Decker v Caisse de Maladie des Employés Privés (Case C-120...

Facts

• Ms. Decker, insured in Luxembourg, purchased spectacles in Belgium.
• Her Luxembourg health insurance fund refused reimbursement, citing a national rule requiring prior authorization for purchases outside Luxembourg.
• The case was referred to the European Court of Justice (ECJ) to determine whether this requirement was compatible with EU law, specifically in relation to the free movement of goods within the internal market.

Issues

1. Whether a national rule requiring prior authorization for reimbursement of medical products purchased in another Member State constitutes a measure having equivalent effect to a quantitative restriction on imports under Article 34 TFEU.
2. Whether such a requirement can be justified by public health concerns or the objective of ensuring quality and control of medical products.
3. Whether the national rule complies with the principles of proportionality and mutual recognition within the EU legal framework.

Decision

• The ECJ held that the prior authorization requirement discouraged insured persons from purchasing spectacles in other Member States and constituted a measure having equivalent effect to a quantitative restriction, prohibited by Article 34 TFEU.
• The Court found that while the protection of public health is a legitimate objective, the means chosen must be proportionate and the least restrictive available.
• The ECJ determined that alternative, less restrictive measures could achieve the stated objectives without hindering intra-Community trade.
• The judgment clarified the need for Member States to rely on mutual recognition of standards and qualifications, rather than imposing additional administrative barriers on cross-border purchases.

Legal Principles

• Administrative procedures such as prior authorization requirements for reimbursement can be measures having equivalent effect, and thus infringe Article 34 TFEU if they restrict market access.
• The principle of proportionality requires that restrictions on the free movement of goods be suitable, necessary, and the least restrictive means to achieve a legitimate objective.
• The doctrine of mutual recognition presumes that goods lawfully marketed in one Member State are suitable for others, limiting justification for national restrictions.
• Legitimate interests in public health must be balanced against the fundamental freedoms that support the internal market.

Conclusion

The ECJ established that national rules requiring prior authorization for reimbursement of goods lawfully purchased in another Member State are generally incompatible with Article 34 TFEU, unless justified and proportionate; Member States must use less restrictive means and respect the principle of mutual recognition, ensuring the free movement of goods and unobstructed patient mobility within the EU.