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Senior Legal Specialist with over 28 years of experience in providing strategic legal consultancy in critical sectors, including healthcare, construction, and public administration (extensive proven experience in medical law).

Specialized in GDPR / Data Protection, Compliance Management and Internal Control Systems, with a demonstrated ability to integrate complex legislative frameworks and implement internal managerial control systems.

Focused on delivering business-oriented solutions that minimize operational risks and ensure data integrity.

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Reimbursement of Cross-Border Healthcare after Case C-489/23 (CJEU)

Context: The judgment of the Court of Justice of the European Union in case C-489/23 clarifies the conditions under which patients may obtain reimbursement for healthcare received in another EU Member State.

Key findings:

Making reimbursement conditional upon a document issued exclusively by a physician within the public healthcare system is disproportionate and restrictive to the freedom to provide services (Art. 56 TFEU and Directive 2011/24/EU).
Medical documents issued in the private sector or in another Member State may be sufficient if they demonstrate the necessity and appropriateness of the treatment.
The right to reimbursement may exist even without prior authorization, subject to applicable conditions.

Practical consequences: Patients may challenge refusals by national health insurance authorities when based solely on the absence of documentation from the domestic public system.

Limitations:

Reimbursement remains subject to compliance with legal requirements (coverage within the national benefits package, medical necessity, etc.).
As a rule, reimbursement is limited to the cost that would have been borne domestically, absent prior authorization.

Conclusion: The ruling requires national authorities to align administrative procedures with EU law principles of proportionality, non-discrimination and transparency.

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