Procedures for appeals and remedies for infringement of insured persons’ rights

Rights and entitlements of patients in connection with the provision of healthcare under Act No. 576/2004 Z. z. on healthcare, services connected with the provision of healthcare and amending certain acts, as amended

Under Article 79(1) of Act No. 578/2004 Z. z., a provider is obliged to follow the law when providing the healthcare. If a person considers that his/her rights were violated or threatened during the provision of healthcare, he/she has the right to file a complaint and request for remedy against the health care provider that threatened or violated his/her rights. The person can also claim her/his rights in court. A person must not be persecuted or otherwise penalised for filing a complaint, motion or criminal complaint against another person, healthcare professional or healthcare provider,.

Under the provisions of Article 79(1)(h) of Act No. 578/2004 Z. z. concerning patients' right to information on their health condition, healthcare providers must give information in advance to patients, their legal representatives or an immediate family member on the scope and conditions of healthcare to be provided to them.

 Under the provisions of Article 79(1)(g) and (o) of Act No. 578/2004 Z. z. concerning patients' rights to information on the price of provided healthcare, healthcare providers must display in a visible location a pricelist of medical procedures carried out at the patient's request, and give patients a document showing the amount to be paid for provided healthcare and services related to the provision healthcare.

Under the provisions of Article 79(1)(l) to (n) of Act No. 578/2004 Z. z. concerning medical documentation, healthcare providers must keep medical documentation, process it, provide and make information available from it, secure and store it in accordance with the act and follow procedure for handing it over and receiving it for safekeeping.

Under Article 80(2) of Act No. 578/2004 Z. z. concerning the confidentiality of all data on patients' state of health and data relating to patients' state of health, healthcare professionals must not disclose matters that they become aware of in the course of their work.

In the event of a breach of the duties of a health care provider or a healthcare professional, a patient can have recourse to the supervisory authority responsible for supervision of the health care providers' and health professionals' compliance with their duties. The competent supervision authorities are the Ministry of Health of the Slovak Republic or the self-governing region that granted a healthcare provider authorisation to operate/to run a healthcare facility, or the competent professional association in the case of a licensed health care provider, or the competent professional association in the case of a healthcare professional.

Under Article 81(2) of Act No. 578/2004 Z. z. the Ministry of Health of the Slovak Republic or the competent self-governing region or the competent licensing professional association may

  • impose fines,
  • temporarily suspend authorisation or a licence,
  • cancel an authorisation or licence,
  • impose disciplinary measures.

Rights and entitlements of patients in connection with the provision of cross-border healthcare pursuant to Act No. 580/2004 Z. z. on health insurance and amending Act No. 95/2002 Z. z. on insurance and amending certain acts, as amended

Under Article 9a(2) of Act No. 580/2004 Z. z. insured persons have the right to ask their health insurance company to grant authorisation for planned healthcare provided abroad other than in Member States, which the health insurance company can reimburse for the insured person provided the statutory criteria are met.

Under Article 9b(10) of Act No. 580/2004 Z. z. insured persons are entitled to reimbursement of healthcare costs for planned healthcare provided in another Member State for which the health insurance company has granted authorisation. Insured persons claim reimbursement of costs from their competent health insurance company.

Under Article 9b(10) of Act No. 580/2004 Z. z. insured persons can also request their health insurance company to pay for cross-border healthcare specified in legislation issued by the Ministry of Health of the Slovak Republic, which is subject to prior authorisation by the competent health insurance company.

The insured person's health insurance company decides on a request to grant authorisation. Insured persons can file an appeal against the health insurance company's decision to the health insurance company up to 20 working days from delivery of the decision. The competent health insurance company may decide on the appeal itself if it fully accepts the appeal. If the health insurance company does not decide within 15 working days of receiving the appeal, it shall submit the appeal and the results of additional proceedings and all documentation on file to the Health Care Surveillance Authority by the end of the period. The Health Care Surveillance Authority will decide on the appeal within 15 working days of receiving the appeal, the results of additional proceedings and all documentation on file. The decision of the health insurance company and the decision of the Health Care Surveillance Authority on prior authorisation by the health insurance company are decisions issued in administrative proceedings. A decision of the Health Care Surveillance Authority is subject to judicial review in accordance with Act No. 99/1963 Zb. the Code of Civil Procedure, as amended, if a complaint is filed within the statutory period.