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Insurance company to reimburse and cover costs for the medicine OPDIVO
In January this year, we informed you about our success with an application for extraordinary reimbursement of the medicine OPDIVO (nivolumab) at the Supreme Administrative Court. Our client was an oncological patient whose chemotherapy treatment failed completely, and the only option for him was immunotherapy in the form of the drug OPDIVO.
The Supreme Administrative Court disagreed with the opinion of both the health insurance company and the Municipal Court in Prague, and concluded that the conditions for extraordinary reimbursement under Section 16 of the Public Health Insurance Act were fulfilled in this case as OPDIVO was the only remaining treatment option for the patient. The Supreme Administrative Court overturned the previous decision of the health insurance company and the Municipal Court in Prague, and returned the case to the insurance company for approval of the application.
The problem that arose thereafter was that the client had already paid for the treatment as his health condition was very serious, and it was not possible to wait any longer. However, reimbursement from public health insurance is usually made only after the treatment has been approved, and the insurance company subsequently sends the payment directly to the account of the health service provider, and not to the patient. However, on the basis of our urgency, and thanks to cooperation from the health service provider, the insurance company was able to pay the health service provider for the treatment cost, which was then refunded to the client by the health service provider.
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Martin Herna
Martin Herna
"I would like to take this opportunity to express my sincere gratitude to the law firm Holubová advokáti s.r.o. for their professional yet genuinely compassionate approach in an exceptionally difficult period of my life.
The firm successfully represented me in a dispute with my health insurance company concerning reimbursement for a medication that enables me to actively fight an oncological illness and has already begun to show positive treatment results.
From the very outset, I felt a high level of expertise, thoroughness, and a genuine interest not only in the case itself but also in the person behind it. All legal steps were explained clearly and comprehensibly, and the communication was factual, calm, and supported by clear arguments. In a time of great uncertainty, this provided me with a much-needed sense of reassurance and trust.
My special and greatest thanks go to JUDr. Klára Dvořáková, whose commitment, precision, and empathy meant more to me than can be conveyed in just a few sentences. Her work was not only highly professional but also marked by human sensitivity and deep respect for the seriousness of the situation.
I can wholeheartedly recommend this law firm to anyone seeking top-tier legal assistance combined with a truly human approach."
Dietmar Repka
Dietmar Repka
"We express our recommendations for the law firm Holubova Advokati.
Holubova Advokati was able to resolve a project for us with confidence, composure, and perseverance that German experts had deemed hopeless.
About 80 years ago, my grandparents and my father had to leave their home. The property has now been returned to our family through the inheritance that was initiated, and thanks to the excellent work of the law firm.
During the two-and-a-half-year negotiations, there were no language problems; everyone was always well informed about the current status.
Keep up the good work, everyone."