Health and Social Services Reform and Act on Cross-Border Health Care

The Government proposal regarding the amendments to the Act on Cross-Border Health Care will proceed to processing by Parliament in late May. The Government proposal is based on the updates necessitated by the Act on Organising Health and Social Services, the Act on Freedom of Choice and the Act on Provision of Social and Health Services.

The key points of the proposal include:

• In cross-border situations, where a client travels to another EU or EEA country or Switzerland to receive treatment, in future, the client would pay a client fee according to his/her region.
• As regards the direct choice services, a person can seek medical treatment abroad without a referral. When a client were to use other services than the direct choice services, he/she would need a referral or an assessment of treatment need in order to be reimbursed according to the client fee level.
• In the future, the client would continue to pay for the treatment him-/herself first and apply for a reimbursement from Kela afterwards.
• The transition period of health insurance reimbursements is 2019–2020. If the treatment is not included in the direct choice services and it does not fulfil the requirements of specialised health care but it does fulfil the preconditions for granting a reimbursement under the Health Insurance Act, the client will receive a reimbursement according to the Health Insurance Act also in EU situations during the transition period.
• In future, the region in question would be responsible for the costs of its residents also in cross-border situations. Kela would invoice the costs from the region once a year.
• In future, no reimbursement will be paid in case of illness situations occurring outside the EU and EEA countries.

Kela has submitted its own statement regarding the proposal. Kela supports the proposed changes. In particular, Kela wishes to draw attention to the fact that cross-border health care is not only about the reimbursements to be paid afterwards for health care costs incurred abroad. Cross-border health care also includes the determination of the right to treatment, processing of prior authorisations for seeking treatment, payment of state reimbursements and the management of invoicing between states regarding the health care costs. Kela sees it appropriate that all the mentioned tasks continue to be tasks ensured by Kela.

All statements (in finnish) that were submitted for the Government proposal to Parliament regarding the amendment of the Act on Cross-Border Health Care are available on the Finnish Government’s project website.

Acts and decrees regarding health care have been assembled by theme to the www.choosehealthcare.fi online service, including the right of foreigners to receive treatment in Finland and the reimbursement of treatment received abroad.