Romania has been referred to the EU’s top court over failures to ensure state health insurance payments to pharmacies are made on time.
The European Commission announced on Wednesday it had decided to take Romania to the Court of Justice of the European Union (CJEU) because the National Health Insurance House (CNAS) does not pay pharmacy operators within deadlines set by the EU Late Payment Directive (Directive 2011/7/EU).
Public bodies providing healthcare must pay for goods and services within a maximum of 60 calendar days under the directive.
CNAS has repeatedly exceeded that limit when reimbursing pharmacies that supply medicines to patients.
The late payments to pharmacies in Romania were described as “systemic and persistent.”
Complaints from pharmacy groups
The case follows an infringement procedure launched after complaints from pharmacy associations representing more than 500 independent pharmacies, the Commission said.
Romanian pharmacies typically buy medicines from manufacturers and distributors with their own funds before dispensing them to patients under the national public health insurance scheme, with CNAS reimbursing the cost afterwards.
The Commission noted it sent Romania a letter of formal notice in April 2024, followed by a reasoned opinion in February 2025 and an additional reasoned opinion in January 2026. Efforts by the authorities had been insufficient so far,.
Pharmacies are paid on average between 62 and 79 days later than the 60-day deadline, based on the most recent information provided by the Romanian authorities.
