Activities of Ria OOMEN-RUIJTEN related to 2008/0142(COD)
Plenary speeches (1)
Patients' rights in cross-border healthcare (debate)
Amendments (53)
Amendment 34 #
Proposal for a directive
Article 2
Article 2
This Directive shall apply to provision of healthcare regardless of how it is organised, delivered and financed or whether it is public or private. This Directive shall apply to statutory, private and combined sickness insurance schemes.
Amendment 35 #
Proposal for a directive
Article 3 – paragraph 1 – letter (f)
Article 3 – paragraph 1 – letter (f)
(f) Regulations on coordination of social security schemes, in particular Article 22s 19, 20, 22 and 25 of Regulation (EC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community and Articles 17, 18, 19, 20, 27 and 28 of Council Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems.
Amendment 36 #
Proposal for a directive
Article 3 – paragraph 1 – letter (g) a (new)
Article 3 – paragraph 1 – letter (g) a (new)
(ga) Council Directive 92/49/EEC of 18 June 1992 on the coordination of laws, regulations and administrative provisions relating to direct insurance other than life assurance and amending Directives 73/239/EEC and 88/357/EEC (third non- life insurance Directive).
Amendment 37 #
Proposal for a directive
Article 3 – paragraph 2
Article 3 – paragraph 2
2. WUntil the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that when the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 22 of Regulation (EC) No 1408/71 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks healthcare in another Member State in other circumstances, Articles 6, 7, 8 and 9 of this Directive apply and Article 22 of Council Regulation (EC) No 1408/71 shall not apply. However, whenever the conditions for granting an authorisation set out in Article 22(2) of Regulation (EC) No 1408/71 are fulfilled, the authorisation shall be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply.
Amendment 38 #
Proposal for a directive
Article 3 – paragraph 2 – subparagraph 1 a (new)
Article 3 – paragraph 2 – subparagraph 1 a (new)
Amendment 39 #
Proposal for a directive
Article 4 – letter g – point (ii) a (new)
Article 4 – letter g – point (ii) a (new)
(iia) an insured person as defined in the policy conditions of private sickness insurance schemes;
Amendment 40 #
Proposal for a directive
Article 5 – paragraph 3 a (new)
Article 5 – paragraph 3 a (new)
3a. In view of the major importance, particularly to patients, of safeguarding the quality and safety of cross-border care, the organisations involved in drawing up norms and guidelines as referred to in paragraphs 1 and 3 shall at the minimum include patients' organisations (particularly those of a cross-border nature).
Amendment 41 #
Proposal for a directive
Article 6 – paragraph 1
Article 6 – paragraph 1
1. Subject to the provisions of this Directive, in particular Articles 7, 8 and 9, the Member State of affiliation shall ensure that insured persons deliberately travelling to another Member State with the purpose of receiving healthcare there or seeking to receive healthcare provided in another Member State, will not be prevented from receiving healthcare provided in another Member State where the treatment in question is among the benefits provided for by the legislation of the Member State of affiliation to which the insured person is entitled. The Member State of affiliation shall reimburse the costs to the insured person, which would have been paid for by its statutory social security system had the same or similar healthcare been provided in its territory. In any event, it is for the Member State of affiliation to determine the healthcare that is paid for regardless of where it is provided.
Amendment 45 #
Proposal for a directive
Article 8 – paragraph 2
Article 8 – paragraph 2
2. This list shall be set up and may be regularly updated by the Commission. Those measures, designed to amend non- essential elements of this Directive by supplementing it, shall be adopted in accordance with the regulatory procedure with scrutiny referred to in Article 19(3). In drawing up this list, the Commission shall take account of the special position of European reference networks as referred to in Article 15.
Amendment 46 #
Proposal for a directive
Article 8 – paragraph 4
Article 8 – paragraph 4
4. The prior authorisation system shall apply without prejudice to Article 3(2) and shall be limited to what is necessary and proportionate to avoid such impact, and shall not constitute a means of arbitrary discrimination.
Amendment 47 #
Proposal for a directive
Article 9 – paragraph 1
Article 9 – paragraph 1
1. The Member State of affiliation shall ensure that administrative procedures regarding the use of healthcare in another Member State related to any prior authorisation referred to in Article 8(3), reimbursement of costs of healthcare incurred in another Member State and other conditions and formalities referred to in Article 6(3), are based on objective, non- discriminatory criteria which are published in advance, and which are necessary and proportionate to the objective to be achieved. IUntil the date on which Regulation (EC) No 883/2004 enters into force: in any event, an insured person shall always be granted the authorisation pursuant to Regulations on coordination of social security referred to in Art. 3.1 f) whenever the conditions of Art.22.1 c) and Art. 22.2 of Regulation 1408/71 are met. From the date on which Regulation (EC) No 883/2004 enters into force: when the circumstances referred to in Article 20 of Regulation (EC) No 883/2004 are met, an insured person shall always be granted authorisation by virtue of the regulations concerning coordination of social security schemes as referred to in Article 3(1)(f).
Amendment 48 #
Proposal for a directive
Article 10 – paragraph 1
Article 10 – paragraph 1
10. The Member States of affiliation shall ensure that there are mechanisms in place to provide patients on request with information on receiving healthcare in another Member State, and the terms and conditions that would apply, inter alia, whenever harm is caused as a result of healthcare received in another Member State. In information about cross-border care, a clear distinction shall be made between the rights which patients have by virtue of this Directive and rights arising from regulations on the coordination of social security schemes as referred to in Article 3(1)(f).
Amendment 49 #
Proposal for a directive
Article 12 – paragraph 1
Article 12 – paragraph 1
1. Member States shall designate national contact points for cross-border healthcare and communicate their names and contact details to the Commission. Member States shall ensure that patients' organisations, health insurance funds and care providers are involved in these national contact points.
Amendment 50 #
Proposal for a directive
Article 13 – paragraph 1
Article 13 – paragraph 1
1. Member States shall render such mutual assistance as is necessary for the implementation of this Directive and shall conclude agreements on this subject.
Amendment 51 #
Proposal for a directive
Article 13 – paragraph 2
Article 13 – paragraph 2
2. Member States shall facilitate cooperation in cross-border healthcare provision at regional and loc, local and national level as well as through information and communication technologies, and cross- border healthcare provided on a temporary or ad hoc basis, and other forms of cross-border cooperationshall conclude agreements on this subject.
Amendment 52 #
Proposal for a directive
Article 15 a (new)
Article 15 a (new)
Article 15 a In order, in future, to establish as effective as possible a care policy, the Commission shall designate border regions as trial areas where innovative initiatives relating to cross-border care can be thoroughly tested, analysed and assessed.
Amendment 53 #
Proposal for a directive
Article 20 – paragraph 2 a (new)
Article 20 – paragraph 2 a (new)
The Commission shall be responsible for the collection of the requisite information to chart cross-border flows of patients and practitioners so as to be able to remedy any adverse effects promptly and to further encourage positive effects. The Commission shall include this information in the report referred to in paragraph 1.
Amendment 64 #
Proposal for a directive
Article 2
Article 2
This Directive shall apply to provision of healthcare regardless of how it is organised, delivered and financed or whether it is public or private. This Directive shall apply to statutory, private and combined sickness insurance schemes.
Amendment 68 #
Proposal for a directive
Article 3 – paragraph 1 – point (f)
Article 3 – paragraph 1 – point (f)
(f) Regulations on coordination of social security schemes, in particular Article 22s 19, 20, 22 and 25 of Regulation (EC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community and Articles 17, 18, 19, 20, 27 and 28 of Council Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems.
Amendment 69 #
Proposal for a directive
Article 3 – paragraph 1 – point (g) a (new)
Article 3 – paragraph 1 – point (g) a (new)
(ga) Council Directive 92/49/EEC of 18 June 1992 on the coordination of laws, regulations and administrative provisions relating to direct insurance other than life assurance and amending Directives 73/239/EEC and 88/357/EEC (third non- life insurance Directive).
Amendment 72 #
Proposal for a directive
Article 3 – paragraph 2
Article 3 – paragraph 2
2. WUntil the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that when the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 22 of Regulation (EC) No 1408/71 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks healthcare in another Member State in other circumstances, Articles 6, 7, 8 and 9 of this Directive apply and Article 22 of Council Regulation (EC) No 1408/71 shall not apply. However, whenever the conditions for granting an authorisation set out in Article 22(2) of Regulation (EC) No 1408/71 are fulfilled, the authorisation shall be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply.
Amendment 74 #
Proposal for a directive
Article 3 – paragraph 2 a (new)
Article 3 – paragraph 2 a (new)
2a. From the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that when the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 20 of Regulation (EC) No 883/2004 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks healthcare in another Member State in other circumstances, Articles 6, 7, 8 and 9 of this Directive apply and Article 20 of Council Regulation (EC) No 883/2004 shall not apply. However, whenever the conditions for granting an authorisation set out in Article 20(2) of Regulation (EC) No 883/2004 are fulfilled, the authorisation shall always be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply.
Amendment 80 #
Proposal for a directive
Article 4 – point g – subpoint (ii) a (new)
Article 4 – point g – subpoint (ii) a (new)
(iia) an insured person as defined in the policy conditions of private sickness insurance schemes;
Amendment 94 #
Proposal for a directive
Article 5 – paragraph 3 a (new)
Article 5 – paragraph 3 a (new)
3a. In view of the major importance, particularly to patients, of safeguarding the quality and safety of cross-border care, the organisations involved in drawing up norms and guidelines as referred to in paragraphs 1 and 3 shall at the minimum include patients' organisations (particularly those of a cross-border nature).
Amendment 97 #
Proposal for a directive
Article 6 – paragraph 1
Article 6 – paragraph 1
1. Subject to the provisions of this Directive, in particular Articles 7, 8 and 9, the Member State of affiliation shall ensure that insured persons deliberately travelling to another Member State with the purpose of receiving healthcare there or seeking to receive healthcare provided in another Member State, will not be prevented from receiving healthcare provided in another Member State where the treatment in question is among the benefits provided for by the legislation of the Member State of affiliation to which the insured person is entitled. The Member State of affiliation shall reimburse the costs to the insured person, which would have been paid for by its statutory social security system had the same or similar healthcare been provided in its territory. In any event, it is for the Member State of affiliation to determine the healthcare that is paid for regardless of where it is provided.
Amendment 139 #
Proposal for a directive
Article 8 – paragraph 2
Article 8 – paragraph 2
2. This list shall be set up and may be regularly updated by the Commission. Those measures, designed to amend non- essential elements of this Directive by supplementing it, shall be adopted in accordance with the regulatory procedure with scrutiny referred to in Article 19(3). In drawing up this list, the Commission shall take account of the special position of European reference networks as referred to in Article 15.
Amendment 151 #
Proposal for a directive
Article 8 – paragraph 4
Article 8 – paragraph 4
4. The prior authorisation system shall apply without prejudice to Article 3(2) and shall be limited to what is necessary and proportionate to avoid such impact, and shall not constitute a means of arbitrary discrimination.
Amendment 161 #
Proposal for a directive
Article 9 – paragraph 1
Article 9 – paragraph 1
1. The Member State of affiliation shall ensure that administrative procedures regarding the use of healthcare in another Member State related to any prior authorisation referred to in Article 8(3), reimbursement of costs of healthcare incurred in another Member State and other conditions and formalities referred to in Article 6(3), are based on objective, non- discriminatory criteria which are published in advance, and which are necessary and proportionate to the objective to be achieved. IUntil the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that, in any event, an insured person shall always be granted the authorisation pursuant to Regulations on coordination of social security referred to in Art. 3.1 f) whenever the conditions of Art.22.1 c) and Art. 22.2 of Regulation 1408/71 are met. From the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that when the circumstances referred to in Article 20 of Regulation (EC) No 883/2004 are met, an insured person shall always be granted authorisation by virtue of the regulations concerning coordination of social security schemes as referred to in Article 3(1)(f).
Amendment 169 #
Proposal for a directive
Article 10 – paragraph 1
Article 10 – paragraph 1
10. The Member States of affiliation shall ensure that there are mechanisms in place to provide patients on request with information on receiving healthcare in another Member State, and the terms and conditions that would apply, inter alia, whenever harm is caused as a result of healthcare received in another Member State. In information about cross-border care, a clear distinction shall be made between the rights which patients have by virtue of this Directive and rights arising from regulations on the coordination of social security schemes as referred to in Article 3(1)(f).
Amendment 177 #
Proposal for a directive
Article 12 – paragraph 1
Article 12 – paragraph 1
1. Member States shall designate national contact points for cross-border healthcare and communicate their names and contact details to the Commission. Member States shall ensure that patients' organisations, health insurance funds and care providers are involved in these national contact points.
Amendment 187 #
Proposal for a directive
Article 13 – paragraph 1
Article 13 – paragraph 1
1. Member States shall render such mutual assistance as is necessary for the implementation of this Directive and shall conclude agreements on this subject.
Amendment 188 #
Proposal for a directive
Article 13 – paragraph 2
Article 13 – paragraph 2
Member States shall facilitate cooperation in cross-border healthcare provision at regional and local level as well as through information and communication technologies, cross-border healthcare provided on a temporary or ad hoc basis and other forms of cross-border cooperation, and shall conclude agreements on this subject.
Amendment 190 #
Proposal for a directive
Article 13 – paragraph 2 a (new)
Article 13 – paragraph 2 a (new)
2a. Member States, particularly neighbouring countries, may conclude agreements among themselves as referred to in paragraphs 1 and 2 concerning, inter alia, worthwhile cooperative frameworks which must remain in existence or be allowed more scope for development, the inflow and outflow of patients between these Member States, planning systems and certain intramural forms of care.
Amendment 202 #
Proposal for a directive
Article 15 a (new)
Article 15 a (new)
Article 15a Trial areas In order, in future, to establish as effective as possible a care policy, the Commission shall designate border regions as trial areas where innovative initiatives relating to cross-border care can be thoroughly tested, analysed and assessed.
Amendment 206 #
Proposal for a directive
Article 20 – paragraph 2 a (new)
Article 20 – paragraph 2 a (new)
The Commission shall ensure that the requisite information is gathered to chart cross-border flows of patients and practitioners so as to be able to remedy any adverse effects promptly and to further encourage positive effects. The Commission shall include this information in the report referred to in paragraph 1.
Amendment 213 #
Proposal for a directive
Article 2
Article 2
This Directive shall apply to provision of healthcare regardless of how it is organised, delivered and financed or whether it is public or private. This Directive shall apply to statutory, private and combined sickness insurance schemes.
Amendment 222 #
Proposal for a directive
Article 3 - paragraph 1 - point (f)
Article 3 - paragraph 1 - point (f)
(f) Regulations on coordination of social security schemes, in particular Article 22s 19, 20, 22 and 25 of Regulation (EC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community and Articles 17, 18, 19, 20, 27 and 28 of Council Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems.
Amendment 228 #
Proposal for a directive
Article 3 - paragraph 1 - point (g a) (new)
Article 3 - paragraph 1 - point (g a) (new)
(ga) Council Directive 92/49/EEC of 18 June 1992 on the coordination of laws, regulations and administrative provisions relating to direct insurance other than life assurance and amending Directives 73/239/EEC and 88/357/EEC (third non- life insurance Directive);
Amendment 234 #
Proposal for a directive
Article 3 - paragraph 2
Article 3 - paragraph 2
2. WUntil the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that, when the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 22 of Regulation (EC) No 1408/71 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks healthcare in another Member State in other circumstances, Articles 6, 7, 8 and 9 of this Directive apply and Article 22 of Council Regulation (EC) No 1408/71 shall not apply. However, whenever the conditions for granting an authorisation set out in Article 22(2) of Regulation (EC) No 1408/71 are fulfilled, the authorisation shall be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply.
Amendment 237 #
Proposal for a directive
Article 3 - paragraph 2 a (new)
Article 3 - paragraph 2 a (new)
2a. From the date on which Regulation (EC) No 883/2004 enters into force the rule shall apply that when the circumstances under which an authorisation to go to another Member State in order to receive appropriate treatment under Article 20 of Regulation (EC) No 883/2004 must be granted are met, the provisions of that Regulation shall apply and the provisions of Articles 6, 7, 8 and 9 of this Directive shall not apply. Conversely, when an insured person seeks health care in another Member State in other circumstances, Articles 6, 7, 8 and 9 of this Directive shall apply and Article 20 of Council Regulation (EC) No 883/2004 shall not apply. However, whenever the conditions for granting an authorisation set out in Article 20(2) of Regulation (EC) No 883/2004 are fulfilled, the authorisation shall always be accorded and the benefits provided in accordance with that Regulation. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply.
Amendment 279 #
Proposal for a directive
Article 4 - point (g) - subpoint (ii a) (new)
Article 4 - point (g) - subpoint (ii a) (new)
(iia) an insured person as defined in the policy conditions of private sickness insurance schemes;
Amendment 376 #
Proposal for a directive
Article 5 – paragraph 3 a (new)
Article 5 – paragraph 3 a (new)
3a. In view of the great importance, particularly to patients, of safeguarding the quality and safety of cross-border care, the organisations involved in drawing up norms and guidelines as referred to in paragraphs 1 and 3 shall at the minimum include patients' organisations (particularly those of a cross-border nature).
Amendment 390 #
Proposal for a directive
Article 6 – paragraph 1
Article 6 – paragraph 1
1. Subject to the provisions of this Directive, in particular Articles 7, 8 and 9, the Member State of affiliation shall ensure that insured persons deliberately travelling to another Member State with the purpose of receiving healthcare there or seeking to receive healthcare provided in another Member State, will not be prevented from receiving healthcare provided in another Member State where the treatment in question is among the benefits provided for by the legislation of the Member State of affiliation to which the insured person is entitled. The Member State of affiliation shall reimburse the costs to the insured person, which would have been paid for by its statutory social security system had the same or similar healthcare been provided in its territory. In any event, it is for the Member State of affiliation to determine the healthcare that is paid for regardless of where it is provided.
Amendment 465 #
Proposal for a directive
Article 8 – paragraph 2
Article 8 – paragraph 2
2. This list shall be set up and may be regularly updated by the Commission. Those measures, designed to amend non- essential elements of this Directive by supplementing it, shall be adopted in accordance with the regulatory procedure with scrutiny referred to in Article 19(3). In drawing up this list, the Commission shall take account of the special position of European reference networks as referred to in Article 15.
Amendment 489 #
Proposal for a directive
Article 8 – paragraph 4
Article 8 – paragraph 4
4. The prior authorisation system shall apply without prejudice to Article 3(2) and shall be limited to what is necessary and proportionate to avoid such impact, and shall not constitute a means of arbitrary discrimination.
Amendment 512 #
Proposal for a directive
Article 9 – paragraph 1
Article 9 – paragraph 1
1. The Member State of affiliation shall ensure that administrative procedures regarding the use of healthcare in another Member State related to any prior authorisation referred to in Article 8(3), reimbursement of costs of healthcare incurred in another Member State and other conditions and formalities referred to in Article 6(3), are based on objective, non- discriminatory criteria which are published in advance, and which are necessary and proportionate to the objective to be achieved. IUntil the date on which Regulation (EC) No 883/2004 enters into force, the rule shall apply that, in any event, an insured person shall always be granted the authorisation pursuant to Regulations on coordination of social security referred to in Art. 3.1 f) whenever the conditions of Art.22.1 c) and Art. 22.2 of Regulation 1408/71 are met. From the date on which Regulation (EC) No 883/2004 enters into force the rule shall apply that when the circumstances referred to in Article 20 of Regulation (EC) No 883/2004 are fulfilled, the authorisation shall always be accorded to the insured person by virtue of the regulations on coordination of social security schemes referred to in Article 3(1)(f).
Amendment 550 #
Proposal for a directive
Article 10 – paragraph 1
Article 10 – paragraph 1
1. The Member States of affiliation shall ensure that there are mechanisms in place to provide patients on request with information on receiving healthcare in another Member State, and the terms and conditions that would apply, inter alia, whenever harm is caused as a result of healthcare received in another Member State. In information about cross-border care, a clear distinction shall be made between the rights which patients have by virtue of this Directive and rights arising from regulations on coordination of social security schemes as referred to in Article 3(1)(f).
Amendment 561 #
Proposal for a directive
Article 12 – paragraph 1
Article 12 – paragraph 1
1. Member States shall designate national contact points for cross-border healthcare and communicate their names and contact details to the Commission. Member States shall ensure that patient organisations, sickness funds and healthcare providers are encompassed by these national contact points.
Amendment 598 #
Proposal for a directive
Article 13 – paragraph 1
Article 13 – paragraph 1
1. Member States shall render such mutual assistance as is necessary for the implementation of this Directive. and shall conclude agreements for this purpose.
Amendment 600 #
Proposal for a directive
Article 13 – paragraph 2
Article 13 – paragraph 2
2. Member States shall facilitate cooperation in cross-border healthcare provision at regional and local level as well as through information and communication technologies, cross-border healthcare provided on a temporary or ad hoc basis and other forms of cross-border cooperation. and shall conclude agreements for this purpose.
Amendment 605 #
Proposal for a directive
Article 13 – paragraph 2 a (new)
Article 13 – paragraph 2 a (new)
2 a. Member States, particularly neighbouring countries may conclude reciprocal agreements as indicated in paragraphs 1 and 2 concerning the continuation or potential further development of rational cooperation arrangements, movements of patients to and from these Member States, planning mechanisms, certain forms of hospital healthcare, etc..
Amendment 674 #
Proposal for a directive
Article 15 a (new)
Article 15 a (new)
Article 15a Trial areas In order to make future healthcare policy as effective as possible, the Commission shall designate border regions as trial areas in which innovative cross-border healthcare initiatives can be exhaustively tested, analysed and evaluated.
Amendment 704 #
Proposal for a directive
Article 20 – paragraph 1 a (new)
Article 20 – paragraph 1 a (new)
The Commission shall ensure that the necessary information is gathered to provide a record of cross-border movements of patients and professional staff with a view to overcoming promptly any drawbacks while encouraging the resulting benefits. The Commission shall include this information in the report referred to in paragraph 1.