S.L. 528.3 ст. 9Maximum reimbursement.

(1) The maximum amount of costs to be reimbursed shall be either the amount of the relative healthcare service or services costs according to the Register provided for in the Act, or the actual costs of the healthcare service or services received, whichever is the lowest. No ancillary or related costs shall be reimbursed.

(2) Reimbursement of the costs of cross-border healthcare shall be subject to the same conditions, criteria of eligibility and regulatory and administrative formalities, as applicable if this healthcare was provided under the Maltese public healthcare system: Provided that notwithstanding the above, the Directorate for Policy in Health shall retain the right to limit the application of the rules on reimbursement for cross-border healthcare based on overriding reasons of general interest, such as planning requirements relating to the aim of ensuring sufficient and permanent access to a balanced range of high-quality treatment in Malta or to the wish to control costs and avoid, as far as possible, any waste of financial, technical and human resources: Provided further that the same conditions, criteria of eligibility, tariffs and regulatory and administrative formalities shall apply in the case of a person insured in a Member State, other than Malta, seeking cross-border healthcare under the Maltese public healthcare system.

(3) Notwithstanding anything contained in these regulations, any cross-border healthcare for which a prior authorisation has already been granted, even before the entry into force of these regulations, shall be reimbursed in accordance with that same authorisation.

(4) Notwithstanding the provisions of this regulation, the Minister shall retain the right to adopt measures regarding access to treatment aimed at fulfilling the fundamental responsibility to ensure sufficient and permanent access to healthcare within Malta and that are justified by overriding reasons of general interest.

Healthcare subject to Prior Authorisation