natgillin/translations-raw huggingface dataset:
Member States shall ensure that the healthcare providers on their territory apply the same scale of fees for healthcare for patients from other Member States, as for domestic patients in a comparable medical situation, or that they charge a price calculated according to objective, non-discriminatory criteria if there is no comparable price for domestic patients.
Države članice zagotovijo, da izvajalci zdravstvenega varstva na njihovem ozemlju pacientom iz drugih držav članic zaračunajo enake cene za zdravstveno varstvo, kot jih zaračunajo domačim pacientom s primerljivim zdravstvenim stanjem, ali da zaračunajo ceno v skladu z objektivnimi, nediskriminatornimi merili, če ni primerljive cene za domače paciente.
This paragraph shall be without prejudice to national legislation which allows healthcare providers to set their own prices, provided that they do not discriminate against patients from other Member States.
Ta odstavek ne posega v nacionalno zakonodajo, ki izvajalcem zdravstvenega varstva omogoča, da določajo svoje cene, pod pogojem, da pri tem ne diskriminirajo pacientov iz drugih držav članic.
This Directive shall not affect laws and regulations in Member States on the use of languages.
Ta direktiva ne vpliva na zakone in predpise držav članic o uporabi jezikov.
Member States may choose to deliver information in other languages than those which are official languages in the Member State concerned.
Države članice se lahko odločijo zagotoviti informacije v jezikih, ki niso uradni jeziki zadevne države članice.
Responsibilities of the Member State of affiliation
Pristojnosti države članice zdravstvenega zavarovanja
The Member State of affiliation shall ensure that:
Država članica zdravstvenega zavarovanja zagotovi, da:
the cost of cross-border healthcare is reimbursed in accordance with Chapter III;
se stroški čezmejnega zdravstvenega varstva povrnejo v skladu s poglavjem III;
there are mechanisms in place to provide patients on request with information on their rights and entitlements in that Member State relating to receiving cross-border healthcare, in particular as regards the terms and conditions for reimbursement of costs in accordance with Article 7(6) and procedures for accessing and determining those entitlements and for appeal and redress if patients consider that their rights have not been respected, in accordance with Article 9.
obstajajo mehanizmi, ki pacientom na zahtevo zagotovijo informacije o njihovih pravicah in upravičenjih v tej državi članici, povezane s prejemanjem čezmejnega zdravstvenega varstva, zlasti v zvezi z določili in pogoji za povračilo stroškov v skladu s členom 7(6) ter postopki o oceni in določitvi teh pravic ter sistemi za pritožbe in pravna sredstva, če pacienti menijo da njihove pravice niso bile spoštovane, v skladu s členom 9.
In information about cross-border healthcare, a clear distinction shall be made between the rights which patients have by virtue of this Directive and rights arising from Regulation (EC) No 883/2004;
V informacijah o čezmejnem zdravstvenem varstvu je treba jasno razlikovati med pravicami, ki jih imajo pacienti na podlagi te direktive, in pravicami, ki izhajajo iz Uredbe (ES) št. 883/2004;
where a patient has received cross-border healthcare and where medical follow-up proves necessary, the same medical follow-up is available as would have been if that healthcare had been provided on its territory;
je v primeru, da ima pacient, ki je bil deležen čezmejnega zdravstvenega varstva in se izkaže, da je potrebna nadaljnja medicinska oskrba, na razpolago enako medicinsko oskrbo, kot če bi bilo zdravstveno varstvo zagotovljeno na njenem ozemlju;
patients who seek to receive or do receive cross-border healthcare have remote access to or have at least a copy of their medical records, in conformity with, and subject to, national measures implementing Union provisions on the protection of personal data, in particular Directives 95/46/EC and 2002/58/EC.
imajo pacienti, ki želijo prejemati ali prejmejo čezmejno zdravstveno varstvo, dostop na daljavo ali vsaj kopijo svoje zdravstvene dokumentacije v skladu z nacionalnimi ukrepi o izvajanju določb Unije o varstvu osebnih podatkov, zlasti direktiv 95/46/ES in 2002/58/ES.
National contact points for cross-border healthcare
Nacionalne kontaktne točke za čezmejno zdravstveno varstvo
Each Member State shall designate one or more national contact points for cross-border healthcare and communicate their names and contact details to the Commission.
Vsaka država članica določi eno ali več nacionalnih kontaktnih točk za čezmejno zdravstveno varstvo ter Komisiji sporoči njihova imena in kontaktne podatke.
The Commission and the Member States shall make this information publicly available.
Komisija in države članice te podatke javno objavijo.
Member States shall ensure that the national contact points consult with patient organisations, healthcare providers and healthcare insurers.
Države članice zagotovijo, da se nacionalne kontaktne službe posvetujejo z organizacijami pacientov, izvajalci zdravstvenega varstva in nosilci zdravstvenega zavarovanja.
National contact points shall facilitate the exchange of information referred to in paragraph 3 and shall cooperate closely with each other and with the Commission.
Nacionalne kontaktne točke olajšajo izmenjavo informacij iz odstavka 3 ter tesno sodelujejo med seboj in s Komisijo.
National contact points shall provide patients on request with contact details of national contact points in other Member States.
Nacionalne kontaktne točke pacientom na zahtevo zagotovijo kontaktne podatke nacionalnih kontaktnih točk v drugih državah članicah.
In order to enable patients to make use of their rights in relation to cross-border healthcare, national contact points in the Member State of treatment shall provide them with information concerning healthcare providers, including, on request, information on a specific provider’s right to provide services or any restrictions on its practice, information referred to in Article 4(2)(a), as well as information on patients’ rights, complaints procedures and mechanisms for seeking remedies, according to the legislation of that Member State, as well as the legal and administrative options available to settle disputes, including in the event of harm arising from cross-border healthcare.
Da bi pacientom omogočili uveljavljanje njihovih pravic v zvezi s čezmejnim zdravstvenim varstvom, jim nacionalne kontaktne točke v državi članici zdravljenja v skladu z zakonodajo te države članice zagotovijo informacije o izvajalcih zdravstvenega varstva, na zahtevo pa tudi informacije o pravici posameznega izvajalca, da opravlja storitve, in o morebitnih omejitvah opravljanja njegovih storitev, informacije iz člena 4(2)(a), kakor tudi informacije o pravicah pacientov, pritožbenih postopkih in mehanizmih za uveljavljanje pravnih sredstev, prav tako o razpoložljivih pravnih in upravnih možnostih za reševanje sporov, vključno s primeri, ko je v okviru čezmejnega zdravstvenega varstva povzročena škoda.
National contact points in the Member State of affiliation shall provide patients and health professionals with the information referred to in Article 5(b).
Nacionalne kontaktne točke v državi članici zdravstvenega zavarovanja in zdravstveni delavci pacientom zagotovijo informacije iz člena 5(b).
The information referred to in this Article shall be easily accessible and shall be made available by electronic means and in formats accessible to people with disabilities, as appropriate.
Informacije iz tega člena so lahko dostopne in se ustrezno dajo na voljo prek elektronskih medijev v obliki, dostopni invalidnim osebam.
REIMBURSEMENT OF COSTS OF CROSS-BORDER HEALTHCARE
POVRAČILO STROŠKOV ZA ČEZMEJNO ZDRAVSTVENO VARSTVO
General principles for reimbursement of costs
Splošna načela za povračilo stroškov
Without prejudice to Regulation (EC) No 883/2004 and subject to the provisions of Articles 8 and 9, the Member State of affiliation shall ensure the costs incurred by an insured person who receives cross-border healthcare are reimbursed, if the healthcare in question is among the benefits to which the insured person is entitled in the Member State of affiliation.
Država članica zdravstvenega zavarovanja brez poseganja v Uredbo (ES) št. 883/2004 in v skladu z določbami iz členov 8 in 9 zagotovi, da se stroški, ki jih ima zavarovana oseba, ki prejme čezmejno zdravstveno varstvo, povrnejo, če zadevno zdravstveno varstvo sodi med storitve, do katerih je zavarovana oseba upravičena v državi članici zdravstvenega zavarovanja.
if a Member State is listed in Annex IV to Regulation (EC) No 883/2004 and in compliance with that Regulation has recognised the rights to sickness benefits for pensioners and the members of their families, being resident in a different Member State, it shall provide them healthcare under this Directive at its own expense when they stay on its territory, in accordance with its legislation, as though the persons concerned were residents in the Member State listed in that Annex;
če država članica iz Priloge IV k Uredbi (ES) št. 883/2004 in v skladu z navedeno uredbo upokojencem in njihovim družinskim članom, ki stalno prebivajo v drugi državi članici, prizna pravico do storitev v primeru bolezni, jim v skladu s to direktivo zagotovi zdravstveno varstvo na svoje stroške, če prebivajo na njenem ozemlju, v skladu z določbami njene zakonodaje, tako kot če bi bile zadevne osebe prebivalci države članice, ki je našteta v navedeni prilogi;
if the healthcare provided in accordance with this Directive is not subject to prior authorisation, is not provided in accordance with Chapter 1 of Title III of the Regulation (EC) No 883/2004, and is provided in the territory of the Member State that according to that Regulation and Regulation (EC) No 987/2009 is, in the end, responsible for reimbursement of the costs, the costs shall be assumed by that Member State.
če zdravstveno varstvo, zagotovljeno v skladu s to direktivo, ni pogojeno s predhodno odobritvijo, se ne zagotovi v skladu s poglavjem 1 naslova III Uredbe (ES) št. 883/2004 in se zagotovi na ozemlju države članice, ki je v skladu z navedeno uredbo in Uredbo (ES) št. 987/2009 na koncu odgovorna za povračilo stroškov, stroške prevzame ta država članica.
That Member State may assume the costs of the healthcare in accordance with the terms, conditions, criteria for eligibility and regulatory and administrative formalities that it has established, provided that these are compatible with the TFEU.
Ta država članica lahko stroške zdravstvenega varstva prevzame v skladu s pogoji, merili o izpolnjevanju pogojev ter regulativnimi in upravnimi formalnostmi, ki jih je določila, pod pogojem, da so ti v skladu s PDEU.
It is for the Member State of affiliation to determine, whether at a local, regional or national level, the healthcare for which an insured person is entitled to assumption of costs and the level of assumption of those costs, regardless of where the healthcare is provided.
Država članica zdravstvenega zavarovanja določi na lokalni, regionalni ali nacionalni ravni, zdravstveno varstvo do katerega je zavarovana oseba upravičena, prevzem stroškov in višino prevzema stroškov, ne glede na to, kje je zdravstveno varstvo zagotovljeno.
The costs of cross-border healthcare shall be reimbursed or paid directly by the Member State of affiliation up to the level of costs that would have been assumed by the Member State of affiliation, had this healthcare been provided in its territory without exceeding the actual costs of healthcare received.
Stroške čezmejnega zdravstvenega varstva povrne ali neposredno plača država članica zdravstvenega zavarovanja do višine stroškov, ki bi jih prevzela država članica zdravstvenega zavarovanja, če bi bilo zdravstveno varstvo zagotovljeno na njenem ozemlju, ne da bi prekoračili dejanske stroške prejetega zdravstvenega varstva.
Where the full cost of cross-border healthcare exceeds the level of costs that would have been assumed had the healthcare been provided in its territory the Member State of affiliation may nevertheless decide to reimburse the full cost.
Država članica zdravstvenega zavarovanja se lahko kljub temu odloči, da v celoti povrne stroške čezmejnega zdravstvenega varstva, tudi če so ti višji od stroškov, ki bi nastali, če bi bilo zdravstveno varstvo zagotovljeno na njenem ozemlju.
The Member State of affiliation may decide to reimburse other related costs, such as accommodation and travel costs, or extra costs which persons with disabilities might incur due to one or more disabilities when receiving cross-border healthcare, in accordance with national legislation and on the condition that there be sufficient documentation setting out these costs.
Država članica zdravstvenega zavarovanja se lahko v skladu z nacionalno zakonodajo in pod pogojem, da za te stroške obstaja zadostna dokumentacija, odloči povrniti druge povezane stroške, kot so stroški nastanitve, potni stroški ali dodatni stroški invalidnih oseb, ki bi lahko nastali zaradi ene ali večplastne invalidnosti, kadar je čezmejnega zdravstvenega varstva deležna invalidna oseba.
Member States may adopt provisions in accordance with the TFEU aimed at ensuring that patients enjoy the same rights when receiving cross-border healthcare as they would have enjoyed if they had received healthcare in a comparable situation in the Member State of affiliation.
Države članice lahko v skladu s PDEU sprejmejo določbe, katerih namen je zagotoviti, da imajo pacienti pri prejemanju čezmejnega zdravstvenega varstva enake pravice, kot bi jih imeli ob prejemanju zdravstvenega varstva v primerljivi situaciji v državi članici zdravstvenega zavarovanja.
For the purposes of paragraph 4, Member States shall have a transparent mechanism for calculation of costs of cross-border healthcare that are to be reimbursed to the insured person by the Member State of affiliation.
Države članice za namene odstavka 4 določijo pregleden mehanizem za izračun stroškov čezmejnega zdravstvenega varstva, ki jih mora država članica zdravstvenega zavarovanja povrniti zavarovani osebi.
This mechanism shall be based on objective, non-discriminatory criteria known in advance and applied at the relevant (local, regional or national) administrative level.
Ta mehanizem temelji na vnaprej znanih objektivnih, nediskriminatornih merilih in se uporablja na ustrezni (lokalni, regionalni ali nacionalni) upravni ravni.
The Member State of affiliation may impose on an insured person seeking reimbursement of the costs of cross-border healthcare, including healthcare received through means of telemedicine, the same conditions, criteria of eligibility and regulatory and administrative formalities, whether set at a local, regional or national level, as it would impose if this healthcare were provided in its territory.
Država članica zdravstvenega zavarovanja lahko za zavarovano osebo, ki želi povračilo stroškov čezmejnega zdravstvenega varstva, vključno s storitvami zdravstvenega varstva prek telemedicine, uporabi enake pogoje, merila o izpolnjevanju pogojev ter regulativne in upravne formalnosti, bodisi na lokalni, regionalni ali nacionalni ravni, ki bi jih naložila, če bi bilo zdravstveno varstvo zagotovljeno na njenem ozemlju.
However, no conditions, criteria of eligibility and regulatory and administrative formalities imposed according to this paragraph may be discriminatory or constitute an obstacle to the free movement of patients, services or goods, unless it is objectively justified by planning requirements relating to the object of ensuring sufficient and permanent access to a balanced range of high-quality treatment in the Member State concerned or to the wish to control costs and avoid, as far as possible, any waste of financial, technical and human resources.
Vendar pa pogoji, merila o izpolnjevanju pogojev ter regulativne in upravne formalnosti, naložene v skladu s tem odstavkom, ne smejo biti diskriminatorne oziroma ne smejo predstavljati ovire za prosti pretok pacientov, storitev ali blaga, razen če to objektivno upravičujejo potrebe za načrtovanje, in sicer v zvezi z zagotavljanjem zadostnega in stalnega dostopa do uravnoteženega obsega visokokakovostnega zdravljenja v zadevni državi članici, ali z namenom obvladovanja stroškov in, kolikor je mogoče, preprečevanja odvečne porabe finančnih, tehničnih in človeških virov.
The Member State of affiliation shall not make the reimbursement of costs of cross-border healthcare subject to prior authorisation except in the cases set out in Article 8.
Država članica zdravstvenega zavarovanja razen v primerih iz člena 8 ne povrne stroškov čezmejnega zdravstvenega varstva, za katerega je potrebna predhodna odobritev.
The Member State of affiliation may limit the application of the rules on reimbursement for cross-border healthcare based on overriding reasons of general interest, such as planning requirements relating to the aim of ensuring sufficient and permanent access to a balanced range of high-quality treatment in the Member State concerned or to the wish to control costs and avoid, as far as possible, any waste of financial, technical and human resources.
Država članica zdravstvenega zavarovanja lahko omeji uporabo pravil o povračilu stroškov čezmejnega zdravstvenega varstva na podlagi prevladujočih razlogov v splošnem interesu, kot so potrebe za načrtovanje, in sicer v zvezi z zagotavljanjem zadostnega in stalnega dostopa do uravnoteženega obsega visokokakovostnega zdravljenja v zadevni državi članici, ali z namenom obvladovanja stroškov in, kolikor je mogoče, preprečevanja odvečne porabe finančnih, tehničnih in človeških virov.
Notwithstanding paragraph 9, Member States shall ensure that the cross-border healthcare for which a prior authorisation has been granted is reimbursed in accordance with the authorisation.
Ne glede na odstavek 9 države članice zagotovijo, da se stroški, za čezmejno zdravstveno varstvo, za katero je bila izdana predhodna odobritev povrnejo v skladu z odobritvijo.
The decision to limit the application of this Article pursuant to paragraph 9 shall be restricted to what is necessary and proportionate, and may not constitute a means of arbitrary discrimination or an unjustified obstacle to the free movement of goods, persons or services.
Odločitev o omejitvi uporabe tega člena v skladu z odstavkom 9 je omejena na to, kar je potrebno in sorazmerno, in ne bi smela predstavljati sredstva za samovoljno diskriminacijo ali neutemeljene ovire za prosti pretok blaga, oseb ali storitev.
Member States shall notify the Commission of any decisions to limit reimbursement on the grounds stated in paragraph 9.
Države članice uradno obvestijo Komisijo o vsaki odločitvi za omejitev povračila stroškov iz razlogov, navedenih v odstavku 9.
Healthcare that may be subject to prior authorisation
Zdravstveno varstvo, za katero se lahko zahteva predhodna odobritev
The Member State of affiliation may provide for a system of prior authorisation for reimbursement of costs of cross-border healthcare, in accordance with this Article and Article 9.
Država članica zdravstvenega zavarovanja lahko uvede sistem predhodne odobritve za povračilo stroškov za čezmejno zdravstveno varstvo v skladu s tem členom in členom 9.
The system of prior authorisation, including the criteria and the application of those criteria, and individual decisions of refusal to grant prior authorisation, shall be restricted to what is necessary and proportionate to the objective to be achieved, and may not constitute a means of arbitrary discrimination or an unjustified obstacle to the free movement of patients.
Sistem predhodne odobritve, vključno z merili in izvajanjem teh meril ter posameznimi odločitvami za zavrnitev predhodne odobritve, je omejen na to, kar je potrebno in sorazmerno z zadanim ciljem, in ne sme predstavljati sredstva za samovoljno diskriminacijo ali neutemeljene ovire za prost pretok pacientov.
Healthcare that may be subject to prior authorisation shall be limited to healthcare which:
Zdravstveno varstvo, ki je lahko predmet predhodne odobritve, je omejeno na zdravstveno varstvo, ki:
is made subject to planning requirements relating to the object of ensuring sufficient and permanent access to a balanced range of high-quality treatment in the Member State concerned or to the wish to control costs and avoid, as far as possible, any waste of financial, technical and human resources and:
je predmet potreb za načrtovanje v zvezi z namenom zagotavljanja zadostnega in stalnega dostopa do uravnoteženega obsega visokokakovostnega zdravljenja v zadevni državi članici, ali z namenom obvladovanja stroškov in, kolikor je mogoče, preprečevanja odvečne porabe finančnih, tehničnih in človeških virov, ter:
involves overnight hospital accommodation of the patient in question for at least one night; or
vključuje prenočitev zadevnega pacienta v bolnišnici vsaj za eno noč; ali
requires use of highly specialised and cost-intensive medical infrastructure or medical equipment;
zahteva uporabo visoko specializirane in drage medicinske infrastrukture ali medicinske opreme;
involves treatments presenting a particular risk for the patient or the population; or
vključuje oblike zdravljenja, ki pomenijo posebno tveganje za pacienta ali prebivalce; ali
is provided by a healthcare provider that, on a case-by-case basis, could give rise to serious and specific concerns relating to the quality or safety of the care, with the exception of healthcare which is subject to Union legislation ensuring a minimum level of safety and quality throughout the Union.
ga opravi izvajalec zdravstvenega varstva, ki bi lahko v posamičnih primerih pomenil resne in konkretne pomisleke glede kakovosti ali varnosti oskrbe, z izjemo zdravstvenega varstva, za katerega velja zakonodaja Unije, ki zagotavlja minimalno raven varnosti in kakovosti po vsej Uniji.
Member States shall notify the categories of healthcare referred to in point (a) to the Commission.
Države članice Komisijo uradno obvestijo o kategorijah zdravstvenega varstva, omenjenih v točki (a).
When a patient affected, or suspected of being affected, by a rare disease applies for prior authorisation, a clinical evaluation may be carried out by experts in that field.
Če pacient, ki ima redko bolezen ali za katerega se sumi, da ima redko bolezen, zahteva predhodno odobritev, lahko klinično oceno opravijo strokovnjaki s tega področja.
If no experts can be found within the Member State of affiliation or if the expert’s opinion is inconclusive, the Member State of affiliation may request scientific advice.
Če v državi članici zdravstvenega zavarovanja ni ustreznega strokovnjaka ali če mnenje strokovnjaka ni dovolj jasno, lahko država članica zdravstvenega zavarovanja zahteva znanstveno svetovanje.
Without prejudice to points (a) to (c) of paragraph 6, the Member State of affiliation may not refuse to grant prior authorisation when the patient is entitled to the healthcare in question in accordance with Article 7, and when this healthcare cannot be provided on its territory within a time limit which is medically justifiable, based on an objective medical assessment of the patient’s medical condition, the history and probable course of the patient’s illness, the degree of the patient’s pain and/or the nature of the patient’s disability at the time when the request for authorisation was made or renewed.
Brez poseganja v točke (a) do (c) odstavka 6 država članica zdravstvenega zavarovanja ne sme zavrniti predhodne odobritve, če je pacient v skladu s členom 7 upravičen do zadevnega zdravstvenega varstva in če tega zdravstvenega varstva ni mogoče zagotoviti v roku, ki je utemeljen z medicinskega vidika, na njenem ozemlju, temelječ na objektivni medicinski oceni pacientovega zdravstvenega stanja, popisa in verjetnega razvoja pacientove bolezni, njegove stopnje bolečine in/ali narave njegove invalidnosti v času, ko je bil vložen zahtevek za odobritev ali njeno obnovitev.
The Member State of affiliation may refuse to grant prior authorisation for the following reasons:
Država članica zdravstvenega zavarovanja lahko predhodno odobritev zavrne iz naslednjih razlogov: