Figures obtained from the Health Service Executive show that spending on the Treatment Abroad Scheme fell by over €1.6m last year and refusals of treatment under the scheme have increased.
Patients can have a procedure they need performed abroad and paid for by the HSE, if it is not available in Ireland and is medically necessary.
The HSE said that each application under the scheme is clinically reviewed by experts whose medical opinion informs the decision as to whether overseas treatment is required.
The figures show that in 2010, €4.4m was spent on the scheme. However, spending fell to €2.8m last year.
In 2010, there were 395 applications and 22 were rejected. Last year, there were 436 applications and 48 were rejected.
The percentage of rejections is up from 5% to 11%.
The HSE said that the scheme is operated in accordance with EU guidelines and legislation.
It said that as more treatments are available in Ireland, there is less need to go abroad.
