Since 2023, Slovakia has been noncompliant with EU rules on payments by public authorities as regards public hospitals. This policy analysis provides a chronological overview of the ongoing developments.
The 2023 infringement
In April 2023, the European Commission referred Slovakia to the EU Court of Justice because Slovak public hospitals were paying suppliers with excessive delays, despite the directive requiring public authorities to pay invoices within 30 days, or within a maximum of 60 days for public hospitals [1]. In the year 2023, publicly owned hospitals under the Ministry of Health in Slovakia had a total outstanding debt of EUR 736 million and the average payment delay was 397 days. This is particularly relevant for healthcare suppliers, including small and medium-sized enterprises (SMEs), because long payment delays reduce liquidity and the financial resilience of companies supplying goods and services to hospitals.
The 2024 court decision
The EU Court of Justice ruled that Slovakia failed to ensure that its public healthcare entities complied in practice with the 60-day payment deadline applicable to public entities providing healthcare [2]. The judgment therefore confirmed that the late-payment problem in Slovak public hospitals was not only a financial management issue, but also a breach of EU law [3].
Formal notice in 2025
In 2025, the European Commission escalated the matter under Article 260 TFEU. In June, it sent Slovakia a post-judgment letter of formal notice, stating that measures announced after the 2024 court ruling had not delivered sufficient improvements [4].
This meant that the European Commission considered Slovakia’s post-judgment measures insufficient to remedy the breach. Slovakia was then given a grace period of two months to respond and address the shortcomings. As of the latest publicly available information, there is no confirmed financial penalty imposed yet, but the case has moved into the post-judgment enforcement stage, and the European Commission is now checking whether Slovakia has properly fixed the breach and may seek financial penalties if the response is insufficient.
As of this writing, the Slovak public hospital debt remains
The debt of public hospitals is rising and has surpassed EUR 1 billion; the payment delay is still between 100 and 300 days per hospital payment, highly above the prescribed 60 days. If Slovakia fails to take the necessary measures to comply with the court judgment, the European Commission may refer the case back to the Court of Justice and request financial sanctions.
These may include a lump-sum penalty of EUR 800 000 for the continued breach and a daily penalty payment of EUR 50 000 until Slovakia brings the situation into compliance [5]. The final decision on whether to impose such sanctions, and their amount, would be made by the court. In practical terms, Slovakia risks turning an already confirmed breach of EU law into a direct fiscal cost for the state, while continued payment delays would also keep financial pressure on hospital suppliers, particularly SMEs.
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