Activities of Dorette CORBEY related to 2008/0142(COD)
Plenary speeches (1)
Patients' rights in cross-border healthcare (debate)
Amendments (15)
Amendment 137 #
Proposal for a directive
Recital 28
Recital 28
(28) Member States may maintain general conditions, criteria for eligibility and regulatory and administrative formalities for receipt of healthcare and reimbursement of healthcare costs, such as the requirement to consult a general practitioner before consulting a specialist or before receiving hospital care, also in relation to patients seeking healthcare in another Member State provided that such conditions are necessary, proportionate to the aim and are not discretionary and discriminatory. It is thus appropriate to require that these general conditions and formalities are being applied in an objective, transparent and non- discriminatory way and are known in advance, that they are based primarily on medical considerations and that they do not impose any additional burden on patients seeking healthcare in another Member State in comparison with patients being treated in their Member State of affiliation, and that decisions are made as quickly as possible. This is without prejudice to the rights of the Member States to provide for criteria or conditions relating to exceptions tof prior authorisation in the case of patients seeking healthcare in their Member State of affiliation.
Amendment 152 #
Proposal for a directive
Recital 31
Recital 31
(31) The evidence available indicates that the application of free movement principles regarding use of healthcare in another Member State within the limits of the cover guaranteed by the statutory sickness insurance scheme of the Member State of affiliation will not undermine the health systems of the Member States or financial sustainability of their social security systems. However, the Court of Justice has recognised that it cannot be excluded that the possible risk of seriously undermining a social security system’s financial balance or the objective of maintaining a balanced medical and hospital service open to all may constitute overriding reasons in the general interest capable of justifying a barrier to the principle of freedom to provide services. The Court of Justice has also recognised that the number of hospitals, their geographical distribution, the way in which they are organised and the facilities with which they are provided, and even the nature of the medical services which they are able to offer, are all matters for which planning must be possible. This Directive should provide for a system of prior authorisation for assumption of costs for hospital and specialised care received in another Member State, whereunless the following conditions are met: had the treatment been provided on its territory, it would have been assumed by its social security system and the consequent outflow of patients due to the implementation of the directive seriously undermines or is likely to seriously undermine the financial balance of the social security system and/or this outflow of patients seriously undermines, or is likely to seriously undermine the planning and rationalisation carried out in the hospital sector to avoid hospital overcapacity, imbalance in the supply of hospital care and logistical and financial wastage, the maintenance of a balanced medical and hospital service open to all, or the maintenance of treatment capacity or medical competence on the territory of the concerned Member. As the assessment of the precise impact of an expected outflow of patients requires complex assumptions and calculations, the Directive allows for a system of prior authorisation if there is sufficient reason to expect that the social security system will be seriously underminecannot be carried out in the Member State of affiliation because of overly long waiting lists, patients are resident in border areas, the complaint to be treated is rare and requires very specialised therapies or the care is based on contracts between sickness insurance funds and healthcare institutions abroad. This should also cover cases of already existing systems of prior authorisation which are in conformity with conditions laid down in Article 8.
Amendment 155 #
Proposal for a directive
Recital 32
Recital 32
(32) In any eventBy prior authorisation, ifn a Member State decided to establish a system of prior authorisation forccordance with the provision of this Directive for the assumption of costs of hospital or specialised care provided in another Member State in accordance with the provision of this Directive, the costs of such care provided in another Member State should also be reimbursed by the Member State of affiliation up to the level of costs that would have been assumed had the same or similar healthcare been provided in the Member State of affiliation, without exceeding the actual costs of healthcare received. However, when the conditions set out in Article 22(2) of Regulation (EEC) No 1408/71 are fulfilled the authorisation should be granted and the benefits provided in accordance with that Regulation. This applies in particular in instances where the authorisation is granted after an administrative or judicial review of the request and that the person concerned has received the treatment in another Member State. In that case Articles 6, 7, 8 and 9 of this Directive shall not apply. This is in line with the case law of the Court of Justice which has specified that patients who received a refusal of authorisation subsequently held to be unfounded, are entitled to have the cost of the treatment obtained in another Member State reimbursed in full according to the provisions of the legislation in the Member State of treatment.
Amendment 378 #
Proposal for a directive
Article 5 a (new)
Article 5 a (new)
Amendment 468 #
Proposal for a directive
Article 8 – paragraphs 3 - 5
Article 8 – paragraphs 3 - 5
3. The Member State of affiliation mayshall provide for a system of prior authorisation for reimbursement by its social security system of the cost of hospital care provided in another Member State where the following conditions are metunless: (a) had the healthcare cannot been provided soon enough in its territory, it would have been assumed by the Member State's social security system; and (b) the purpose of the system is to address the consequent outflow of patients due to the implementation of the present Article and to prevent it from seriously undermining, or being likely to seriously undermine: (i) the financial balance of the Member State's social security system; and/or (ii) the planning and rationalisation carried out in the hospital sector to avoid hospital overcapacity, imbalance in the supply of hospital care and logistical and financial wastage, the maintenance of a balanced medical and hospital service open to all, or the maintenance of treatment capacity or medical competence on the territory of the concerned Member State. 4. The prior authorisation system shall be limited to what is necessary and proportionate to avoid such impact, and shall not constitute a mean on account of excessively long waiting lists; or (aa) cross-border care is the most efficient way of organising health services for the local population, particularly in border regions; or (ab) the case involves treatment of rare conditions; or (ac) the care is based on contracts between care insurers and care institutions abroad. 5. Member States shall adopt implementing provisions laying down details of parbitrary discrimination. 5. The Member State shall make publicly available all relevant information on the prior authorisation systems introduced pursuant to the provisions of paragraph 3agraph 3 (ab) and (ac) and shall communicate them to the Commission.
Amendment 520 #
Proposal for a directive
Article 9 – paragraph 3
Article 9 – paragraph 3
3. Member States shall specify in advance and in a transparent way the criteria for refusal of and/or exceptions to the prior authorisation referred to in Article 8(3).
Amendment 533 #
Proposal for a directive
Article 9 – paragraph 4 – point (a)
Article 9 – paragraph 4 – point (a)
(a) the specific medical condition and social circumstances,
Amendment 560 #
Proposal for a directive
Article 12 – paragraph 1
Article 12 – paragraph 1
1. Member States shall designate one or more national contact points for cross- border healthcare and communicate their names and contact details to the Commission.
Amendment 565 #
Proposal for a directive
Article 12 – paragraph 2 – introductory paragraph
Article 12 – paragraph 2 – introductory paragraph
2. The national contact point in the Member State of affiliation shall, using a website if appropriate, in close cooperation with other competent national authorities, and with national contact points in other Member States, in particular in the Member State of treatment, and with the Commission:
Amendment 570 #
Proposal for a directive
Article 12 – paragraph 2 – point a
Article 12 – paragraph 2 – point a
(a) provide and disseminate information to patients, in accordance with demand, in particular on their rights related to cross- border healthcare and the guarantees of quality and safety, protection of personal data, procedures for complaints and means of redress available for healthcare provided in another Member State, and on the terms and conditions applicable;
Amendment 591 #
Proposal for a directive
Article 12 – paragraph 2 – point d a (new)
Article 12 – paragraph 2 – point d a (new)
(da) provide clarification regarding parallel cross-border healthcare arrangements (Council Regulation (EEC) No 1408/71 and the provisions of this directive).
Amendment 601 #
Proposal for a directive
Article 13 – paragraph 2 a (new)
Article 13 – paragraph 2 a (new)
2a. Member States guarantee that registers in which healthcare providers are listed can be equally consulted by equal competent bodies in all Member States.
Amendment 602 #
Proposal for a directive
Article 13 – paragraph 2 b (new)
Article 13 – paragraph 2 b (new)
2b. Member States may exchange information about ethical and criminal procedures against healthcare providers.
Amendment 603 #
Proposal for a directive
Article 13 – paragraph 2 c (new)
Article 13 – paragraph 2 c (new)
2c. Member States shall provide the European Commission with information about cases in which Member States have not fulfilled their obligation of mutual assistance. If necessary the European Commission shall undertake appropriate action as provided for in Article 226 of the Treaty. The European Commission shall inform Member States regularly about the functioning of the provisions relating to mutual assistance.
Amendment 652 #
Proposal for a directive
Article 15 - paragraph 2 - point b a (new)
Article 15 - paragraph 2 - point b a (new)
(ba) contribute to the pooling of knowledge regarding sickness prevention and the treatment of major commonly occurring disorders;