Romania sued for 79-day pharmacy payment delays

A pharmacy that dispenses state-reimbursed medicine still pays its wholesaler, its staff and its rent on schedule. When the state reimburses late, the pharmacy covers the gap: borrowing, delaying its own suppliers, or thinning its stock. The European Commission has referred Romania to the Court of Justice of the EU (the bloc's highest court) for exactly this. CNAS, the public body that reimburses Romanian pharmacies for dispensed medicines, allegedly paid so late and so persistently that it broke EU single-market law.

Three warnings, no fix

The Commission's legal tool is the Late Payment Directive, an EU law requiring public authorities to pay suppliers within strict deadlines. Healthcare bodies get up to 60 days, more time than most public payers, but not an open-ended right to delay.

The Commission warned Romania three times over two years: a formal notice in April 2024, followed by two reasoned opinions (formal written demands to fix the breach or face court) in February 2025 and January 2026. When Romania's response still fell short, the Commission went to court. Romania's own submissions showed the scale: CNAS was still paying pharmacies an average of 62 to 79 days beyond the 60-day legal ceiling (Stiri pe surse).

CNAS contests the framing. It says the case reflects an older situation, that it cleared arrears between October 2025 and April 2026, and that medicine payments were current as of 8 July 2026 (Digi24). Whether that late fix matters legally depends on what Romania had actually corrected by the time the infringement procedure reached its decisive stage. An infringement case tests conduct during a defined period. What the defendant has fixed since the referral may soften the political optics but does not retroactively cure the violation.

What the Italian ruling tells Romania

The Court has already decided a near-identical case. In Commission v Italy (C-122/18), it ruled that Italy violated the Late Payment Directive because its public authorities actually paid late. That Italy had formally written the directive into national law and that unpaid suppliers could theoretically sue did not save it. The test was whether the state really paid on time. It did not.

That ruling points against Romania. If the Commission demonstrates CNAS paid beyond the 60-day limit during the infringement period, Romania faces the same finding. Italy responded by building a public-sector payment monitoring platform and improved enough for the Commission to close the case (IFEL). Romania's "historical problem" defence becomes credible only with comparable, durable compliance data showing CNAS consistently pays within 60 days, not with a one-off clearance timed to blunt a judgment.

Romania is hardly unique in treating late reimbursement as a budgeting tool. Poland's national health fund has proposed settlement cycles that would force hospitals to treat patients first and wait months for payment, effectively lending the state their operating capital (Rzeczpospolita). In Hungary, delayed hospital payments have grown through accumulated default interest over years of litigation (Portfolio). But Romania is the first member state the Commission has taken to court over the practice.

A narrow rule with real teeth

The EU does not run national healthcare. Treaties leave the organisation and financing of health services to member states (Article 168 TFEU). The Commission is enforcing something narrower: when a state uses private pharmacies to deliver public healthcare, it must pay them within the legal deadline. The directive exists to prevent exactly this, public authorities using their purchasing power to push hidden financing costs onto smaller suppliers. Using pharmacies as a cash buffer is a single-market violation, not a sovereign prerogative.

If the Court rules against Romania and CNAS still fails to comply, the Commission can return under Article 260 TFEU (the treaty route for seeking daily financial penalties when a state ignores a court ruling). A judgment would also put other member states with similar habits on notice. Romania's defence now depends less on calling the arrears historical than on proving CNAS will keep paying on time.