An investigation by Ombudsman for Public Services Ger Deering has found an "unreasonable and inflexible" approach by the Health Service Executive in reimbursing patients for treatment in other countries.
The HSE administers schemes that fund treatment abroad for healthcare, which the State is either unable to provide, or unable to provide in a timely manner in Ireland.
In his report published today, Mr Deering said that some patients faced a fight to be reimbursed for the legitimate costs they had incurred for necessary treatment they received abroad, with many borrowing money and some falling into debt as a result.
The Ombudsman said some patients were refused reimbursement due to mistakes made by someone else.
In one case, a letter of referral from an Irish GP was addressed to a department in a Northern Ireland hospital, but not a named individual in the hospital.
The HSE refused to accept a subsequent amended referral letter from the GP.
In other cases, approval to have treatment abroad was unreasonably refused or delayed.
A number of elderly patients who sought refunds for treatment were in receipt of UK pensions.
Due to the lack of information provided by the HSE these patients were unaware that the fact they were in receipt of a pension from another EU country would negatively affect their application.
The report found the patients had borrowed significant amounts of money to have the treatment but received no reimbursement.
The Ombudsman has set out 21 recommendations to improve the administration of the schemes.
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Following discussions between the Ombudsman and new HSE Chief Executive Bernard Gloster, the HSE has agreed to implement the 21 recommendations in the Ombudsman's report.
Mr Deering has welcomed that the HSE will implement the recommendations.
"Their implementation will have a significant positive impact on the lives of those who need to access treatment abroad, and will help ensure that decisions under the schemes are focused on the patient's needs," he said.
Speaking on RTÉ's Morning Ireland, Mr Deering said no one wanted to travel for medical treatment and it was very stressful for patients.
He said: "These people are doing this because they can't get the treatment here. So you have obviously the pain and the surgery, then you have the distress that goes with that and the recovery, and now you could find yourself in debt as a result and having to pay back money.
"In some instances, people borrow the money from family members, who could ill afford to be without it. And now you have two family members who are distressed."
