The Supreme Court abolishes the 3 euro fee for accompanying patients at UCCK

The Supreme Court's ruling states that co-payments can only be imposed on persons who are direct beneficiaries of a health service, a criterion that accompanying persons do not meet. It found that the Ministry of Health exceeded its legal authorizations through the administrative instruction, creating a new financial obligation without a clear legal basis, contrary to the principle of legality.

The Supreme Court has declared illegal the 3 euro fee for accompanying persons over 15 years of age of patients during their stay at the University Clinical Center of Kosovo (UCCK), partially repealing Administrative Instruction No. 03/2024 on co-payments in health services.

The decision was made following a lawsuit filed by the Kosovo Institute for Justice (KIJ) against the Ministry of Health (MoH), which challenged the legality of provisions that provided for a payment of 3 euros for each day of hospital stay for companions of patients over the age of 15.
According to the KLI, the Law on Health defines co-payment as payment for healthcare services by the persons who use them, while accompanying persons cannot be considered beneficiaries of healthcare services, as they do not receive medical treatment or diagnostic and rehabilitation services.

The Supreme Court assessed that the contested provisions did not have a sufficient legal basis and unduly expanded the notion of "co-payment".

"The Supreme Court, after administering the evidence and reviewing the constitutional and legal provisions, has assessed that the contested provisions do not have a sufficient legal basis and that through them the notion of 'co-payment' has been expanded in an impermissible manner. In the judgment, the Supreme Court emphasizes that co-payment can only be imposed on persons who are direct beneficiaries of a health service. According to the Court's assessment, the accompanying person does not meet this criterion, since his presence in the health institution is related to supporting the patient and not to receiving health services," the decision states.

The Supreme Court ruling states that co-payments can only be imposed on persons who are direct beneficiaries of a health service, a criterion that accompanying persons do not meet.

The court also found that the Ministry of Health exceeded its legal authorizations through this administrative instruction.

"The Supreme Court also assessed that the Ministry of Health, through Administrative Instruction no. 03/2024, has exceeded the legal authorization granted by the Law on Health, creating a new financial obligation without a clear legal basis, contrary to the principle of legality. Charging accompanying persons violates the rights of citizens to equal and effective access to healthcare, especially considering the actual practice in public health institutions, where the presence of family members often represents a real need for patients' support during hospitalization," the decision states.

According to the decision, charging for companions violates the right of citizens to equal and effective access to healthcare, especially considering that the presence of family members is often necessary to support patients during hospitalization.

“From the perspective of citizens’ rights, as guaranteed in Article 4 of Law No. 04/L-125 on Health, the imposition of a fee for accompanying persons constitutes an unjustified interference in the effective exercise of the right to health care. This article requires that the implementation of the law be carried out while respecting human dignity and fundamental rights guaranteed by the Constitution and international instruments, which also implies ensuring real and not merely formal access to health services,” the Supreme Court’s judgment states. “In this context, the imposition of a financial obligation on the accompanying person creates a direct economic burden on the families of patients, which is not provided for in the law and is not related to the receipt of a health service. As such, this burden may have a discouraging effect on the presence of the accompanying person, indirectly affecting the well-being and adequate treatment of the patient, especially in the cases of elderly people, patients with disabilities or those who require continuous care.”

The court has emphasized that bylaws must be in accordance with the law and cannot create new tariff categories or financial obligations that are not provided for by law.

The 3 euro fee began to be implemented in February of this year, determined by the administrative instruction on co-payments for health services that entered into force in 2024.

The payment, which was determined in the Administrative Instruction on co-payments for health services that entered into force in 2024, began to be implemented at the beginning of February.

Patient associations expressed concern about this payment, emphasizing that the attendant is not a visitor, but often a necessary part of patient care.