December 02
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Trajan Shipley
7th October 2021
Consumer, Health & Environment Internal Market

Court of Justice clarifies conditions of medical reimbursement when there are diverging medical opinions

The Court of Justice delivered its judgment in Casa Naţională de Asigurări de Sănătate and Casa de Asigurări de Sănătate Constanţa (C‑538/19), ruling that under Article 20 of Regulation 883/2004 together with Article 56 TFEU, insured persons are entitled to full reimbursement of treatment costs where they have received treatment in a Member State other than that of their residence without being able to obtain the required authorisation, on the specific ground of national law not allowing for having consideration of a second medical opinion of a doctor of the Member State where treatment was given. 

In the case at issue, a Romanian resident was diagnosed with tongue cancer by a Romanian doctor, who prescribed a surgery that would r


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