NHF return for treatment in the European Union – News 24

NHF return for treatment in the European Union – News 24

On Saturday, came into force the provisions of the Law on cross-border care, which allows reimbursement of medical expenses in the countries of the European Union.

Patient who is entitled to public health services in Poland will be able to receive reimbursement from the National Health Fund medical treatment in another EU country.

However, this applies only to guaranteed benefits. For the treatment of the patient must first pay from their own pockets, and after its completion only apply for a refund of the amount paid for the right NFZ attaching the necessary documents. When it happens that service abroad is more expensive, the NHF will pay only up to the amount for which it pays to these benefits in Poland. If it is lower, it will be a reimbursement for what amounts invoiced.

Sometimes treatment abroad have to obtain the consent of the NFZ. On the Patient Ombudsman says that “dependence on the reimbursement of health care benefits to obtaining the prior consent of the patient can only relate to the benefits: 1.
that involve planning to ensure sufficient and permanent access to a balanced range of high-quality treatment in a Member State or on the need to control costs and avoid, as far as possible, any waste of financial, technical and human resources and: includes stay of the patient in the hospital for at least one night, or there is a need for highly specialized and cost-intensive medical infrastructure or medical equipment;
2. involves treatments presenting a particular risk for the patient or the public;
3 is given by a healthcare provider, which in individual cases may give rise to serious doubts about the quality or safety of care.

At the same time the refusal to grant prior authorization for services in another EU country can only occur for the following reasons:
a) in the light of clinical evaluation with reasonable certainty that patient safety is at risk, which is not acceptable, taking into account the potential benefit to the patient of the sought cross-border healthcare;
b) there is reasonable certainty that the public will be exposed to a significant security risk due to the cross-border provision of health care;
c) the type of care care is provided by a provider that raises serious and specific concerns relating to the respect of standards and guidelines on quality of care and patient safety;
d) healthcare can be provided on its territory within a time limit which is medically justifiable, taking into account the current state of health and the probable course of the disease each patient concerned. “.

Created National Contact Points provide assistance to people who have benefited from medical treatment abroad or have them in the plan (for more information on this topic can be found on page www.kpk.nfz .gov).

The entry into force of the regulations will also arrive patients eg. Behind the western frontier, who will be treated in our institutions, because the prices will be cheaper than treatment in their countries.