An introduction to the EU Patients Rights Directive: whats new for - - PowerPoint PPT Presentation

An introduction to the EU Patients’ Rights Directive: what’s new for patients?

Ann Marie Borg

MHN seminar, Monday 24th June 2013

Outline

A

• From Kohll and Decker to Directive 2011/24/EU
• Milestones

B

• Key features of Directive 2011/24/EU
• Main provisions of the Directive

C

• What’s new?
• Opportunities and Challenges
• Willingness to seek healthcare abroad

D

• Conclusions

Milestones

High level reflection process on patient mobility & HC developments in the EU

2003 2004 2006 2006

First ECJ rulings on patient mobility: Kohll & Decker

1998

Exclusion

• f health

services from the Services Directive Adoption of Regulation 883/04 on social security coordination: Introduction

• f the EHIC

Watts Ruling

Milestones

2011 2010 2008

Adoption of Directive 2011/24/EU

• n patients’

rights in cross-border healthcare 2006

Start of consultation process on Community action on health services Adoption of Commission proposal on cross-border healthcare Common position adopted under the Belgian Presidency

• A Directive sets the goals to be achieved but

Member States have discretion to choose the means

• Not directly applicable but MS need to

TRANPOSE the provisions of the Directive into their national legislation

Small vs Big Taking stock Challenges -- PRD Way forward

• B. Key features of Directive

2011/24/EU

From Kohll & Decker.. Key features What’s new? Conclusions

• Article 114 TFEU on the functioning of the

internal market (exclusive EU competence) &

• Article 168 TFEU on public health (limited EU

competence) Can we reconcile both legal bases? ?

Small vs Big Taking stock Challenges -- PRD Way forward

• B. Key features of Directive

2011/24/EU

From Kohll & Decker.. Key features What’s new? Conclusions

Small vs Big Taking stock Challenges --PRD Way forward

• Codify ECJ judgments & clarify “old” patients’

rights on reimbursement and entitlement for patients who seek planned, non-emergency cross- border healthcare

• Create “new” patients’ rights on quality and

safety standards, access to information relevant to making informed (consumer) choices, complaint procedures and redress mechanisms

• B. Key features of Directive

2011/24/EU

From Kohll & Decker.. Key features What’s new? Conclusions

High quality & safe healthcare

• Facilitate patient access to high quality and safe cross-

border healthcare

• Provide information to patients to make informed choices

Reimbursement rights

• Set up a harmonised framework for reimbursement of

healthcare received in another MS

Health systems co-operation

• Foster co-operation among EU health systems
• Encourage the setting up of voluntary networks: European

Reference Networks, Health Technology Assessment…

Importance Problems Solutions Next

• B. Key features of Directive 2011/24/EU

Small vs Big Taking stock Challenges --PRD Way forward

From Kohll & Decker.. Key features What’s new? Conclusions

Small vs Big Taking stock Challenges --PRD Way forward

• B. Key features of Directive

2011/24/EU

Let’s take a closer look…

From Kohll & Decker.. Key features What’s new? Conclusions

Importance Problems Solutions Next

Main provisions of Directive 2011/24/EU

Citizen-friendly information

• Article 6
• Patients are entitled to access all information

relevant for making informed decisons on their health and cross-border healthcare

• ptions  setting up of National Contact

Point (NCP)

• Consultation with patient organisations

Small vs Big Taking stock Challenges --PRD Way forward

From Kohll & Decker.. Key features What’s new? Conclusions

Importance Problems Solutions Next

National health sytem safeguards: Prior Authorisation (PA)

• National authorities OBLIGED to grant PA to

patients when HC cannot be provided within “a time-limit which is medically justifiable”

• Patients REQUIRE PA in cases of overnight hospital

stay, highly specialised and cost-intensive treatment

• PA may be REFUSED when there are concerns over

quality of care & patient safety, no undue delay

Small vs Big Taking stock Challenges --PRD Way forward

Main provisions of Directive 2011/24/EU

From Kohll & Decker.. Key features What’s new? Conclusions

Importance Problems Solutions Next

National health system safeguards: Conditions of reimbursement

• Patients have right to be reimbursed for

healthcare up to what it would have cost had they received it in their home country

• MS may decide to reimburse the full cost and
• ther related costs

Small vs Big Taking stock Challenges --PRD Way forward

Main provisions of Directive 2011/24/EU

From Kohll & Decker.. Key features What’s new? Conclusions

• C. What’s new?

Previous scenario EU Regulation 883/2004 on social security (implementing Regulation 987/2009) E111 (tourists/emergencies) - EHIC E112 (planned HC) – PA necessary condition Now Directive 2011/24/EU(patient-oriented approach)

• consumer choice, flexibility, more transparency

& information on quality and safety standards

Small vs Big Taking stock Challenges -- PRD Way forward Small vs Big Taking stock Challenges --PRD Way forward

From Kohll & Decker.. Key features

What’s new?

Conclusions

The path to patient empowerment?

Small vs Big Taking stock Challenges -- PRD Way forward Small vs Big Taking stock Challenges --PRD Way forward

From Kohll & Decker.. Key features

What’s new?

Conclusions

Opportunities

• Patient entitlement to clear and

comprehensive information

• Mechanisms to ensure remedies &

compensation in case of harm

• Patient access to medical records
• Support for patients with rare

diseases

• One-stop-shop for

incoming/outgoing patients

• Faster treatment access for patients

experiencing long waiting times

• Increased transparency of providers

& pricing of medical procedures

• MS urged to upgrade & improve

national performance and quality of care

Challenges

• Difficulties for patients to deduce

whether treatment is covered in national health basket and reimbursable

• Difficulties in determining exact

pricing of procedures (total cost of procedure from provider abroad & level up to which it is reimbursed nationally)

• Affluent, high SES patients search for

the best, less invasive treatment with latest technologies  amplify existing health inequalities

• Determining “undue delay”
• Continuity of patient care
• Patients paying for treatment costs

upfront Small vs Big Taking stock Challenges -- PRD Way forward From Kohll & Decker.. Key features

What’s new?

Conclusions

Importance Problems Solutions Next

Willingness to seek healthcare abroad

Small vs Big Taking stock Challenges --PRD Way forward

Eurobarometer survey on cross-border health services in the EU (2007) Small Member States could experience greater patient outflows

From Kohll & Decker.. Key features

What’s new?

Conclusions

Importance Problems Solutions Next

Willingness to seek healthcare abroad

Small vs Big Taking stock Challenges --PRD Way forward

Eurobarometer report on European Union citizenship (2012)

• 3/4 Maltese citizens feel they are EU citizens which is above the

current EU average

• Nearly 50% of Maltese citizens who would like more information

about their rights as EU citizens say that they would like to know more about receiving medical assistance in another EU MS Is this an indication of the way forward with patients using the Directive to exercise their rights as EU citizens?

From Kohll & Decker.. Key features

What’s new?

Conclusions

Importance Problems Solutions Next

• D. Conclusions

How did the EU Patients’ Rights Directive come about and evolve?  What are its legal bases, scope, specific aims and key provisions?  How does it complement previous EU Regulations?  What are “new” patients’ rights?

Small vs Big Taking stock Challenges --PRD

From Kohll & Decker… Key features What’s new?

Conclusions