Region: Europe
Year: 1995
Court: Court constitutionnelle [Constitutional Court of Belgium]
Health Topics: Health systems and financing
Human Rights: Freedom from discrimination, Freedom of association, Right to due process/fair trial, Right to property
Tags: Budget, Health expenditures, Health insurance, Reimbursement, Social security
The petitioners challenged Article 28 of the law dated March 30, 1994, which instituted a system intended to guarantee the claims of the National Institute for Health an Disability Insurance (“INAMI”) on clinical pathology laboratories. The provisions at issue “[allowed] the health treatment Service of INAMI to require insuring organizations to retain the amounts that they owe laboratories for the services the latter have performed, in guarantee of the sums that the laboratories have to reimburse to INAMI.” (Para. B.3)
The petitioners argued that, in contravention of certain provisions of the Belgian Constitution and Articles 6 (Right to a fair trial) , 13 (Right to an effective remedy) and 14 (Prohibition on discrimination) and the First Protocol of the European Convention for Human Rights: (a) Article 28 deprived the laboratories of the benefit of past or future legal decisions, thus infringing upon such fundamental legal principles as the separation of powers, equality of citizens, independence of the courts, legal security, and the equality of litigation tools, without providing any justification, proportionality or legitimacy for such discriminatory treatment; (b) Article 28 gave INAMI the benefit of an absolute privilege of jurisdiction and execution by exempting it from the ordinary rules of procedure, thus making it more difficult for laboratories to access labor courts; (c) Article 28 damaged the equal position of the laboratories creditors by allowing INAMI a privileged position; and (d) Article 28 deprived laboratories of the right to a claim that is part of their assets.
Ultimately, the petitioners claimed that Article 28 violated their fundamental right to property, payment for a professional activity, freedom of association and breached the principle of equality.
The Court noted that the contested provision allowed for a deduction to be withheld even where the laboratories had introduced, or would introduce, actions to contest the amounts to be paid to INAMI and where non-final legal decisions had been made to annul or suspend an invoice. The Court thus held that the legislator, through this provision, “took a measure which, in a discriminatory manner, [damaged] the recognized right of each person to submit to an effective legal control any request for payment formulated by itself or against itself and any seizure of which it is the subject.” (Para. B.10). The Court agreed with petitioners that Article 28 established a difference in treatment between laboratories and other persons, as well as between clinical pathology laboratories and other creditors of sums due for health services in violation of the legal code.
However, the Court found that the legislator could guarantee INAMI against the risk of insolvency of laboratories without creating discrimination, but that it had failed to do so under the current provision. Had the legislator guaranteed INAMI against the risk of insolvency via a protective measure that was reasonably justified and subject to legal control, such contested provision would not have infringed upon the equality of the laboratories’ creditors, created expropriation, excessively hampered the freedom of commerce or restricted freedom of association.
The Court thus annulled the part of the contested provisions allowing the Institute to retain the withheld amounts until a final legal ruling had been made.
“The litigious provisions have the effect of exercising discretionary power by an administrative authority and the administrative act that stems from it – the “petition” of the healthcare Service in the insuring organizations to retain certain amounts, a “petition” which contains an obligation for these insuring organizations and therefore constitutes an administrative act accompanied by major legal effects – are at least temporarily beyond any effective jurisdictional control. It follows that the category of persons to whom these provisions are applicable is treated differently from other justiciable parties.” Paragraph B.6
"Les dispositions litigieuses ont pour effet que l'exercice du pouvoir discrétionnaire par une autorité administrative et l'acte administratif qui en découle - la « demande » du Service des soins de santé aux organismes assureurs de retenir certains montants, « demande » qui contient une obligation pour ces organismes assureurs et constitue donc un acte administratif assorti d'effets juridiques importants - échappent du moins temporairement à tout contrôle juridictionnel effectif. Il s'ensuit que la catégorie de personnes auxquelles ces dispositions sont applicables est traitée différemment des autres justiciables.” B.6
“By taking the common law of seizures, which in any case guarantees that there will be jurisdictional control, and substituting for it a general measure which infringes in certain aspects upon the authority of a final legal ruling, and which, without any effective jurisdictional control being provided for, may be applied “upon the request of the Service”, the legislator took a measure which, in a discriminatory manner, damages the recognized right of each person to submit to an effective legal control any request for payment formulated by itself or against itself and any seizure of which it is the subject.” Paragraph B.10
“En substituant au droit commun des saisies, qui garantit dans tous les cas un contrôle juridictionnel, une mesure générale qui déroge à certains aspects de l'autorité de la chose jugée par les tribunaux et qui, sans qu'un contrôle juridictionnel effectif soit prévu, peut être appliquée « à la demande du Service », le législateur a pris une mesure qui, de manière discriminatoire, porte atteinte au droit reconnu à toute personne de soumettre toute demande de paiement formulée par elle ou contre elle et toute saisie dont elle est l'objet à un contrôle judiciaire effectif.” B.10
“Between clinical pathology laboratories and the two categories of persons mentioned above, there is however an objective difference: certain laboratories have significant sums of debt owing to INAMI. The legislator may, without creating discrimination, guarantee INAMI against the risk of insolvency of laboratories by bringing to common law the exemptions that are described in B.13. Such measures would be excessive if they left the laboratories without defence against arbitrary deductions.” Paragraphs B.14-B.15.
“Entre les laboratoires de biologie clinique et les deux catégories de personnes précitées, il existe cependant une différence objective : certains laboratoires sont redevables envers l'INAMI de sommes importantes. Le législateur peut, sans créer de discrimination, garantir l'INAMI contre le risque d'insolvabilité des laboratoires en apportant au droit commun les dérogations décrites au B.13. De telles mesures seraient excessives si elles laissaient les laboratoires sans défense contre des retenues arbitraries.” B.14-15
“As soon as they are analyzed as organizing protective measures that are reasonably justified and subject to legal control, the provisions being contested do not infringe upon the equality of the laboratories’ creditors, they do not create any expropriation, they do not hamper in any excessive fashion the freedom of commerce and industry of those who operate a laboratory, and they do not create any restriction to their freedom of association. It follows that they do not damage the rights and freedoms guaranteed by the provisions invoked in the arguments.” Paragraph B.16
“Dès lors qu'elles s'analysent comme organisant des mesures conservatoires raisonnablement justifiées et susceptibles d'un contrôle judiciaire, les dispositions attaquées ne dérogent pas à l'égalité des créanciers des laboratoires, ne créent aucune expropriation, n'entravent pas de manière excessive la liberté de commerce et d'industrie de ceux qui exploitent un laboratoire et n'apportent aucune restriction à leur liberté d'association. Il s'ensuit qu'elles ne portent pas atteinte aux droits et libertés garantis par les dispositions invoquées aux moyens.” B.16