«(Freedom to provide services – Articles 59 of the EC Treaty (now, after amendment, Article 49 EC) and 60 of the EC Treaty (now Article 50 EC) – Sickness insurance – System providing benefits in kind – System of agreements – Medical costs incurred in another Member State – Prior authorisation – Criteria – Justification)»

1.. Freedom to provide services – Restrictions – National rules on reimbursement of medical costs incurred in another Member State – Treatment provided in a hospital – Requirement of prior authorisation from the insurance fund in the Member State in which the person concerned is insured – Grant subject to requirements that the treatment must be necessary – Whether permissible – Conditions – Possibility of obtaining equally effective treatment without undue delay – Criteria for assessment (EC Treaty, Art. 59 (now, after amendment, Art. 49 EC) and Art. 60 (now Art. 50 EC))

2.. Freedom to provide services – Restrictions – National rules on reimbursement of medical costs incurred in another Member State – Non-hospital treatment – Requirement of prior authorisation from the insurance fund in the Member State in which the person concerned is insured – Not permissible – Whether justifiable – Threat to the financial balance of the social security system, the protection of public health and the essential characteristics of the national sickness insurance scheme – None (EC Treaty Art. 59 (now, after amendment, Art. 49 EC) and Art. 60 (now Art. 50 EC))

JUDGMENT OF THE COURT 13 May 2003 (1)

((Freedom to provide services – Articles 59 of the EC Treaty (now, after amendment, Article 49 EC) and 60 of the EC Treaty (now Article 50 EC) – Sickness insurance – System providing benefits in kind – System of agreements – Medical costs incurred in another Member State – Prior authorisation – Criteria – Justification))

In Case C-385/99,

REFERENCE to the Court under Article 234 EC by the Centrale Raad van Beroep (Netherlands) for a preliminary ruling in the proceedings pending before that court between

and

on the interpretation of Article 59 of the EC Treaty (now, after amendment, Article 49 EC) and Article 60 of the EC Treaty (now Article 50 EC),

THE COURT,,

composed of: G.C. Rodríguez Iglesias, President, M. Wathelet (Rapporteur) R. Schintgen and C.W.A. Timmermans (Presidents of Chambers), D.A.O. Edward, A. La Pergola, P. Jann, F. Macken, N. Colneric, S. von Bahr and J.N. Cunha Rodrigues, Judges,

Advocate General: D. Ruiz-Jarabo Colomer,

after considering the written observations submitted on behalf of:

after considering the additional written observations submitted at the Court's request on behalf of:

having regard to the Report for the Hearing,

after hearing the oral observations of Onderlinge Waarborgmaatschappij OZ Zorgverzekeringen UA, represented by J.K. de Pree; Onderlinge Waarborgmaatschappij ZAO Zorgverzekeringen, represented by R. Out, acting as Agent; the Netherlands Government, represented by H.G. Sevenster; the Danish Government, represented by J. Molde; the Spanish Government, represented by N. Díaz Abad; the Irish Government, represented by A. Collins BL; the Finnish Government, represented by T. Pynnä, acting as Agent; the United Kingdom Government, represented by D. Lloyd-Jones QC, and the Commission, represented by H. Michard, acting as Agent, and H.M.H. Speyart, at the hearing on 10 September 2002,

after hearing the Opinion of the Advocate General at the sitting on 22 October 2002,

gives the following

...

...

The Müller-Fauré case

The Van Riet case

The arguments submitted to the Court

Findings of the Court

The risk that the protection of public health may be adversely affected

The risk of seriously undermining the financial balance of the social security system

Hospital services

Non-hospital services

The argument based on the essential characteristics of the Netherlands sickness insurance scheme

On those grounds,

THE COURT,

in answer to the questions referred to it by the Centrale Raad van Beroep by order of 6 October 1999, hereby rules:

Rodríguez Iglesias

Wathelet

Schintgen

Timmermans

Edward

La Pergola

Jann

Macken

Colneric

von Bahr

Cunha Rodrigues

Delivered in open court in Luxembourg on 13 May 2003.

R. Grass

G.C. Rodríguez Iglesias

Registrar

President