Romania Taken to Court Over Pharmacy Delays

A pharmacy does not get to pause its own bills while it waits for the state. The wholesaler still has to be paid. Staff wages still fall due. Rent still lands on the same date. When public reimbursement arrives late, the pharmacy becomes the lender of last resort: borrowing, stretching its own suppliers, or carrying less stock than patients need. That is the practice now taking Romania to the Court of Justice of the EU, the bloc's highest court. CNAS, the public body that reimburses Romanian pharmacies for dispensed medicines, is accused of paying so late, and so repeatedly, that it breached EU single-market law.

Three warnings, no fix

The Commission is using the Late Payment Directive, a piece of EU law designed to stop public bodies from treating suppliers as interest-free credit lines. Public healthcare bodies get more room than most, with up to 60 days to pay, but the extra time is a ceiling, not a licence to drift.

Romania was warned three times over two years: first through a formal notice in April 2024, then through reasoned opinions in February 2025 and January 2026. A reasoned opinion is the Commission's formal written demand that a breach be fixed before the case goes to court. Romania's answer did not satisfy Brussels. Its own submissions showed why: CNAS was still paying pharmacies an average of 62 to 79 days beyond the 60-day legal ceiling (Stiri pe surse).

CNAS rejects the charge as out of date. It says the case reflects an older situation, that arrears were cleared between October 2025 and April 2026, and that medicine payments were current as of 8 July 2026 (Digi24). That may help politically, but legally the question is narrower: what had Romania actually corrected when the infringement procedure reached its decisive stage? A later clean-up can improve the optics. It does not automatically erase the breach being tested.

What the Italian ruling tells Romania

The Court has already dealt with a very similar case. In Commission v Italy (C-122/18), it found that Italy had violated the Late Payment Directive because its public authorities paid late in practice. Italy had written the directive into national law, and suppliers could in theory sue for payment. Neither point was enough. The test was whether the state actually paid on time. It did not.

That precedent is awkward for Romania. If the Commission can show that CNAS paid outside the 60-day limit during the infringement period, the legal path is fairly clear. Italy eventually built a public-sector payment monitoring platform and improved enough for the Commission to close the case (IFEL). Romania's "historical problem" argument will carry weight only if it can produce durable evidence that CNAS is now paying within 60 days as a matter of routine, not because a court case was approaching.

Romania is not alone in using delayed reimbursement as a quiet budget device. Poland's national health fund has proposed settlement cycles that would require hospitals to treat patients first and wait months for payment, effectively making them finance the state from their operating cash (Rzeczpospolita). In Hungary, delayed hospital payments have grown through accumulated default interest after years of litigation (Portfolio). Romania, though, is the first member state the Commission has brought to court over the practice.

A narrow rule with real teeth

The EU does not run national health systems. Under Article 168 TFEU, member states remain responsible for organising and financing healthcare. The Commission's case is more limited, and more practical: when a state relies on private pharmacies to deliver public healthcare, it has to pay them within the legal deadline. The directive exists to stop public authorities from shifting hidden financing costs onto smaller suppliers. A pharmacy can be part of the public health chain. It cannot be turned into a cash buffer for the state.

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 against a member state that ignores a judgment. A ruling would also be read carefully elsewhere in Europe by health systems with similar habits. Romania's defence now depends less on describing the arrears as historical than on proving that CNAS can keep paying on time.