With judgement no. 608 of 22 May 2019, the Piedmont Regional Administrative Tribunal (TAR) issued a ruling on a new question concerning the possibility for the Italian regional authorities to enable medical practitioners other than those employed by or with an agreement with the Italian national health service (SSN) to prescribe health services whose costs are borne by the SSN.

The TAR developed its reasoning from an examination of the challenged resolution of the Regional Council to investigate the resolution’s compatibility with the relevant national laws, specifically art. 2 decree law no. 443/1987, which expressly restricts use of prescription pads for state-funded services to medical practitioners employed by or with an agreement with the SSN. Consistently with the reconstruction of a previous ruling of the Constitutional Court (judgement no. 1103 of 20 December 1988), the TAR cites two fundamental reasons for the restriction ex art. 2 legislative decree no. 443/1987: on the one hand, it meets the need to restrict prescriptions, or proposed services deliverable by the SSN, to practitioners of proven competence; on the other, it avoids an anomalous and uncontrolled increase in prescription of medicinal products.

According to the reconstruction of the Piedmont TAR in the judgement in question, the laws subsequent to the above-mentioned decree law do not have either an implicit or an explicit revoking effect, indeed they highlight that the restriction is still evident in the relevant legislation, specifically in the technical regulations on the dematerialisation of hard-copy medical prescriptions (decree 2 November 2011 on “Dematerialisation of the hard-copy medical prescription, as per art. 11, paragraph 16, legislative decree no. 78/2010 - Medical Card Project”): prescribing cannot be mixed with the delivery of healthcare services, which would only appear to be exercisable also by accredited private healthcare bodies.

For these reasons the TAR annulled the ruling of the Piedmont Regional Council which extended the power to prescribe services whose costs are borne by the SSN to medical practitioners in private bodies (Piedmont TAR, Section I, ruling no. 608 of 22 May 2019).