European law report - Patient mobility directive
The free movement of people, goods and services is a driving force behind the establishment and continued sustainability of the European Union. In a bid to ensure free movement to health services, the European Commission recently adopted a proposal for...
The free movement of people, goods and services is a driving force behind the establishment and continued sustainability of the European Union. In a bid to ensure free movement to health services, the European Commission recently adopted a proposal for a directive aimed at facilitating patient mobility within the EU.
The Commission's draft directive is an attempt at codifying the European Courts' judgements in recent years, which have consistently upheld patients' freedom to obtain healthcare from abroad for the best and quickest treatment.
Cross-border healthcare can be provided in a number of ways: for instance, by the patient himself moving to a healthcare provider in another member state for treatment, or by delivery of service from the territory of one member state into the territory of another, or by the establishment of a healthcare provider in another member state, or by health-care professionals moving temporarily to the member state of the patient to provide services.
Currently the European Health Insurance Card (EHIC) provides emergency care across the EU for patients who fall ill while abroad. It only applies to those who have health insurance at home. The new initiative goes further than the EHIC by ensuring a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek care provided in a member state other than in their home country, or where a particular treatment can be provided faster or more expertly abroad.
The draft directive on the application of patients' rights in cross-border healthcare applies to all types of healthcare.
However, the directive does not apply to assistance and support for families or individuals who are, over an extended period of time, in a particular state of need. It does not apply, for example, to residential homes or housing, or assistance provided to elderly people or children by social workers or volunteer carers.
Under the draft directive, patients obtain greater freedom in choosing where they get treatment and they do not need to get their doctor's prior approval for non-hospital care abroad. Patients will be able to claim up to the amount their treatment would have cost in their home country. Patients must, however, pay upfront the healthcare of the member state where they receive healthcare services and then seek to get reimbursement from the national health system of their home country.
A number of limitations on the provision of cross-border health care services is envisaged in the draft directive. In order to cut down on possible abuses to this new system of cross-border healthcare, patients are entitled to be reimbursed for treatment from their home state only for those services their home health authority would normally provide. Therefore, if the national health service does not provide a particular service for a particular treatment, the patient would not be entitled to obtain reimbursement of that particular service from his home country even though he may have paid for such service during his treatment abroad. In this sense, this draft directive does not create any new entitlement for patients to have such treatment abroad and be reimbursed. Member states may therefore stipulate the level of financial coverage they will reimburse based on the amount that a particular treatment would have cost the national health service at home.
Essentially, member states retain discretion to decide on what care they will fund. They may require that their citizens get prior authorisation for hospital treatment abroad. In such circumstances, however, states will have to justify their limitation of a patient's right to foreign healthcare. The draft directive will certainly boost health toursim. Meanwhile European hospitals will be competing for patients by providing better quality of care and patient safety. Ultimately consumers of health services will benefit from medical facilities of their choice anywhere in the EU.
• Dr Grech is an associate with Guido de Marco & Associates and heads its European law division.
jgrech@demarcoassociates.com
The Commission's draft directive is an attempt at codifying the European Courts' judgements in recent years, which have consistently upheld patients' freedom to obtain healthcare from abroad for the best and quickest treatment.
Cross-border healthcare can be provided in a number of ways: for instance, by the patient himself moving to a healthcare provider in another member state for treatment, or by delivery of service from the territory of one member state into the territory of another, or by the establishment of a healthcare provider in another member state, or by health-care professionals moving temporarily to the member state of the patient to provide services.
Currently the European Health Insurance Card (EHIC) provides emergency care across the EU for patients who fall ill while abroad. It only applies to those who have health insurance at home. The new initiative goes further than the EHIC by ensuring a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek care provided in a member state other than in their home country, or where a particular treatment can be provided faster or more expertly abroad.
The draft directive on the application of patients' rights in cross-border healthcare applies to all types of healthcare.
However, the directive does not apply to assistance and support for families or individuals who are, over an extended period of time, in a particular state of need. It does not apply, for example, to residential homes or housing, or assistance provided to elderly people or children by social workers or volunteer carers.
Under the draft directive, patients obtain greater freedom in choosing where they get treatment and they do not need to get their doctor's prior approval for non-hospital care abroad. Patients will be able to claim up to the amount their treatment would have cost in their home country. Patients must, however, pay upfront the healthcare of the member state where they receive healthcare services and then seek to get reimbursement from the national health system of their home country.
A number of limitations on the provision of cross-border health care services is envisaged in the draft directive. In order to cut down on possible abuses to this new system of cross-border healthcare, patients are entitled to be reimbursed for treatment from their home state only for those services their home health authority would normally provide. Therefore, if the national health service does not provide a particular service for a particular treatment, the patient would not be entitled to obtain reimbursement of that particular service from his home country even though he may have paid for such service during his treatment abroad. In this sense, this draft directive does not create any new entitlement for patients to have such treatment abroad and be reimbursed. Member states may therefore stipulate the level of financial coverage they will reimburse based on the amount that a particular treatment would have cost the national health service at home.
Essentially, member states retain discretion to decide on what care they will fund. They may require that their citizens get prior authorisation for hospital treatment abroad. In such circumstances, however, states will have to justify their limitation of a patient's right to foreign healthcare. The draft directive will certainly boost health toursim. Meanwhile European hospitals will be competing for patients by providing better quality of care and patient safety. Ultimately consumers of health services will benefit from medical facilities of their choice anywhere in the EU.
• Dr Grech is an associate with Guido de Marco & Associates and heads its European law division.
jgrech@demarcoassociates.com