Ms. Françoise Grossetête, a senior Member of European Parliament, has a background in law – and Ms. Grossetête personally served as the European Parliament’s Special Rapporteur for the EU’s 2011 Directive on Cross-border Healthcare. Ms. Grossetête knows cross-border healthcare law. On our daughter Lysiane’s behalf, she sent the letter below directly to France’s Minister of Health, Agnès Buzyn, making it clear that this situation is “unacceptable”, and that the rejection was legally unfounded.
Brussels, 18 December 2017
Ms. Agnès BUZYN
Ministry of Social Affairs, Health, and Women’s Rights
14, avenue Duquesne
75350 Paris 07 SP
Dear Ms. Minister,
I wish with this letter to alert you to the very urgent case of Lysiane Pakter, born on 29 March 2017, and diagnosed with a rare disease called Pierre Robin Sequence. To treat this pathology, Lysiane should receive a highly specialized treatment, which the Orphanet Reference Centre for this rare disease confirmed is only available in Germany.
In accordance with the Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare, Lysiane’s parents, Mr. Pakter and Ms. ███████, applied, as properly required, for prior authorization for this care, via the S2 form.
Unfortunately, their application was rejected by the Caisse Primaire d’Assurance Maladie (CPAM) of Lyon; the parents found themselves running up against the administration’s lack of knowledge of the applicable rules and procedures of cross-border healthcare. At this point, the case is still undergoing an internal administrative review by CPAM.
Viewing CPAM’s decision as a violation of European law, the parents referred the matter to the SOLVIT network (Case No. 2569/17/DE), which acknowledged that in this case, CPAM’s refusal to provide prior authorization was contrary to the laws in force.
While these procedures are underway, and in the face of the emergency, Lysiane was transferred to Germany without waiting for CPAM’s decision, because to correct the problem, the treatment should begin as early as possible.
Faced with this unacceptable situation, and sensitive to the distress of this family, I appeal to you for your support and assistance in calling upon the appropriate department in the Social Security administration to move this issue forward, and ensure the correct application of the Directive 2011/24/EU on Patients’ Rights in Cross-border Healthcare.
Thanking you in advance for your attention to this request, I remain at your disposal, and I ask you to please accept, Ms. Minister, the assurance of my highest consideration.
I am counting on you.
Member of European Parliament
Vice-President of the PPE Group
Rue Wiertz, B-1047