EU court backs UK patient on refund for treatment abroad
The EU's top court has backed an argument that European patients should be refunded for their health treatment abroad if it was undertaken due to long waiting lists in their home country.
In a pre-judgement opinion issued on 15 December, the advocate-general for the Luxembourg-based European Court of Justice argued that EU citizens can receive certain medical services across the union, and the refund for their costs abroad "may not be refused if the treatment is one which is normally provided and cannot be granted without undue delay in the home member state".
"The sickness insurance fund is then obliged to reimburse the person for the costs incurred", the advocate added.
On average, the court follows the advice of its advocates in an estimated 80 percent of cases, so it is quite likely the judges will later endorse his opinion.
Thursday's case involves a complaint from Yvonne Watts, a 74-year-old British woman with serious arthritis, who went to France for a hip operation after she was told she would have to wait up to four months to get the treatment in Britain.
The home insurance authorities had refused to authorise Mrs Watt's operation abroad, and the UK High Court later rejected her application for the refund of her costs worth around €6,000 on the basis that there was no "undue delay" in her case.
But the advocate general Leendert Adrie Geelhoed disagreed.
He stated that the British National Health Service (NHS) does not have "a clearly defined procedure" for considering applications for treatment abroad, meaning patients have restricted possibilities to seek treatment outside the system.
"It therefore constitutes a restriction of their freedom to receive services and is contrary to the EC Treaty", said Mr Geelhoed.
Bron: Stichtig Grensarbeid
|Het is natuurlijk nog maar de conclusie van de advocaat-generaal Geelhoed, en niet het arrest, maar het is volstrekt in lijn met hetgeen in eerdere procedures (VandeBraeckel, Decker-Kohll, Smits-Peerbooms, etc) aan rechtspraak is ontwikkeld: Een toestemming om in het buitenland een ziekenhuisbehandeling te ondergaan mag niet worden geweigerd, tenzij bij een gecontracteerd ziekenhuis dezelfde behandeling ook kan worden verstrekt binnen dezelfde periode. De vergoeding kan in geval van toestemming wel beperkt worden tot hetgeen in de woonstaat als normale vergoeding geldt, maar ingeval vast komt te staan dat de toestemming ten onrechte is geweigerd (en daar lijkt het in dit geval op) moet de verzekeraar het volle pond betalen.|
|Vorige discussie | Vandaag | Week | Maand||© Zorgwet.info|