natgillin/translations-raw huggingface dataset:
Ifølge den irske, den nederlandske og Det Forenede Kongeriges regering angiver forelæggelsesdommen ikke præcist grundene til, at den nationale ret har behov for en fortolkning af fællesskabsretten for at afgøre tvisten, og den indeholder ikke tilstrækkelige oplysninger med hensyn til de retlige og faktiske omstændigheder, som kan gøre det muligt for medlemsstaterne effektivt at udøve deres ret til at indgive skriftlige indlæg til Domstolen.
It held that the only question still to be resolved was the amount of the costs assumed and decided to stay proceedings and to refer the following question to the Court for a preliminary ruling:
Jeanne Descamps er afgået ved døden den 10. august 1996, mens sagen verserede. Hendes arvinger, nemlig hendes ægtefælle Abdon Vanbraekel og hendes seks børn, er indtrådt i sagen.
The referring court's judgment indicates the applicable national provisions and gives a description of the facts which, although concise, is sufficient to enable the Court to adjudicate on the matter.
Det bemærkes, at det følger af fast retspraksis, at det for at opnå en fortolkning af fællesskabsretten, som den nationale ret kan bruge, er påkrævet, at denne giver en beskrivelse af de faktiske omstændigheder og regler, som de forelagte spørgsmål hænger sammen med, eller i alt fald forklarer de faktiske forhold, der er baggrunden for dens spørgsmål.
'Where, in the context of proceedings before it, a national court has acknowledged that hospital treatment in a Member State other than that of the competent institution was necessary, although the prior authorisation provided for in Article 22 of Regulation No 1408/71 was refused:
Domstolen har endvidere gentagne gange understreget nødvendigheden af, at den forelæggende ret angiver de nøjagtige grunde til, at den har rejst spørgsmål om fortolkningen af fællesskabsretten og har fundet det nødvendigt at forelægge Domstolen præjudicielle spørgsmål.
Must the costs of hospital treatment be reimbursed in accordance with the scheme of the State of the competent institution or in accordance with that organised by the State on whose territory the hospital treatment has taken place?
Cour du travail de Mons har under hensyn til udtalelsen fra den sagkyndige anført, at ANMC vil blive dømt til at afholde udgifterne i forbindelse med Jeanne Descamps hospitalsindlæggelse »i overensstemmelse med artikel 22 i forordning 1408/71 og traktatens artikel 59 og 60«.
Furthermore, as previously observed, the national court has already held that, in the circumstances of the case before it, the conditions to which Community law subjects the existence of a right to reimbursement of the costs of treatment received in a Member State other than the State in which the person concerned is insured were satisfied.
Cour du travail de Mons har udtalt, at det eneste punkt i sagen, der står tilbage, vedrører størrelsen af det beløb, der skal godtgøres, og den har derfor besluttet at udsætte sagen og forelægge Domstolen følgende præjudicielle spørgsmål:
As the judgment makes clear, the request for a preliminary ruling addressed to the Court seeks only to ascertain the amount of the reimbursement to be made and, in particular, whether it is the scheme of the Member State in which the person concerned is insured or the scheme governed by the legislation of the Member State on whose territory the treatment was provided that must be applied in this regard.
Det bemærkes, at forelæggelsesdommen indeholder en angivelse af de gældende nationale bestemmelser og en beskrivelse af faktiske omstændigheder, der, selv om den er kortfattet, er tilstrækkelig til, at Domstolen kan træffe afgørelse.
In those circumstances, the question referred by the national court does indeed call for examination.
Som anført ovenfor har den forelæggende ret i øvrigt allerede fastslået, at under de i hovedsagen foreliggende omstændigheder var de betingelser,
The Irish, Netherlands and United Kingdom Governments argue that the judgment asking for a preliminary ruling does not state precisely why the national court needs an interpretation of Community law to decide the case and that it does not contain sufficient information about the
Skal godtgørelsen af udgifterne i forbindelse med hospitalsindlæggelsen gennemføres
By the first part of its question, the national court is asking essentially whether, when a
det første bemærkes, dels at Jeanne Descamps har indgivet en ansøgning om forhåndstilladelse baseret på denne bestemmelse, dels at den forelæggende ret har besluttet at ophæve virkningen af det afslag, der blev meddelt hende.
the circumstances in which such authorisation may be granted pursuant to Article 22(l)(c). It follows that, where permission is granted on the basis of a national rule which, like the legislation at issue in the main proceedings, provides that authorisation is to be granted where it is established that hospital treatment can be provided under better medical conditions abroad, such permission constitutes an authorisation within the meaning of Article 22(1)(c) of Regulation No 1408/71.
som fællesskabsretten fastsætter for eksistensen af en ret til godtgørelse af behandling modtaget i en anden medlemsstat end den, hvori vedkommende er forsikret, opfyldt. Som anført i forelæggelsesdommen tilsigtes det med den anmodning om fortolkning, der er forelagt Domstolen, alene at få fastlagt størrelsen af det beløb, der skal godtgøres, og navnlig, såfremt det er fornødent, i denne henseende at anvende den ordning, der er gældende i den medlemsstat, hvori vedkommende er forsikret, eller den, som fremgår af lovgivningen i den medlemsstat, på hvis område behandlingen er blevet givet.
person who has requested authorisation on the basis of Article 22(l)(c) of Regulation No 1408/71 has been refused by the competent institution and it is subsequently established that that refusal was unfounded, the reimbursement by the competent institution of the costs of the treatment should be made according to the relevant rules in force in the Member State in which the person concerned is insured or according to those laid down in the legislation of the Member State on whose territory the treatment was provided.
Det bemærkes for det andet, at den omstændighed, at afslaget på ansøgningen om tilladelse i hovedsagen blev kendt ubegrundet i henhold til de godkendelseskriterier, der er fastsat i den nationale lovgivning, og ikke i henhold til de kriterier, der er formuleret i artikel 22, stk. 2, andet afsnit, i forordning nr. 1408/71, på ingen måde gør det muligt at antage, således som den belgiske regering har anført, at der ikke er anledning til at anvende denne forordning.
In answering that question, it should be noted at the outset that, although the national court does not say so, the Community provisions whose interpretation appears to be relevant for the purpose of answering the question are, first, Article 22(l)(c) and (i) of Regulation No 1408/71 and, second, Article 59 of the Treaty.
Under disse omstændigheder skal der således foretages en gennemgang af spørgsmålet fra den forelæggende ret.
As already observed, the national court states that it has held that the medical costs at issue in the main proceedings must be paid by the ANMC 'in accordance with Article 22 of Regulation No 1408/71 and Articles 59 and 60 of the Treaty'.
Det første led i det præjudicielle spørgsmål
Article 22 of Regulation No 1408/71
Det fremgår af artikel 22, stk. 2, andet afsnit, i forordning nr. 1408/71, at denne bestemmelse alene har til formål at identificere de omstændigheder, hvorunder det er udelukket, at den nationale kompetente institution kan afslå en tilladelse, som der ansøges om i henhold til artikel 22, stk. 1, litra c).
As regards the extent of the rights conferred by Article 22(1)(c) on an insured person who has been granted such authorisation, it follows from paragraph l(i) that the insured person must in principle be entitled to the benefits in kind provided on behalf of the competent institution by the institution of the place where the insured person is staying, in accordance with the provisions of the legislation of the State in which the benefits are provided, as if the covered person were insured in that State.
Bestemmelsen har derimod på ingen måde til formål at begrænse de tilfælde, hvori en sådan tilladelse kan meddeles i henhold til artikel 22, stk. 1, litra c).
Only the length of the period during which benefits are provided remains to be governed by the legislation of the competent State.
Det følger heraf, at når en tilladelse meddeles i henhold til en national regel, der, ligesom den i hovedsagen omhandlede lovgivning, foreskriver meddelelse af tilladelse, når det er godtgjort, at en hospitalsindlæggelse kan gennemføres under bedre lægelige vilkår i udlandet, må det antages, at en sådan tilladelse udgør en tilladelse i den forstand, hvori udtrykket er anvendt i artikel 22, stk. 1, litra c), i forordning nr. 1408/71.
By guaranteeing that insured persons covered by the legislation of one Member State and granted authorisation have access to treatment in the other Member States on conditions as favourable as those enjoyed by persons covered by the legislation of those other States, that provision helps to facilitate the free movement of persons covered by social insurance.
Med henblik på besvarelsen af dette spørgsmål skal det indledningsvis bemærkes, at selv om den forelæggende ret ikke præciserer det, er de fællesskabsbestemmelser, hvis fortolkning forekommer relevant med henblik på besvarelsen af det forelagte spørgsmål, dels artikel 22, stk. 1, litra c), nr. i), i forordning nr. 1408/71, dels traktatens artikel 59.
As regards the applicability of Article 22 of Regulation No 1408/71 to the case before the national court, it must be borne in mind first of all that Ms Descamps did request prior authorisation on the basis of that provision and that the national court decided to declare the refusal of authorisation inoperative.
Som ovenfor anført har den forelæggende ret i øvrigt præciseret, at den selv har truffet afgørelse om, at de i hovedsagen omhandlede lægeudgifter skal godtgøres af ANMC »i overensstemmelse med artikel 22 i forordning 1408/71 og traktatens artikel 59 og 60«.
It follows from the foregoing that, as regards the basis on which costs are borne, the legislation of the Member State in which the treatment is given is to be applied, while the competent institution remains responsible for subsequently reimbursing the institution of the place of stay, as provided for in Article 36 of Regulation No 1408/71.
Hvad angår rækkevidden af de rettigheder, som artikel 22, stk. 1, litra c), i forordning nr. 1408/71 giver en socialt forsikret, der er indehaver af en tilladelse, fremgår det af artikel 22, stk. 1, litra c), nr. i), at en sådan forsikret i princippet har ret til naturalydelser, der for den kompetente institutions regning ydes af opholdsstedets institution efter lovgivningen i den stat, hvori ydelserne udredes, som om den socialt forsikrede var forsikret dér, og at alene det tidsrum, for hvilket disse ydelser kan udredes, fortsat afhænger af den kompetente stats lovgivning.
The fact that the refusal of authorisation was held unfounded in the main proceedings, on the basis of the criteria for authorisation laid down in the national legislation and not according to the criteria set out in the second paragraph of Article 22(2) of Regulation No 1408/71, does not mean that there was no ground to apply that regulation, as the Belgian Government maintains.
Ved således at garantere de socialt forsikrede, som er omfattet af en medlemsstats lovgivning og i besiddelse af en tilladelse, adgang til behandling i de øvrige medlemsstater på betingelser, der er
Both the practical effect and the spirit of those provisions require, moreover, that the request of an insured person for authorisation on the basis of Article 22(l)(c) of Regulation No 1408/71 has been refused by the competent institution and it is subsequently established, either by the competent institution itself or by a court decision, that that refusal was unfounded, that person is entitled to be reimbursed directly by the competent institution by an amount
Hvad angår anvendeligheden i hovedsagen af artikel 22 i forordning nr. 1408/71 skal det for
It follows from the second subparagraph of Article 22(2) of Regulation No 1408/71 that the sole purpose of that provision is to identify the circumstances in which the competent national institution is precluded from refusing authorisation sought on the basis of Article 22(l)(c). That provision is not designed to limit
lige så fordelagtige som dem, der gælder for de socialt forsikrede, der er omfattet af sidstnævntes lovgivning, bidrager denne bestemmelse til at fremme de socialt forsikredes frie bevægelighed.
equivalent to that which it would ordinarily have borne if authorisation had been properly granted in the first place.
Det følger af det ovenfor anførte, at de betingelser for godtgørelse, der er foreskrevet i lovgivningen i den medlemsstat, hvori behandlingen gives, skal finde anvendelse til byrde for den kompetente institution, der senere skal yde refusion til opholdsstedets institution på de betingelser, der er fastsat i artikel 36 i forordning nr. 1408/71.
It must be determined first of all whether the situation at issue in the main proceedings falls within the scope of freedom to provide services within the meaning of Article 59 of the Treaty.
I det foreliggende tilfælde er der ikke tvivl om, at den omstændighed, at en socialt forsikret opnår et mindre fordelagtigt dækningsniveau, når han modtager hospitalsbehandling i en anden medlemsstat, end når han modtager samme behandling i den medlemsstat, hvori han er forsikret, kan afholde eller endog forhindre denne forsikrede fra at rette henvendelse til personer, der leverer lægelige tjenesteydelser, og som er etableret i andre medlemsstater, og udgør såvel for denne forsikrede som for tjenesteyderne en hindring for den frie udveksling af tjenesteydelser.
It should be remembered that the Court has held that it cannot be excluded that the risk of seriously undermining the financial balance of a social security system might constitute an overriding reason in the general interest capable of justifying a barrier to the principle of freedom to provide services.
Den effektive virkning af og ånden i disse bestemmelser påbyder i øvrigt, at det antages, at når en social forsikret, der har indgivet en ansøgning om tilladelse i henhold til artikel 22, stk. 1, litra c), i forordning nr. 1408/71, er blevet meddelt afslag af den kompetente institution, og det senere er blevet fastslået, at et sådant afslag er ubegrundet, enten af den kompetente institution selv eller ved en retsafgørelse, har denne forsikrede ret til direkte fra den kompetente institution at få godtgjort et beløb svarende til det, der normalt ville være blevet godtgjort, såfremt tilladelsen var blevet forskriftsmæssigt meddelt allerede fra begyndelsen.
It is settled case-law that medical activities fall within the scope of Article 60 of the Treaty, there being no need to distinguish in that regard between care provided in a hospital environment and care provided outside such an environment.
Reglerne om fri udveksling af tjenesteydelser
It is also settled case-law that the special nature of certain services does not remove them from the ambit of the fundamental principle of freedom of movement.
Det skal herefter undersøges, om den omstændighed, at en national lovgivning ikke garanterer en person, som er forsikret i henhold hertil, et mindst lige så fordelagtigt dækningsniveau, når tjenesteydelser inden for hospitalssektoren ydes i en anden medlemsstat, vil kunne begrundes objektivt.
The Court has likewise recognised, as regards the objective of maintaining a balanced medical and hospital service open to all, that even if that objective is intrinsically linked to the method of financing the social security system, it may also fall within the derogations on grounds of public health under Article 56 of the EC Treaty (now, after amendment, Article 46 EC) in so far as it contributes to the attainment of a high level of health protection.
Det skal først undersøges, om situationen i hovedsagen henhører under anvendelsesområdet for den fri udveksling af tjenesteydelser i henhold til traktatens artikel 59.
The Court has also stated that Article 56 of the Treaty allows Member States to restrict the freedom to provide medical and hospital services in so far as the maintenance of treatment capacity or medical competence on national territory is essential for the public health, and even the survival, of the population.
Det bemærkes, at Domstolen tidligere har fastslået, at det ikke kan udelukkes, at en risiko for et alvorligt indgreb i den sociale sikringsordnings økonomiske ligevægt kan udgøre et tvingende alment hensyn, som kan begrunde en begrænsning af princippet om fri udveksling af tjenesteydelser.
Since the hospital services at issue in the main proceedings fall within the scope of freedom to provide services, it is necessary to go on to consider whether the fact that national legislation does not guarantee a person covered by its social insurance scheme who has been authorised to receive hospital treatment in another Member State in accordance with Article 22(1)(c) of Regulation No 1408/71 a level of payment equivalent to that to which he would have been entitled if he had received hospital treatment in the Member State in which he was insured entails a restriction of freedom to provide services within the meaning of Article 59 of the Treaty.
Det bemærkes, at det fremgår af fast retspraksis, at lægelig virksomhed henhører under anvendelsesområdet for traktatens artikel 60. uden at der herved skal sondres efter, om hjælpen ydes inden for eller uden for hospitalssektoren.
In the present case, there is no doubt that the fact that a person has a lower level of cover when he receives hospital treatment in another Member State than when he undergoes the same treatment in the Member State in which he is insured may deter, or even prevent, that person from applying to providers of medical services established in other Member States and constitutes, both for insured persons and for service providers, a barrier to freedom to provide services.
Det fremgår endvidere af fast retspraksis, at visse tjenesteydelsers særlige beskaffenhed ikke kan bevirke, at disse aktiviteter ikke omfattes af det grundlæggende princip om fri udveksling.
In the present case, the national court held that Ms Descamps was in fact entitled to obtain the authorisation provided for by the national legislation under which she was covered and by Article 22(l)(c) of Regulation No 1408/71.
Domstolen har endvidere med hensyn til formålet om at opretholde en stabil læge- og hospitalstjeneste, som alle har adgang til, udtalt, at selv om dette formål hænger nært sammen med ordningen for finansiering af den sociale sikringsordning, kan den også være omfattet af undtagelserne af hensyn til den offentlige sundhed i henhold til EF-traktatens artikel 56 (efter ændring nu artikel 46 EF), i det omfang det bidrager til at opnå et højt niveau for beskyttelse af sundheden.
In such circumstances, it cannot be claimed that payment of additional reimbursement, covering the difference between the system of cover laid down by the legislation of the Member State in which she was insured and that applied by the Member State in which the treatment was provided, when the former is more advantageous than the latter, would be liable to jeopardise the maintenance, in the Member State of registration, of a balanced medical and hospital service open to all or the maintenance of treatment capacity or medical competence on national territory.
Da de i hovedsagen omhandlede hospitalsydelser således henhører under anvendelsesområdet for den frie udveksling af tjenesteydelser, skal det herefter undersøges, om den omstændighed, at en national lovgivning ikke garanterer en
Consequently, it is necessary to examine whether the fact that the national legislation of a Member State does not guarantee a person insured in that State at least an equally advantageous level of
omstændighed, at en sådan supplerende godtgørelse pålægges sygeforsikringssystemet, vil kunne have nogen væsentlig betydning for finansieringen af den sociale sikringsordning.
reimbursement of all the medical costs which he incurred in the Member State in which he received treatment once it is established that the rejection of his request for authorisation was unfounded.
Det andet led i det præjudicielle spørgsmål
Second part of the question referred to the Court
Domstolen har endvidere fastslået, at traktatens artikel 56 tillader medlemsstaterne at begrænse den frie udveksling af læge- og hospitalsydelser, i det omfang opretholdelse af behandlingsmuligheder eller en lægelig kompetence på det nationale territorium er væsentlig for den offentlige sundhed eller endog for befolkningens overlevelse.
In order to answer that reformulated question, it is sufficient to state that it follows from the actual wording of Article 36 of Regulation No 1408/71 that the full refund between institutions to which that provision refers concerns only benefits in kind provided by the institution of a Member State of stay on behalf of the competent institution, pursuant to the provisions of Title III, Chapter 1, of that regulation.
H\'ad angår situationen i hovedsagen må det imidlertid antages, at intet af de krav, der er nævnt i denne doms præmis 47, 48 og 49, kan begrunde den i hovedsagen omhandlede hindring.
Consequently, as observed in paragraphs 32 and 33 above, that refund applies only to benefits in kind for which the assumption of costs by the institution of the place of stay is provided for by the legislation applied by that institution, and in precise proportion to which that assumption of costs is stipulated.
Med spørgsmålets andet led spørger den forelæggende ret nærmere bestemt, om artikel 36 i forordning nr. 1408/71 skal fortolkes således, at det fremgår af denne bestemmelse, at en socialt forsikret, der har indgivet en ansøgning om tilladelse i henhold til artikel 22, stk. 1, litra c), i forordning nr. 1408/71, og som er blevet meddelt afslag af den kompetente institution, har ret til godtgørelse af samtlige de lægeudgifter, som han har afholdt i den medlemsstat, hvor behandlingen er blevet ydet ham, når det er fastslået, at afslaget på hans ansøgning om tilladelse var ubegrundet.
By the second part of its question, the national court asks essentially whether Article 36 of Regulation No 1408/71 is to be interpreted as meaning that an insured person who has requested authorisation on the basis of Article 22(l)(c) of Regulation No 1408/71 and been refused by the competent institution is entitled to
For så vidt som en sådan supplerende godtgørelse, som er forbundet med den kompetente stats ordning med dækning af udgifter, ikke i et tænkt tilfælde indebærer nogen supplerende økonomisk byrde for denne medlemsstats sygeforsikringsordning i forhold til den godtgørelse, som skulle have været ydet i tilfælde af hospitalsindlæggelse i sidstnævnte stat, kan det heller ikke hævdes, at den
Where the request of an insured person f or authorisation on the basis of Article 22(1)(c) of that regulation has been refused by the competent institution and it is subsequently established that such refusal was unfounded, the person concerned is entitled to be reimbursed directly by the competent institution by an amount equivalent to that which would have been borne by the institution of the place o f stay under the rules laid down by the legislation applied by the latter institution if authorisation had been property granted in the first place.