A landmark ruling by the administrative court in Nicosia, it emerged on Thursday, has overturned a previous decision by the health insurance organisation (OAY), allowing a patient to obtain medication under the national health scheme (Gesy) with a prescription from a non-Gesy doctor.

The court’s decision, issued on Wednesday, is expected to have significant implications for patients and private doctors across Cyprus.

The case centred on whether patients enrolled in Gesy must obtain prescriptions exclusively from doctors registered with the system to have their medication covered.

OAY had rejected the patient’s request for reimbursement, arguing that only prescriptions from Gesy-affiliated doctors were eligible. However, the court ruled that the law does not explicitly require prescriptions to be issued by a Gesy doctor, as long as the medication itself is included in the system’s approved list and is dispensed by a participating pharmacy.

The court’s decision highlighted a crucial distinction in the law. While personal and specialist medical services within Gesy are provided by registered doctors, the regulation does not specify that prescriptions must come exclusively from these practitioners. Instead, the law states that prescriptions must be issued by a “doctor” or “dentist” without requiring them to be affiliated with Gesy. The ruling confirmed that only pharmacists are mandated to be registered with Gesy when dispensing covered medicines.

The judgment clarifies that patients who choose to consult private doctors outside Gesy must bear the consultation cost themselves. However, if the prescribed medication is included in the Gesy list and dispensed by a participating pharmacy, the cost of the medicine should still be covered by the system. The court found that OAY’s interpretation of the law had added restrictions that were not originally stated in the legislation.

Meanwhile, OAY chairman Stavros Michail told the Cyprus News Agency that the organisation was awaiting an opinion by its legal advisers regarding the decision.

He added that the OAY board would be convening on Thursday to discuss the issue and would take any legal advice into consideration, given that it arrived in time.

Following the ruling, the Cyprus association of private doctors (Enik) welcomed the decision, stating that it would ease pressure on the Gesy system by allowing private doctors to issue prescriptions for eligible patients. In a statement, Enik urged OAY to implement the decision immediately, emphasising that it upholds patients’ rights to equal and uninterrupted access to essential healthcare services.

The ruling also cited the legislative framework governing the execution of prescriptions within Gesy, reaffirming that the system must cover the cost of necessary medications as long as they are prescribed by any qualified doctor and dispensed by a Gesy-affiliated pharmacist.

This decision is expected to provide greater flexibility for patients while alleviating strain on Gesy-registered doctors. However, it also raises questions about the potential need for further clarification in healthcare legislation to ensure consistency in the system’s application.

OAY has yet to comment on whether it will challenge the ruling or adjust its policies accordingly.

Later in the day, during the session of the House plenary, an MP attempted to fast-track an amendment to the current law in a bid to address the ramifications of the administrative court’s ruling.

Disy MP Efthymios Diplaros wanted to table an amendment ensuring that only Gesy-affiliated doctors can prescribe medications under the national health system.

The law as it stands does not distinguish between Gesy-contracted doctors and doctors in general. Regarding Gesy prescriptions, the text only says “a doctor”.

Diplaros’ amendment would add the following words to the text: “a doctor contracted with Gesy”.

However his proposal to fast-track the amendment got no traction when other MPs said it would be better to revisit the matter in detail in committee next week.