A New EU Directive: Reimbursment for Treatment Abroad

Last Friday an important new law about healthcare came into force. The law is an EU directive, that was developed since 2008 with the support of the British government, called “Patients’ Rights in Cross Border Health Care”.

An EU citizen in one country can now claim the costs of healthcare treatment in any other EU state. The basic principle behind the health care directive is: if you are entitled to it here, you can get it there.

In an NHS presentation this June the directive was described as the most “significant and wide ranging European Health Legislation in a generation”. It has also been described as a watershed for the NHS, mainly because for the first time it is going to have to cost its treatment services properly.

One of the basic commitments imposed on EU member states is the requirement to set up national contact points (information centres and websites). These are to be friendly contacts in each country where information is easily available on how a patient can access healthcare in another EU country.

If a member state doesn’t comply with the law they could be liable to a fine from the European Court of Justice of upwards of 11 million Euros. A comment from a very senior NHS source was “we need to get this right”.

How Will it Operate?

1. The treatment cannot cost more than it would have at home.

2. If the treatment is not provided at home then you cannot get it abroad. For example a British patient could not go to a German spa and get it on the NHS – even though Germans are entitled to this form of treatment.

3. Day care does not require prior authorisation. Mental health care is covered as is long term care such as kidney dialysis. Therefore three months of day addiction treatment followed by after-care would be acceptable.

4. Hospital care (anything over one night in a hospital) requires prior authorisation from your local health authority, but authorisation is difficult to refuse and appeal processes are easily available.

5. Referral requires a GP or specialist but this can be from any suitably qualified doctor anywhere in the EU, not just your home GP.

6. Remuneration can either be paid up front to the patient or directly to the health care provider. This is up to the funder. However it is generally conceded that it would be very unfair on poorer patients if they had to pay up front and so it is likely that the latter form of payment will be readily permitted.

7. Accommodation for day care patients and travelling and carer expenses are not provided – unless they would have been provided under the same package in the home state.

8. There is special provision for Telemedicine which is very flexible and opens up enormous possibilities in the future.

At Castle Craig we got expert advice from a legal consultant in the Netherlands who acted for the European Commission and also from another consultant who actually wrote the EU directive. So we are well able to advise our patients and referral sources.

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This text was taken from Peter McCann’s speech at out reception held at the British Ambassador’s residence in Brussels on October 23rd 2013.

To see a video interview with Peter McCann talking about the Directive in Brussels, please click here: http://www.neurope.eu/article/can-increasing-patient-mobility-help-treat-addicts

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