
The Commission has also criticised France for failing to implement the Court’s ruling in Case C-368/98 (Abdon Vanbraeckel and others v Alliance nationale des mutualités chrétiennes). French legislation runs contrary to Article 49 of the EC Treaty, in that it does not allow patients treated in a hospital in another Member State to be reimbursed at levels at least equivalent to what they would have received had they received treatment in a French hospital.
The Commission has therefore decided to bring actions against these two Member States before the Court.
Spain and Luxembourg
The Commission has decided to send a reasoned opinion to Luxembourg, due to its failure to reimburse the cost of medical tests carried out in another Member State. Given the case-law referred to above, the Commission regards the systematic refusal to reimburse patients in respect of these costs as incompatible with Article 49 of the Treaty.
The Commission has also decided to send a reasoned opinion to Spain, since prior authorisation continues to be required in this country for the reimbursement of non-hospital treatment. As with the cases of France and Portugal as indicated above, this obligation amounts to a restriction of patients' rights. The Commission has also criticised Spain for requiring prior authorisation for the reimbursement of the cost of hospital treatment, despite not having a system for the issuing of such authorisations that is in line with legal certainty and transparency criteria.
Like the Court, the Commission takes the view that the implementation of a system of this kind is essential if patients’ rights are to be protected so that, if necessary, they can challenge any refusal decisions made against them. The Commission has also criticised Spain for refusing to include hospitalisation costs simply because a request for authorisation was not submitted before treatment was started in another Member State.
Up-to-date information on the infringement proceedings involving Member States can be found at the following address: