Approval from the Constitutional Court for the Sicilian Region's rates for outpatient services

With the ruling number 26, filed today, the Constitutional Court declared partially inadmissible and partially unfounded the questions of constitutional legitimacy of Article 6 of the Sicilian regional law of June 10, 2025, no. 26, which, "in order to ensure equity of access to services by beneficiaries and guarantee the appropriateness of the economic tariff values of certain services referred to in the decree of the Minister of Health of November 25, 2024," authorized, for the financial year 2025, the allocation of 15,000 thousand euros to "increase regional spending for private outpatient specialist care for the year 2025".

The appeal by the President of the Council of Ministers contested the regional provision for violation of Article 117, third paragraph, of the Constitution, in relation to the matter of "coordination of public finance", arguing that it, by exceeding statutory competencies and conflicting with state regulations expressing the principle of coordination of public finance, would have provided, for the year 2025, for the application of tariffs for private outpatient specialist services higher than those set at the national level. The same appeal also contested the violation of Article 81, third paragraph, of the Constitution, regarding financial coverage.

The Consultation preliminarily declared inadmissible, for lack of motivation, the objections related to the violation of Article 81, third paragraph, of the Constitution and the exceeding of statutory competencies. On the merits, it declared unfounded the alleged violation of Article 117, third paragraph, of the Constitution, noting that the contested provision complies with the general rule established by Article 15, paragraph 17, first period, of decree-law of July 6, 2012, no. 95, as converted, and as amended by Article 1, paragraph 322, of law of December 30, 2024, no. 207, under which "the tariff amounts, set by individual regions, exceeding the maximum tariffs remain "the responsibility of regional budgets".

In the case examined by the Consultation, the contemplated tariff increase would indeed burden "on regional resources (not subject to the constraints of the recovery plan) not drawn from the regional health fund", thus not being conditioned by the procedural obligations that the aforementioned paragraph 17, in the periods following the first, requires in the event that the Region intends to derogate from the aforementioned general rule.

The Consulta clarified that the provision contested by Palazzo Chigi falls within the scope of the concurrent legislative competence of the Region in the matter of health protection, since "it does not introduce additional services compared to those identified at the national level, but merely envisions an increase in fees for certain outpatient specialist services already included in the Lea, in a regulatory context that allows regions to increase fees with resources at their expense, when necessary to ensure the effective provision of national Lea.” 

“An important result for the Sicilian Region and for the actions of my government. The decision of the Constitutional Court clearly recognizes the spaces of financial and regulatory autonomy of the Region in health matters, confirming the legitimacy of the choice, strongly desired by us, to allocate greater regional resources to increase fees for certain outpatient services and thus ensure a more effective provision of essential levels of care,” comments the president of the Sicilian Region, Renato Schifani.

“But what matters most - he adds - is that this measure will allow for providing more services to citizens, reducing waiting times, and bringing Sicilian healthcare closer to the concrete needs of the people. Finally, I would like to thank the Legislative and Legal Office of the Region for the precise and decisive work that made this result possible.”