The European Public Health Alliance (EPHA) released a report last October on the implementation of Directive 2011/24/EU (the so-called Cross-Border Healthcare Directive), which clarifies the rights of patients to seek reimbursement when travelling abroad for the purpose of receiving healthcare treatments. The Commission released its first report on the implementation of this Directive in September 2015, where a number of important gaps were identified. In particular, these concern the general low awareness among citizens about their rights as mobile patients, in spite of the National Contact Points established to provide this information, and the substantial differences in the practical implementation of the Directive at national level, with some Member States deliberately placing considerable obstacles to the patients’ rights to cross-border healthcare. The Commission also found that overall, patient flows under the Directive have been quite low so far, whether for planned care (including treatments subject to prior authorisation by the affiliate Member State) or unplanned treatments.
Essentially, the Cross-Border Healthcare Directive states that patients are entitled to receive reimbursement of health services received abroad, up to the value that the same treatment would cost in their home state. This rule was adopted in 2011 following extensive case law of the ECJ on this issue, which ended up with the Court ruling that health falls within the scope of the single market. Further, as per article 8 of the Directive, national health systems may not require patients to obtain prior authorisation to access healthcare abroad, unless the procedure is highly specialised, cost intensive, or involves overnight hospital accommodation. And in any case, Member States cannot refuse to grant the prior authorisation unless they can prove that the same treatment can be received at home without ‘undue delay’, based on an objective assessment of the patient’s condition.
The latest report by EPHA examines the status of cross-border healthcare in the EU based on the findings of the Commission report and puts forward a number of key concerns to be addressed in order to improve the implementation of the Directive:
The most ardent recommendations put forward by the EPHA to address these shortcomings include: