Elena Petru v Casa Judeţeană de Asigurări de Sănătate Sibiu and Casa Naţională de Asigurări de Sănătate.
Date: 2014-10-09
20. In that regard, it must be noted that, according to the settled case-law of the Court, the procedure provided for in Article 267 TFEU is an instrument for cooperation between the Court of Justice and the national courts, by means of which the Court provides the national courts with the points of interpretation of EU law which they need in order to decide the disputes before them ( Geistbeck , C‑509/10, EU:C:2012:416, paragraph 47, and Impacto Azul , C‑186/12, EU:C:2013:412, paragraph 26).
21. In the context of that cooperation, it is solely for the national court before which the dispute has been brought, and which must assume responsibility for the subsequent judicial decision, to determine in the light of the particular circumstances of the case both the need for a preliminary ruling in order to enable it to deliver judgment and the relevance of the questions which it submits to the Court (see, inter alia, Bosman , C‑415/93, EU:C:1995:463, paragraph 59, and Confederación Española de Empresarios de Estaciones de Servicio , C‑217/05, EU:C:2006:784, paragraph 16).
23. Since questions concerning EU law enjoy a presumption of relevance, the Court may refuse to rule on a question referred by a national court only where it is quite obvious that the interpretation of EU law that is sought is unrelated to the actual facts of the main action or its purpose, where the problem is hypothetical, or where the Court does not have before it the factual or legal material necessary to give a useful answer to the questions submitted to it (see, inter alia, Cipolla and Others , C‑94/04 and C‑202/04, EU:C:2006:75, paragraph 25 and The Chartered Institute of Patent Attorneys , C‑307/10, EU:C:2012:361, paragraph 32).
30. It must be observed that the second subparagraph of Article 22(2) of Regulation No 1408/71 lays down two conditions which, if both are satisfied, render mandatory the grant by the competent institution of the prior authorisation applied for on the basis of Article 22(1)(c)(i). The first condition requires the treatment in question to be among the benefits provided for by the legislation of the Member State on whose territory the insured person resides. The second condition requires that the treatment which the latter plans to receive in a Member State other than that of residence cannot be given within the time normally necessary for obtaining the treatment in question in the Member State of residence, account being taken of his current state of health and the probable course of his disease (see, to that effect, Elchinov , C‑173/09, EU:C:2010:581, paragraphs 53 and 54, and case-law cited).
31. As regards the second condition, with which the question in the present case is concerned, the Court has held that the authorisation required cannot be refused if the same or equally effective treatment cannot be given in good time in the Member State of residence of the person concerned (see, to that effect, Inizan , C 56/01, EU:C:2003:578, paragraphs 45 and 60; Watts , C‑372/04, EU:C:2006:325, paragraph 61, and Elchinov , EU:C:2010:581, paragraph 65).
32. In that regard, the Court has pointed out that, in order to determine whether treatment which is equally effective for the patient can be obtained in due time in the Member State of residence, the competent institution is required to have regard to all the circumstances of each specific case and to take due account not only of the patient’s medical condition at the time when authorisation is sought and, where appropriate, of the degree of pain or the nature of the patient’s disability which might, for example, make it impossible or extremely difficult for him to carry out a professional activity, but also of his medical history ( Inizan , EU:C:2003:578, paragraph 46; Watts , EU:C:2006:325, paragraph 62, and Elchinov , EU:C:2010:581, paragraph 66).