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Israel: Knesset Passes Medical Tourism Legislation

(Sept. 25, 2018) On July 18, 2018, the Knesset (Israel’s Parliament) approved the Medical Tourism Law, 5778-2018 (SEFER HAHUKIM [SH] 5778 No. 2750 p. 963, Ministry of Justice website (in Hebrew; click on issue No. 2750).

The Law regulates the medical tourism industry in Israel. Among other things, it introduces registration requirements for medical tourism agents (MTAs) and defines the responsibilities of medical institutions (MIs) that provide medical tourism services.

Registration of Agents

The Law authorizes the general manager of the Ministry of Health or the general manager’s designee to establish a register of MTAs. Information contained in the register must be posted on the Ministry’s website in Hebrew, Arabic, English, Russian, and any other language or form of publication as determined by the Minister of Health. (Id. § 3.)

An application for MTA registration must include the applicant’s identifying information and relevant activities. Requests by businesses and corporations must include names and identifying information of position holders, with additional information on control shareholders and documents of incorporation required for corporations. (Id. § 4.)

Registration once approved is valid for a period of four years (id. § 7), and can be extended for an applicant who is either an individual or an official or control shareholder in a corporation, as relevant, if the applicant

  • has an address or, in the case of a nonresident, a representative in Israel;
  • is not employed by either a public or a private MI; and
  • has not been convicted of an offense that, due to its nature, seriousness, or circumstances, renders the applicant unfit to engage in arranging medical tourism services (id. § 5).

Additional requirements for corporations incorporated outside of Israel include

  • registration as a foreign company under section 346 of the Companies Law, 5759-1999, SH 5759 No. 1711 p. 189, as amended; and
  • the existence of “sufficient legislation on prohibition of money laundering” in the country of incorporation. (Id. (all translations by author).)

Registration may be denied even if the conditions specified above are met if the general manager or the general manager’s designee has determined that the applicant is unfit to engage in facilitation of medical tourism. Prior to denying registration, the applicant must be given an opportunity to be heard. The applicant must be notified in writing of the reasons for the denial. (Id. § 6.)

Duties of Medical Tourism Agents

The Law requires an MTA to act in a “trustworthy, decent and acceptable way” toward both the medical tourist and the MI care provider. (Id. § 9(a).) The MTA owes the medical tourist a duty of confidentiality regarding all relevant medical information the MTA receives from the medical tourist. (Id. § 10.) Additionally, the MTA must not arrange for medical tourism care in an MI in which the MTA has any personal interest or with whose staff the MTA has any relationship. This prohibition does not apply if the medical tourist was notified of the personal interest and consented in writing to receive care by the MI in question. (Id. § 12.) The MTA is required to wear some sign of identification as an MTA while at an MI in the course of work. (Id. § 14.)

Duties of Medical Institutions

One of the conditions for authorizing an MI to provide medical tourism care is that its main activity and the main activity in the department where the care is provided is the provision of medical treatment to patients who are not medical tourists. (Id. § 15.)

The Law requires that an MI invitation extended to a medical tourist for provision of medical care be in writing and include the following:

  • tentative diagnosis that must be confirmed or negated, specification of required tests, and details regarding documents on which the tentative diagnosis is based
  • details regarding the proposed care in accordance with the tentative diagnosis, as well as potential significant risks associated with the proposed medical care
  • prognosis for success of the offered medical care
  • for public MIs, reference to the Ministry of Health’s web address that lists fees for medical care (Id. § 17.)

The Law provides that an MI that provides services to medical tourists must not give priority care to such patients. (Id. § 21.) It further requires MIs to conduct separate accounting for medical tourists and other patients. (Id. § 23.)

Disciplinary Sanctions and Oversight

The Law lists several offenses to be adjudicated by a disciplinary committee established by the Minister of Health according to conditions specified. (Id. §§ 28–33.) It regulates the procedures that apply to submission of complaints and the committee’s hearings (id. §§ 34–42), as well as the sanctions that the committee may impose as a result of violations of the Law (id. §§ 43–44.) The Law further provides for rules that govern publication of the committee’s decisions and appeals. (Id. §§ 45–46.) A determination of guilt or the lack thereof in a criminal trial does not preempt disciplinary procedures for alleged violations, and vice versa. (Id. § 48.)

The Law authorizes the Minister of Health to appoint inspectors to enforce its provisions. (Id. §§ 51–52.) It also provides for criminal penalties of fines and imprisonment for negotiating medical tourism without registration (id. §§ 53–54) and financial levies on MIs that violate their obligations (id. §§ 55–68).