1. Directive 2011/24/EU on patients’ rights in cross-border healthcare
Advisory Committee,
Directive 2011/24/EU on patients’ rights in cross-border healthcare
DG SANCO
Unit D2 Healthcare systems

2. Background
- Cross-border healthcare not new – both unplanned care (EHIC) and planned care covered in social security Regulations since 1970s
- ECJ jurisprudence 1997 – 2006 developed additional rights based on free movement of services
- Initial attempt to codify via Services Directive – separate piece of legislation required
- Contentious negotiations

3. Provisions of Directive 1: patient entitlements
- Patients have right of reimbursement when they receive healthcare in another EU MS
- Level of reimbursement up to cost of treatment at home
- Quality and safety standards / legislation of MS of treatment applies

4. Provisions of Directive 2: prior authorisation
- Prior authorisation possible for a) overnight stay; b) highly specialised healthcare ("hospital care")
- Authorisation may be refused if no "undue delay"
- Authorisation processes must be reasonable, "properly reasoned"

5. Provisions of Directive 3: National Contact Points
- Each MS must set up a National Contact Point (NCP)
- NCPs tell outgoing patients about: rights; entitlements; reimbursement; appeal processes
- NCPs tell incoming patients about: quality and safety standards and systems; complaints and redress procedure; rights as a patient; provider's right to practice

6. NATIONAL CONTACT POINTS Functioning6 6

7. Provisions of Directive 4: prices, access, information, prescriptions
- Healthcare providers must provide information on: treatment options; quality and safety; prices; authorisation status; insurance / liability cover
- Patients should have access to care on basis of non- discrimination; providers must apply same scale of fees as for domestic patients
- Directive introduces cross-border prescriptions to help patients moving across borders

8. Main differences Directive / Regulations
- Regulations only cover public-sector or contracted providers: Directive covers all providers in EU for planned and unplanned care (but not long-term care)
- Planned care – prior authorisation is the norm under Regulations, but the exception (if used at all) under Directive
- Regulations cover patient cost at level of MS of treatment; Directive at level of MS of affiliation ("home" MS)
- Regulations primarily direct payment; Directive primarily reimbursement

9. Interaction between two instruments
- Where terms of Regulations are met, Regulations should be used…
- …unless patient specifically requests otherwise
- Patients should not be deprived of rights under Regulation where this is more beneficial for them

10. Transposition process
- Bilateral engagement with MS capitals
- Formal committee meetings in Brussels
- Discussions in Administrative Commission
- Regular informal workshops on transposition
- Guidance note on Regulation / Directive
- Working party on Regulation / Directive
- "Europa" website to be updated shortly

11. Thank you! Further information: 11