[Board of appeals for decision on reimbursement of expenses for medical treatment abroad].
In Norway, a National Insurance Board decides whether patients treated abroad should have their expenses reimbursed. Its decisions may be appealed to an independent governmental board of appeals. This article presents the appeals procedure and discusses the experience gained over its first three years. The most important criterion for reimbursement is whether there is a lack of expertise in Norway on the relevant condition, which must be severe. A statement must be sought from a tertiary-level hospital about the proposed intervention. A referral or recommendation is not required. Reimbursement will not be considered for interventions defined as experimental, except in conditions that are so rare that the number of patients in Norway will be so small that one cannot expect large-scale randomised trials organised in this country. During its first three years, the board of appeals considered 184 cases; decisions were revered in 21 cases (11%). The appeals procedure remains well known among the public. Doctors should make themselves familiar with the criteria and the appeals procedure.
Fagområdet medisinsk etikk og vitenskapsteori Seksjon for allmennmedisin Universitetet i Bergen Ulriksdal 8c, 5009 Bergen.
Ole Frithjof
OF
Norheim
Jan
J
Fougner
Odd
O
Søreide
Ingebjørg
I
Storm-Mathisen
Ellen
E
Strengehagen
D004608:Eligibility Determination; D006801:Humans; D007345:Insurance Claim Review; D007391:International Cooperation; D009313:National Health Programs / Q000191:economics*; D009664:Norway; D012017:Referral and Consultation; D012051:Reimbursement Mechanisms; D014195:Travel / Q000191:economics*