Team (2013:513) For Reimbursement Of Costs Of Care In Another Country Within The European Economic Area

Original Language Title: Lag (2013:513) om ersättning för kostnader till följd av vård i ett annat land inom Europeiska ekonomiska samarbetsområdet

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Read the untranslated law here: http://rkrattsbaser.gov.se/sfst?bet=2013:513

Preliminary provisions and scope



section 1 of this Act contains provisions on the compensation of

patients for costs incurred as a result of the

have received care in another country within the European

economic area (EEA).



Provisions on compensation to patients for the costs of

care is also available in European Parliament and Council regulation

(EC) No 883/2004 of 29 april 2004 on the coordination of

social security systems.



section 2 of this Act shall not apply in cases where a patient's right

the compensation is based on Regulation (EC) No 883/2004.



3 §/expires U: 2016-04-15/

For the purposes of this law 1. care: the measures and products covered by the definitions in paragraphs 2, 3 and 5 – 9, 2. health care: steps to medical prevention, investigation and treatment of diseases and injuries and medical transport, 3. dental care: measures referred to in paragraph 1 of the dental Act (1985:125), 4. health professionals: doctors, nurses responsible for general care, dental practitioner, a midwife or a pharmacist within the meaning of Directive 2005/36/EC of 7 september 2005 on the recognition of professional qualifications or other person exercising a professional activity in health care that are restricted to a regulated profession as defined in article 3(1)(a) of Directive 2005/36/EC , or a person considered as health workers under the legislation of the Member State of treatment, 5. Medicine: medicinal products under the medicines Act (2015:315) intended for Administration to humans,



6. other products: those products referred to in paragraphs 18 and 20 of the Act (2002:160) on drug benefits, etc., 7. accessibility: such facilities as referred to in paragraph 3 (b) of the health and medical services Act (1982:763), 8. consumables: consumables such as referred to in paragraph 3 (d) health care Act, 9. other care products: products that are not covered by the definitions in paragraphs 5 to 8, but provided by healthcare or dentistry and that a patient may care. Law (2015:330).



3 section/entry into force: 04/15/2016

For the purposes of this law



1. health: the measures and products covered by the definitions in paragraphs 2, 3 and 5 – 9,



2. health care: steps to medical prevention, investigation and treatment of diseases and injuries, as well as the transport of the sick,



3. dental care: measures referred to in paragraph 1 of the dental Act (1985:125),



4. health professionals: doctors, nurses responsible for general care, dental practitioner, a midwife or a pharmacist within the meaning of Directive 2005/36/EC of 7 september 2005 on the recognition of professional qualifications, in wording pursuant to European Parliament and Council directive 55/EU, or any other person exercising a professional activity in health care that are restricted to a regulated profession as defined in article 3(1)(a) of Directive 2005/36/EC , or a person considered as health workers under the legislation of the Member State of treatment,



5. medicine: medicinal products under the medicines Act (2015:315) intended for Administration to humans,



6. other products: those products referred to in paragraphs 18 and 20 of the Act (2002:160) on drug benefits, etc.,



7. AIDS: such facilities as referred to in paragraph 3 (b) of the health and medical services Act (1982:763),



8. consumables: consumables such as referred to in paragraph 3 (d) health care Act,



9. other care products: products that are not covered by the definitions in paragraphs 5 to 8, but provided by healthcare or dentistry and that a patient may care. Law (2016:153).



section 4 of this Act, It is said that if a county councils also applies to a

municipality that is not part of a County.



The right to compensation



§ 5, a patient is entitled to compensation for costs which have

the result of that he or she has received medical care

in another country within the EEA where



1. the patient when the costs were incurred belonged to the persons

for which Sweden is authorized to announce such a State

to treatment outside the Member State of residence referred to in

Article 20 of Regulation (EC) No 883/2004,



2. care has been provided by health

professionals, and



3. the patient would have been entitled to receive care paid for by the

General if it provided in Sweden.



Amount of compensation



section 6, the maximum compensation the amount corresponding to the

actual costs of care incurred for

the patient.



section 7 of the health care and dental care for other than such

referred to in section 10 shall be determined compensation to an amount

equal to the cost that would be incurred if the

the patient's care had been provided in Sweden. The same

applies to medicinal products, other goods, utilities,

supplies and other health products as a patient

received by care.



In determining remuneration, deductions made with the

an amount equal to the fees that the patient would have

paid for care in Sweden.



section 8 For tools and supplies as a patient

obtained at any other time than care

the compensation shall be determined in the same manner as set out in section 7.



section 9 For medicines and other goods that a patient has

acquired at a different time than care, and for

which there is an at least equivalent product within

pharmaceutical benefits under the Act (2002:160) if

drug benefits, etc., should compensation be determined to a

amount corresponding to the cost reduction as the patient

would have been entitled to if the medicinal product or the goods had been included in the

pharmaceutical benefits.



In determining compensation under the first subparagraph of

each drug or be a cost amount determined as

corresponds to the minimum sales price set for

a product that is at least equivalent and that is included in the

pharmaceutical benefits. If there are medical reasons, may be

a higher selling price should be fixed. The amount at a

comparison between the cost amount and the

actual cost that the patient has had the lowest, should be added

the basis for the determination.



section 10 Of dentistry who had eligible for aid under the law

(2008:145) on State dental care if it had

in Sweden, the compensation must be determined to

an amount equal to what the insurance fund would have

paid for dental care provided in Sweden. The same

apply to drugs and other health products as a patient

received by care.



Advance notification



section 11 if a patient applying for it, the social insurance Office

provide advance notice of



1. whether the patient has the right to compensation under this

law for the specific care that he or she intends to receive at a

particular care category in another EEA country, and



2. the maximum amount of compensation may be paid for this

care.



Has notice been provided pursuant to the first subparagraph is

Social insurance obligation to subsequent examination of the question

on the compensation to the patient for the specified care pay out

at least the amount specified in the ruling.



Investigation and disclosure



section 12 of the social insurance agency shall, unless it is clear

unnecessary, in a case about compensation or advance ruling

According to this law, obtain an opinion from the County that

According to health and medical services Act (1982:763) has responsibility for

the patient's care in Sweden.



If a county shall be heard in a case relating to the

compensation for AIDS that affects a municipality which is part of

the County Council, the County Council before the opinion shall consult with

the municipality.



paragraph 13 of the authorities in the context of a proceeding under section 12

or, on request, provide the social insurance office, counties and

local authorities such information as is relevant for the

the application of this law.



Decision on compensation and advance ruling



section 14 of the health insurance fund hearing, at the request of a patient,

questions about compensation under this Act.



A decision on the reimbursement or advance must always

State the reasons on which it is based.



Decisions on remuneration paid by the social insurance agency.



section 15 decision on the reimbursement or advance must be taken as

soon as possible and no later than 90 days from the time a

complete application has been received by the Swedish social insurance agency. If

There are special reasons, may this time be exceeded.



Appeal



section 16 of the social insurance agency's decision on compensation or

notice under this Act may be referred to the General

Administrative Court.



Leave to appeal is required for an appeal to

the administrative court.



Transitional provisions



2013:513



1. this law shall enter into force on 1 October

2013.



2. The law shall not be applied for medical expenses that have

arose before its entry into force.