SRC Law Firm represented a client in a dispute with the National Health Fund (NFZ) concerning hemodialysis services provided by a healthcare entity in excess of the limit specified in the contract with the NFZ.
In a precedent-setting judgment (Ref. I ACa 204/2012), the Appeal Court in Rzeszów unequivocally confirmed that hemodialysis, despite being a planned service, is also an emergency service within the meaning of Article 5 point 33 of the Act of August 27, 2004 on healthcare services financed from public funds in conjunction with Article 3 point 8 of the Act of September 8, 2006, on State Medical Emergency Services, which obliges the payer (NFZ) to pay the healthcare provider for services provided in this respect in excess of the limit specified in the contract with the NFZ. The position of the Court of Appeal was confirmed in a ruling by the Supreme Court (I CSK 575/12).
In the course of the proceedings, it was demonstrated that an emergency situation (i.e., requiring urgent medical assistance) may be the result of a predictable and even well-known cause, such as cancer or another chronic condition, e.g. kidney failure. In such a situation, it would be difficult to refuse medical assistance to a patient solely on the grounds that they are not in a classic emergency situation (i.e. their condition was not caused by a sudden event).
The case was handled on behalf of SRC Law Firm by attorneys Monika Urbańska and Łukasz Caban.
“The court rightly found that the planned and repetitive nature of the services does not preclude the fact that, for medical reasons, these services, such as dialysis, are services that require immediate provision, and postponing them in each case results in a threat to health and life” – comments Łukasz Caban, partner at SRC Law Firm.
