Under the Patient Mobility Directive 2011/24/EU the basic principle holds that cost reimbursements shall be rendered without prior authorisation and at that, in the amount of the costs which the insurance system had incurred were the relevant service provided in Austria. The prior authorisation concept is thus regarded as an exception to this general rule.
Likewise must be ensured that the prior authorisation concept for cost reimbursement will not result in discrimination or unjustified obstacles to patient mobility in regard to cross-border healthcare.
Table of contents
Treatments requiring prior authorization
Commitment to approve
Prior authorisation must be granted by the social insurance carrier responsible at all events, if the patient is entitled to the particular service in Austria and if this cannot be provided within a reasonable time. In terms of the assessment, what timeframe shall be regarded as “reasonable”, an assessment on a case-by-case basis must be conducted, including the patient’s subjective and objective health status as well as disease progression up to now and the anticipated future development.
The used references can be found in the List of sources.
Last update: 19 July 2019
Approved by: Redaktion Gesundheitsportal