Session 25 andrzej_rys
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Session 25 andrzej_rys
- 2. 5th European Conference on Rare Diseases ECRD, Krakow Proposal for a Directive on Patients’ rights in cross-border healthcare OPENING THE DOOR TO BETTER HEALTHCARE ACROSS EUROPE 15 May 2010 Andrzej RYS Director European Commission, DG SANCO Directorate C - Public Health and Risk Assessment
Notas do Editor
- NON HOSPITAL CARE The rule is NO PRIOR AUTHORISATION for reimbursement of healthcare if it is reimbursed by the MS of affiliation. So, the patient has the right to seek healthcare in another MS without PA & to be reimbursed (eg. consultations) This is identical in latest SW text HOSPITAL CARE INITIAL PROPOSAL: MS may choose to introduce a system of PA for reimbursement IF the outflow of patients risks undermining financial balance or planning of the hospital sector LATEST TEXT: PA system CAN be introduced (NO CONDITIONS except necessary, non discriminatory and proportionate) Intro an OPEN list of REASONS for REFUSING to grant a PA CLEAR RULES ON REIMBURSEMENT Upfront payment with reimbursement at home up to the level for the same or similar treatment in the home system INFORMATION AVAILABLE TO PATIENTS to make informed decisions to provide patients with equal opportunities to receive cross-border healthcare PROCEDURAL GUARANTEES fair & quick procedures right to ask for a review of administrative decision
- Clarifies that MS of treatment is overall responsible Applies to all healthcare private and public
- Efficient use of resources: Strengthening eHealth and improving interoperability European Reference networks (to share expertise and innovation on specialised care) Sharing efforts on Health Technology Assessment Easier recognition of prescriptions issued in other MS Information on cross-border flows – for planning (not anymore there)
- FYI: “ The Commission shall support Member States in the development of European reference networks between healthcare providers and centres of expertise in the Member States. The networks shall be based on voluntary participation by its members, which shall participate and contribute to the networks activities according to the legislation of the Member State where they are established”. “ Providing clarity on the definition of an ERN” through: - developing & publishing criteria & conditions that the ERN should fulfil in order to receive support from the Commission - developing & publishing criteria for evaluating ERN;
- FYI: “ The Commission shall support Member States in the development of European reference networks between healthcare providers and centres of expertise in the Member States. The networks shall be based on voluntary participation by its members, which shall participate and contribute to the networks activities according to the legislation of the Member State where they are established”. “ Providing clarity on the definition of an ERN” through: - developing & publishing criteria & conditions that the ERN should fulfil in order to receive support from the Commission - developing & publishing criteria for evaluating ERN;
- FYI: “ The Commission shall support Member States in the development of European reference networks between healthcare providers and centres of expertise in the Member States. The networks shall be based on voluntary participation by its members, which shall participate and contribute to the networks activities according to the legislation of the Member State where they are established”. “ Providing clarity on the definition of an ERN” through: - developing & publishing criteria & conditions that the ERN should fulfil in order to receive support from the Commission - developing & publishing criteria for evaluating ERN;
- FYI: “ The Commission shall support Member States in the development of European reference networks between healthcare providers and centres of expertise in the Member States. The networks shall be based on voluntary participation by its members, which shall participate and contribute to the networks activities according to the legislation of the Member State where they are established”. “ Providing clarity on the definition of an ERN” through: - developing & publishing criteria & conditions that the ERN should fulfil in order to receive support from the Commission - developing & publishing criteria for evaluating ERN;
- FYI: “ The Commission shall support Member States in the development of European reference networks between healthcare providers and centres of expertise in the Member States. The networks shall be based on voluntary participation by its members, which shall participate and contribute to the networks activities according to the legislation of the Member State where they are established”. “ Providing clarity on the definition of an ERN” through: - developing & publishing criteria & conditions that the ERN should fulfil in order to receive support from the Commission - developing & publishing criteria for evaluating ERN;
- The latest Swedish Compromise text (26/11/09) - Main provisions : NON-HOSPITAL CARE: no PA may be introduced HOSPITAL CARE SW text weakened the proposal Regarding PA in the latest SW text: EC ok to dilution of its proposal only to enable 1st reading For hospital care & highly-specialised care , MS may introduce a PA system in so far as it is justified, non discriminatory and proportionate to the objective pursued (financial stability of the system). MAIN PROBLEMS The OPEN list of reasons for refusing an individual prior authorisation. It allows MS to refuse for any reasons not listed Refusal for "undue delay“ introduced in SW (same wording for refusing under 883/2004: confusing & no progress for patients!!)
- New Spanish Proposal: Basis: Swedish text Only 4 points of discussion: Dual legal basis MS of affiliation-pensioners quality of care eHealth