THE LEGAL SITUATION UNTIL 1998

Since 1971, the issue of cross-border health care has been governed, at European Union level, by 'Regulation (EEC) No 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons and their families moving within the Community'.

Broadly, that legislation enables patients to travel to another Member State to receive treatment after they have obtained the prior authorisation of their health insurance fund (form S2). Where such authorisation is granted, the treatment costs are generally paid for or reimbursed to the patient in accordance with the tariffs applied in the country of treatment, even if those tariffs are higher than the tariffs in the patient's country.

At the beginning of the 1990s the European Union became an area without internal frontiers, which facilitated the free movement of persons. Increasing numbers of patients then sought to receive treatment from doctors established in another Member State, and the key issue was whether they systematically required prior authorisation from their health insurance fund to do so. In 1998, the Court of Justice adjudicated on two cases in which the patients did not request, or did not obtain, prior authorisation, but nevertheless wished to be reimbursed by their health insurance fund.