Keywords

Summary



Keywords

1 Social security for migrant workers - Powers of the Member States to organise their social security systems - Limits - Compliance with Community law - Treaty rules on freedom to provide services

(EC Treaty, Arts 59 and 60)

2 Social security for migrant workers - Sickness insurance - Benefits provided in another Member State - Article 22 of Regulation No 1408/71 - Scope - Reimbursement by the Member States, at the tariffs in force in the competent State, of costs incurred in connection with treatment provided in another Member State - Whether excluded

(Council Regulation No 1408/71, Art. 22)

3 Freedom to provide services - Restrictions - National rules on reimbursement of medical expenses incurred in another Member State - Dental treatment - Requirement of prior authorisation by the social security institution of the State of insurance - Not permissible - Justification - Control of health expenditure - Protection of public health - None

(EC Treaty, Arts 56, 59 and 60)

Summary

4 The fact that national rules fall within the sphere of social security cannot exclude the application of Articles 59 and 60 of the Treaty.

While Community law does not detract from the powers of the Member States to organise their social security systems, they must nevertheless comply with Community law when exercising those powers.

5 Article 22 of Regulation No 1408/71 is intended to allow an insured person, authorised by the competent institution to go to another Member State to receive there treatment appropriate to his condition, to receive sickness benefits in kind, on account of the competent institution but in accordance with the provisions of the legislation of the State in which the services are provided, in particular where the need for the transfer arises because of the state of health of the person concerned, without that person incurring additional expenditure. It is not intended to regulate and hence does not in any way prevent the reimbursement by Member States, at the tariffs in force in the competent State, of costs incurred in connection with treatment provided in another Member State, even without prior authorisation.

6 Articles 59 and 60 of the Treaty preclude national rules under which reimbursement, in accordance with the scale of the State of insurance, of the cost of dental treatment provided by an orthodontist established in another Member State is subject to authorisation by the insured person's social security institution.

Such rules deter insured persons from approaching providers of medical services established in another Member State and constitute, for them and their patients, a barrier to freedom to provide services.

They are not justified by the risk of seriously undermining the financial balance of the social security system, since reimbursement of the costs of dental treatment provided in other Member States in accordance with the tariff of the State of insurance has no significant effect on the financing of the social security system, nor are they justified on grounds of public health within the meaning of Articles 55 and 66 of the Treaty in order to protect the quality of medical services provided to insured persons in other Member States and to maintain a balanced medical and hospital service open to all. Since the conditions for taking up and pursuing the profession of doctor and dentist have been the subject of several coordinating or harmonising directives, doctors and dentists established in other Member States must be afforded all guarantees equivalent to those accorded to doctors and dentists established on national territory, for the purposes of freedom to provide services. It has not been argued that such rules are indispensable for the maintenance of an essential treatment facility or medical service on the national territory of that Member State.