Supreme Court dismisses appeal; Health Fund cannot deny drug costs based on age or self-assessment of treatment validity.
Legislator summary
AI generatedThe Supreme Court dismissed the National Health Fund's cassation appeal regarding a refusal to reimburse medication costs for a minor with multiple sclerosis. The Fund argued that the drug Betaferon was only tested on adults, while the patient and lower courts contended the treatment was medically necessary and effective. The court ruled that the Health Fund lacks authority to question the medical validity of a prescribed treatment or deny coverage based on arbitrary age restrictions, thereby upholding the patient's right to equal access to care.
Legislator headnote
AI generatedArt. 39 ust. 1 ustawy o powszechnym ubezpieczeniu zdrowotnym; Art. 68 ust. 2 Konstytucji RP: The Health Fund cannot refuse reimbursement for prescribed medication by questioning the medical validity of the treatment method or by applying arbitrary age-based restrictions that violate the principle of equal access to healthcare.