Cross-Border Telemedicine: Applicability of a General Country-of-Origin Principle?

Jun 25, 2026 Benn-Ibler Rechtsanwälte

The decision in the case at hand addresses the issue of which legal framework applies to cross-border dental treatment provided by a foreign telemedicine provider.

The Austrian Dental Association had brought an action for injunctive relief against a dentist established in Austria, alleging an unfair competitive advantage through a violation of the law pursuant to Section 1 of the Unfair Competition Act (Gesetz gegen den unlauteren Wettbewerb, UWG). According to the claimant, the defendant was acting as an auxiliary for a German dental company in performing dental services, even though that company did not possess the authorisations required under Austrian law, thereby contravening the dentist reservation provision in Section 4(3) of the Dentists Act (Zahnärztegesetz, hereinafter ZÄG). The defendant conducted examinations locally and transmitted the collected data to the dental company, which subsequently prepared the treatment plan and supervised further treatment via an app.

The defendant relied upon the Directive on the Application of Patients’ Rights in Cross-Border Healthcare (the Patient Mobility Directive), arguing that the dental company only needed to comply with the regulations of its home state regarding telemedical services. The Austrian Supreme Court (Oberster Gerichtshof, hereinafter OGH) referred the question of whether a general country-of-origin principle applies to telemedical services to the Court of Justice of the European Union (CJEU) for a preliminary ruling. The CJEU held that only the national statutes and standards of the Member State in which the treatment is provided apply. The Member State of treatment is defined as the state where the healthcare service is actually rendered to the patient, and thus for telemedicine, where the provider is established. Services that are provided with the physical presence of the practitioner are excluded from the concept of telemedicine, irrespective of whether they form part of a complex treatment in which telemedical services otherwise predominate. Accordingly, the partner dentist’s treatment does not qualify as a telemedical service, and the Member State of treatment in this instance is Austria, as the place where the treatment was actually provided.

Consequently, Austrian law applies to the Austrian dentist who provides services physically in Austria, and the requirements of that law are met. With regard to the law applicable to the German dental company, a distinction must be drawn: For those telemedical services provided by the German dental company, Germany is considered the Member State of treatment. Accordingly, the German professional regulations and quality standards are, in principle, decisive for these services.

Austrian law does not contain explicit provisions for determining the applicable law in cases of cross-border telemedical dental treatments; however, it must be interpreted in conformity with the Patient Mobility Directive, which must therefore be taken into account in the interpretation of the ZÄG.

Based on these considerations, the OGH concluded that the defendant’s legal position is sustainable on reasonable grounds and therefore does not constitute an unfair competitive advantage through a violation of the law under Section 1 UWG.

OGH 4 Ob 154/25p (20 February 2026)