As the Deputy will be aware the EU Cross-Border Directive allows patients to access treatment in another EU/EEA Member State and be reimbursed for that care by the HSE. In addition, earlier this year this Government introduced the NI Planned Healthcare Scheme to enable patients to continue to access private healthcare in Northern Ireland, post-Brexit, and be reimbursed by the HSE under similar parameters to the EU Cross-Border Directive.
The HSE advises that a breakdown of applications by County is collated for the NI Planned Healthcare Scheme but is not generally collated for the EU Cross-Border Directive. However, an analysis has been undertaken to collate data specific to Donegal to the greatest extent possible and is set out in a table as requested for the period 2019-2021 which can be provided to the Deputy.
I can confirm that to date in 2021 under both those schemes there were 788 reimbursement applications received by the HSE for persons with an address in Donegal, of which 514 have been approved to date and only 36 declined.
The HSE advises that reimbursements may be declined where an individual is not eligible for reimbursement; has not followed the public patient pathway or there is inaccurate or misleading documentation in the application process.
Where an application for reimbursement is declined, the decision letter will inform the patient of the reason for declining and importantly sets out the HSE appeals process.
Oral PQ 58422/21 - EU Cross-Directive & NI Planned Healthcare Scheme Reimbursement Applications for Persons with a Donegal Address
|
Year
|
Total Reimbursement Applications Received
|
Approved Reimbursement
Applications
|
Declined Reimbursement
Applications
|
2021 YTD - NI Planned Healthcare Scheme
|
346
|
179
|
11
|
2021 YTD – EU Cross-Border Directive
|
442
|
335
|
25
|
2021 YTD - Total
|
788
|
514
|
36
|
2020 – EU Cross-Border Directive
|
991
|
694
|
37
|
2019 – EU Cross-Border Directive
|
1454
|
857
|
24
|
Note: The disparity between applications received and the number of decisions issued relates to applications awaiting processing or awaiting further documentation from the applicant.
Brief