Report from the Commission to the Council and the European Parliament compliant with the obligations foreseen under Article 20(3) of Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare

This report considers the effects resulting from Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients' rights in cross-border healthcare, for insured patients wishing to be reimbursed for healthcare received outside their country of residence and in another EU Member State.

Specifically it considers the potential effects of prior authorisation systems introduced under Directive 2011/24/EU and of the definition of the Member State responsible for reimbursing patients the costs of cross-border healthcare. The latter point particularly concerns the specific case of pensioners having transferred their residence and, for that reason, their access to healthcare to their new Member State of residence, which is different from the Member State that has recognised the pensioner's rights to social security benefits. This latter Member State remains responsible for the coverage of the costs of healthcare for these groups of pensioners. Through this report the Commission complies with the requirement in paragraph 3 of Article 20 of Directive 2011/24/EU.

As from 25 October 2013, two legal instruments apply to the situation of patients seeking healthcare outside their country of residence: Directive 2011/24/EU, hereinafter “the Directive”, and Regulations (EC) No 883/2004 and (EC) No 987/2009 of the European Parliament and the Council on the coordination of social security systems, hereinafter “the Regulations”.

As the Directive was due to be transposed by Member States into national legislation by 25 October 2013, there is obviously no data available at this point in time on the impact of the Directive, either alone or in interaction with the Regulations. Consequently, this first report considers the possible effects resulting from the joint application of the two instruments to the situation of patients seeking healthcare in another Member State. It is intended to serve as a reference point for future reports produced according to Article 20(3) of the Directive.

This report outlines the two instruments and then goes on to assess possible impacts of their interaction in two areas: possible substitution effects between the prior authorisation systems used under the two instruments; and the adequacy of the financial compensation for costs of healthcare paid between Member States under the Regulations. On the latter part it will specifically consider those cases where Member States receive fixed amounts intended to cover the costs of healthcare benefits in kind for pensioners. It will then explain that, due to the lack of available information noted above, no clear conclusions can currently be drawn on either of these two issues but some important messages for the future administration of the two instruments can nevertheless already be discerned.

• Primary Source

EUR-Lex: COM(2014)44: Follow the progress of this report through the decision-making procedure http://eur-lex.europa.eu/legal-content/EN/HIS/?uri=COM:2014:044:FIN

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