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Miscellaneous Provisions Act Accessibility To Health Care (1)

Original Language Title: Loi portant des dispositions diverses en matière d'accessibilité aux soins de santé (1)

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belgiquelex.be - Carrefour Bank of Legislation

27 DECEMBER 2012. - An Act respecting various accessibility provisions for health care (1)



ALBERT II, King of the Belgians,
To all, present and to come, Hi.
The Chambers adopted and We sanction the following:
CHAPTER 1er. - Introductory provision
Article 1er. This Act regulates a matter referred to in Article 78 of the Constitution.
CHAPTER 2. - Amendments to the Compulsory Health Care and Compensation Insurance Act, coordinated on 14 July 1994
Section 1re. - Unaccompanied foreign minors
Art. 2. Article 32, paragraph 1er, 22°, of the Compulsory Health Care Insurance Act, coordinated on 14 July 1994, inserted by the Act of 13 December 2006, paragraph 1er is supplemented by the following sentence:
"The King can determine the periods that are assimilated to periods of attendance at the basic or secondary level. »
Section 2. - Smoking protection
Art. 3. In article 34, paragraph 1er, of the same law, last amended by the law of 23 December 2009, the 24th is replaced by the following:
"24° intervention in smoking withdrawal assistance. The King may extend the drug-assisted treatment of tobacco withdrawal; "
Section 3. - Hair prosthesis
Art. 4. In article 34, paragraph 1er, of the same law, last amended by the law of 23 December 2009, is inserted on 20° bis as follows:
"20° bis the provision of hair prosthetics; "
Art. 5. In Article 35, § 1er, paragraph 8, of the same law, replaced by the law of 10 August 2001 and amended by the laws of 22 August 2002 and 22 December 2003, the words "and 20°" are each replaced by the words ", 20° and 20° bis".
Art. 6. Article 37, § 20, paragraph 1er, of the same law, inserted by the law of 22 February 1998 and amended by the laws of 27 April and 27 December 2005, the words "the benefits referred to in article 34, 14°, 24° and 25°" are replaced by the words "the benefits referred to in article 34, 14°, 20° bis, 24° and 25°".
Section 4. - Radio-isotopes
Art. 7. In section 18, paragraph 4, of the Act, replaced by the Act of 25 January 1999 and amended by the Acts of 24 December 1999 and 10 August 2001, the words "a note summarizing the amendments to the list referred to in section 35 bis" are replaced by the words "two summary notes, the first resuming the amendments to the list referred to in section 35, § 2ter, and the second amendments to the list referred to in section 35
Art. 8. In article 22, paragraph 1er, 4°, of the same law, replaced by the law of 27 December 2005, the words « referred to in articles 23, § 2, 35, § 1er, and 35, § 2ter, are replaced by the words " referred to in Articles 23, § 2 and 35 § 1er "
Art. 9. In section 27, paragraph 4, of the Act, replaced by the Act of 24 December 1999, and amended by the Acts of 10 August 2001 and 24 December 2002, the words "subject to paragraph 2" are replaced by the words "as provided in section 35, paragraph 2".
Art. 10. In section 35 of the Act, subsection 2ter, replaced by the Act of 27 December 2005 and amended by the Act of 13 December 2006, is replaced by the following:
§ 2ter. The King confirms the list of reimbursable radioisotopes referred to in article 34, paragraph 1er5°, d). Upon a proposal by the Technical Council for Radioisotopes, or after notice by the Minister, the Minister shall amend the list of reimbursable radioisotopes referred to in section 34, paragraph 1er, 5°, d), as well as the terms and conditions of reimbursement relating thereto. On the proposal of the Radioisotopes Technical Council, the King determines the procedure that must be followed by those who request the admission, modification or removal of a product on the list of repayable radioisotopes. It also defines deadlines and obligations for applications for admission, modification or removal. For the purposes of this paragraph, the King may assimilate to the repayable radioisotopes of radioactive products or radioactive renditions that would belong to other categories of health services. »
Art. 11. In section 37, § 3, of the Act, amended by the Acts of 22 December 2003, 27 December 2005 and 13 December 2006, paragraph 6 is repealed.
Art. 12. In Title III, Chapter V, of the same Act, a section XXI containing an article 77quines is inserted as follows:
“Section XXI. - Obligations of companies that put radiopharmaceutical products on the Belgian market and ask for their admission to reimbursement
Art. 77quinquies. § 1er. The company that puts radiopharmaceutical products on the Belgian market and has applied for reimbursement is required, from the introduction of a refund request, to ensure that the radiopharmaceutical product concerned will be effectively available no later than the date of entry into force of the refund and to guarantee continuity of the availability of the product.
When the company that puts radiopharmaceutical products on the Belgian market and has asked for reimbursement is unable to supply the market for packaging, this packaging is considered unavailable. The firm notifies the start date, the alleged end date and the reason for the unavailability of the Radioisotopes Technical Council.
§ 2. If the Institute's Health Care Service is informed of the unavailability of a radiopharmaceutical product other than the firm, it requests confirmation to the firm that the product is actually unavailable. The firm has 14 days from receipt of this request to confirm or invalidate the unavailability by registered mail with acknowledgement of receipt. If she infirms her, she joins the evidence that the product is available. If the firm confirms the unavailability, it specifies the start date, the expected end date and the reason for the unavailability.
If the firm does not respond within the specified time limit, or if the elements that the firm provides do not allow for a certainty to establish the availability of the product, the specialty shall be deleted as soon as possible from the list, in full right and without taking into account the procedures determined under section 35, § 2ter.
§ 3. If the firm communicates that the packaging will be unavailable for more than three months, or if the unavailability lasts more than three months, the packaging concerned shall be removed in full right from the list, without taking into account the procedures determined under section 35, § 2ter, respectively the first day of the month following the discharge of a period of 10 days from the receipt of the notification or the first day of the fourth month of unavailability.
§ 4. If the unavailability is the result of a proven case of force majeure, the packaging is re-registered on the list on the first day of the month following the end of the unavailability, without taking into account the procedures determined under section 35, § 2ter. »
Section 5. - Maximum charge
Art. 13. In section 37sexies, paragraph 8, 1°, of the same law, inserted by the law of 5 June 2002 and amended by the laws of 27 December 2005 and 22 December 2008, the following amendments are made:
1° in (a), the words "personal interventions set under Article 37, § 2 (b), for pharmaceutical specialties that are classified as categories A, B and C in the list of repayable pharmaceutical specialties" are replaced by the words "personal interventions for pharmaceutical specialties that are classified as categories A, B, C, Fa and Fb in the list of repayable pharmaceutical specialties";
2° 1° is completed by g) written as follows:
"(g) of the lump-sum personal intervention which is supported under Article 37, § 3/3, by the beneficiaries who reside in rest and care homes and day-care centres, approved by the competent authorities, or in rest homes for the elderly or short-stay centres, approved by the competent authority, or in institutions that, without being approved as a common home, are the residence or residence established by the King, »
Art. 14. Article 37s, paragraph 1er, first dash of the same law, inserted by the law of 5 June 2002 and amended by the laws of 24 December 2002, 27 December 2005 and 22 December 2008, the following amendments are made:
1° the words "Pharmaceous specialties of categories A, B and C" are replaced by the words "Pharmaceous specialties of categories A, B, C, Fa and Fb";
2° the words "of the lump-sum personal intervention that is supported by the beneficiaries who reside in rest and care homes and day-care centres, approved by the competent authorities, or in rest homes for the elderly or short-term care centres, approved by the competent authority, or in institutions that, without being registered as rest homes, constitute the domicile or common residence of the elderly, and who respond to the conditions set by the King
Art. 15. Articles 13 and 14 produce their effects on 1er March 2012.
Section 6. - Status of chronic affection
Art. 16. In title III of the Act, a chapter III shall be inserted entitled:
“Chapter IIIter. Chronic affection status »
Art. 17. In chapter IIIter, inserted by article 16, an article 37vicies/1 is inserted as follows:
"Art. 37vicies/1. The King shall, on the proposal of the insurable working group referred to in article 31bis or after notice of the working group rendered at the request of the Minister of Social Affairs within the time limit set by him and after the advice of the Insurance Committee, by order deliberately in the Council of Ministers, establish a chronic affection status to which he shall bind the rights he determines. For the development of this statute, one or more of the following criteria shall be taken into account:
1° a minimum amount of health expenses of a beneficiary fixed by the King over a period of time fixed by the King;
2° the benefit of the lump sum allowance referred to in Article 37, § 16bis, 2°;
3° to be affected by a rare orphan condition.
Upon the proposal of the insurable working group referred to in Article 31bis and after the advice of the Insurance Committee, the King shall determine, by order deliberately in the Council of Ministers, the conditions for the opening, maintenance, withdrawal of the status of chronic affection and the rights related thereto. It also specifies what is meant by "health spending" referred to in paragraph 1er1° and "refrequent or orphaned affection" for the purposes of paragraph 1erThree. »
Section 7. - Third-time pay
Art. 18. Article 53, § 1erof the same Act, as amended by the Acts of 22 February 1998, 25 January 1999, 24 December 1999, 26 June 2000, 14 January 2002, 27 December 2004, 27 December 2005 and 19 December 2008, the following amendments are made:
1° paragraph 8 is supplemented by the following sentence:
"The King may, subject to situations for which the application of the paid third party plan is mandatory, also specify the conditions and conditions under which a prohibition on the application of the paid third party plan is imposed with respect to individual dispensators. »;
2° Two sub-paragraphs are inserted between paragraphs 8 and 9:
"From 1er January 2015, the obligation to apply the paid third party plan is introduced for the beneficiaries of the increased intervention of the insurance referred to in Article 37, § 19, and to the beneficiaries of the chronic condition status referred to in Article 37vicies/1 for the medical benefits determined by the King:
1° on the basis of a proposal by the Committee of Conventions or Competent Agreements which decides on its transmission to the Insurance Committee;
2° on the basis of the proposal made by the committee of conventions or agreements competent at the request of the Minister; these proposals are communicated to the Insurance Committee;
3° on the basis of the Minister's proposal.
The procedure referred to in paragraph 9, 3°, may be followed when the proposals of the relevant convention or agreement committee do not meet the objectives contained in the application referred to in paragraph 9, 2°. In this case, the refusal of the proposal of the relevant convention or agreement committee must be motivated. »
Section 8. - Sanctions
Art. 19. In Article 37, § 6, paragraph 3, of the Act, the words "the sanctions referred to in Article 170" are replaced by the words "a level 2 penalty referred to in Article 101 of the Social Criminal Code".
Section 9. - Pediatric Liaison
Art. 20. In article 22, paragraph 1er, 6° ter, of the same law, replaced by the law of March 18, 2009, the words ", and with the paediatric palliative care teams referred to in section 34, 21° bis" are repealed.
Art. 21. In article 23, § 3bis, of the same law, inserted by the law of 22 February 1998 and amended by the law of 18 March 2009, the words "and with the palliative palliative care teams at home referred to in article 34, 21° bis" are repealed.
Art. 22. In article 34, paragraph 1er, of the same law, 21° bis, inserted by the law of 18 March 2009, is repealed.
CHAPTER 3. - Hospitals and other care facilities
Section 1re. - Amendments to the Hospitals and Other Care Facilities Act, coordinated on 10 July 2008
Art. 23. In title Ier of the Hospitals and Other Care Institutions Act, coordinated on 10 July 2008, a chapter VI entitled "Financial Accessibility of the Hospital" is inserted.
Art. 24. In Chapter VI, inserted by Article 23, an article 30/1 is inserted as follows:
"Art. 30/1. This article is applicable to hospitalized patients, including those admitted to day hospital for the services defined by the King.
Concerning the imputation of supplements, the King may, by order deliberately in the Council of Ministers, extend the provisions referred to in Article 152, § 2, paragraphs 1er and 2, and in section 152, § 4, to other categories of health professionals referred to in Royal Decree No. 78 of 10 November 1967 concerning the exercise of health care professions, in the hospital.
For the purposes of paragraph 2, the amounts claimed in excess of the mandatory tariffs shall be defined by supplements if agreements or agreements referred to in Part III, Chapter V, Section Ire and II of the Compulsory Health Care Insurance Act, coordinated on 14 July 1994, are applicable, or rates that are used as a basis for the calculation of the intervention of insurance if such agreements or agreements are not in force. »
Art. 25. In section 98, paragraph 2, of the Act, the words "paragraph 3" are repealed.
Art. 26. Section 152 of the Act is replaced by the following:
"Art. 152. § 1er. This article is applied to hospitalized patients, including patients admitted to day hospitalization for the services defined by the King after the advice of the National Medical-Mutualist Commission.
The Minister may request that the Board make a notice within one month. If the notice is not made within the time limit or the Minister cannot agree to it, the Minister may submit his or her own proposal to the Board. The Commission then renders an opinion on this proposal within one month. This notice is considered to have been given if the notice has not been filed within that time limit.
§ 2. Hospital physicians may not charge tariffs that deviate from the rates of the agreement in the event that an agreement referred to in section 50 of the Compulsory Health Care and Allowance Act, coordinated on July 14, 1994, is in force, or rates that deviate from the rates that are used as a basis for the calculation of the intervention of the insurance in the event that such an agreement is not in force on an individual basis only for admission to the room. For the purposes of this section, the tariffs that deviate from it are defined by surcharges.
Derogation from paragraph 1er, hospital doctors may not charge supplements for admission to the individual room in the cases provided for in Article 97, § 2.
By derogation from paragraph 2, hospital doctors may charge supplements for admission to an individual room referred to in section 97, § 2, d), provided that:
1° the accompanying parent expressly opts, in accordance with the terms referred to in paragraph 6, for admission to an individual room;
2° the number of beds that the hospital provides for the accommodation of patients wishing to be admitted without charge, pursuant to Article 97, § 1er, has enough beds for children staying in the hospital with a accompanying parent.
Hospital doctors cannot, pursuant to paragraphs 1er and 3, charge supplements only provided that maximum rates are set in the general regulation referred to in section 144. This element of the general regulation is, prior to its application, communicated by the manager to the National Joint Hospital Medical Board and, through the National Disability Insurance Institute, to insurance organizations.
§ 3. The manager and the medical board shall ensure that patients admitted to two-bed or common-bed rooms, as well as patients admitted to a single-bed room in the cases referred to in section 97, § 2, with the exception of the exemption provided for in paragraph 2, paragraph 3, shall be provided with care without charge by hospital doctors. The manager, after consultation with the medical council, shall take the necessary measures to that end and inform the medical council.
The King may establish terms and conditions for the application of paragraph 1er.
§ 4. The King may, by order deliberately in the Council of Ministers, define additional categories of patients to whom hospital doctors cannot, under paragraph 2, charge an additional charge in the event of admission to an individual room.
§ 5. Hospital physicians may not, for admission to a room with two beds or in a common room, apply supplements to the flat fee payable by admission and/or a day of hospitalization for the services of clinical biology or medical imaging, on all the components of such fees.
Hospital physicians may not, for admission to a single room, apply supplements on the lump sum fees payable by admission and/or day of hospitalization for clinical biology or medical imaging services, on the lump sum portion of such fees.
§ 6. In the event of the admission of a child accompanied by a parent referred to in Article 97, § 2(d), a separate document shall be submitted to the signature of that parent at the same time as the declaration of admission. This document provides for the option of choosing an admission that does not allow hospital doctors to charge supplements, i.e. a two-bed room or a common room.
In this document, the accompanying parent may waive the option of choice referred to in paragraph 1er and choose expressly for a stay in a single room.
In the event of the absence of the signed document, in which the accompanying parent makes a choice, hospital doctors cannot charge supplements. »
Art. 27. Section 153 of the Act is supplemented by a paragraph written as follows:
"Hospital physicians inform the manager whether or not they are related to the agreement referred to in section 50 of the Compulsory Health Care and Compensation Insurance Act, coordinated on July 14, 1994. The manager informs the medical board. »
Section 2. - Abrogatory provision
Art. 28. The Royal Decree of 29 September 2002 enforcing section 138 of the Hospitals Act, coordinated on 7 August 1987, is repealed.
Section 3. - Entry into force
Art. 29. Sections 23 to 28 come into force on 1er January 2013.
Section 4. - Opinion of the National Medical Commission
Art. 30. The opinion of the National Medical-Mutualist Commission, in accordance with the defiant terms set out in section 50, § 2, of the Compulsory Health Care and Compensation Insurance Act, coordinated on 14 July 1994, is requested on any amendment to section 152 of the Hospitals Act and other care facilities, coordinated on 10 July 2008, or its enforcement orders.
CHAPTER 4. - Help granted by the C.P.A.S.
Section 1re. - Amendments to the Act of 2 April 1965 on the care of relief provided by public social action centres
Art. 31. In the Act of 2 April 1965 on the care of relief provided by public welfare centres, an article 9bis is inserted as follows:
"Art. 9bis. When the costs are borne by the State in accordance with Articles 4 or 5, a social investigation finds the existence and extent of the need for assistance.
The King may determine the elements of the social investigation that will be subject to the Minister's control. "
Art. 32. In the same law, an article 9ter is inserted as follows:
"Art. 9ter. § 1er. Articles 9 and 10, § 1er, are not applicable when the public centre of social action makes a decision on medical and pharmaceutical assistance, with or without hospitalization, in a care facility, granted to indigent persons, not receiving health insurance covering the risks in Belgium and not being insured on the basis of the law on compulsory health care and allowances, coordinated on 14 July 1994, and the Royal Decree of July 3, 1996
The King may, by order deliberately in the Council of Ministers, extend the scope of this article:
- indigent persons with health insurance covering the risks in Belgium or insured on the basis of the above-mentioned law, or who may be insured;
- medical and pharmaceutical assistance provided by caregivers outside the care facility referred to in section 2, n), of the aforementioned law.
§ 2. The decision referred to in paragraph 1er cannot relate to the aids given during a period that began more than forty-five days before that decision.
§ 3. When the public social action centre makes a decision referred to in paragraph 1er, it shall enter it into the database determined for this purpose in the manner determined by the Minister and at the latest in the communication to the interested party of the decision of the centre.
§ 4. In the absence of introducing the decision in accordance with paragraph 3, the public welfare centre shall take charge of these costs within the limits of Article 11, § 1erstarting on the ninth day from the decision date until the time it introduces this decision into the database.
§ 5. In the case referred to in paragraph 1er, the Auxiliary Disability Insurance Fund is responsible for conducting checks and reimbursement of the costs of the aforementioned aid on behalf of and on behalf of the State.
An advance will be paid to the Auxiliary Disability Insurance Fund.
Each month, on the basis of an electronic monthly statement, the State reimburses the amounts paid to the Auxiliary Disability Insurance Fund.
The King determines the terms of controls and refunds.
On the proposal of the Insurance Committee of the National Institute of Invalid Health Insurance, the Federal Public Service for Programming Social Integration, Poverty Reduction, Social Economy and Policy of the Great Cities sets out the electronic billing instructions applicable to the billing of medical and pharmaceutical assistance referred to in paragraph 1er. »
Art. 33. Section 10 of the Act, the current text of which will form paragraph 1er, is supplemented by paragraph 2, as follows:
Ҥ2. In the event of a lack of social investigation as provided for in Article 9bis, the Minister shall recover, from the public centre of social action, the costs incurred by the State. "
Art. 34. In Article 11, § 1erParagraph 2, inserted by the Act of 27 December 2005, is repealed.
Art. 35. In Article 11, § 2, of the same law, as amended by the Act of 22 December 2003, the words "as long as a pre-social investigation has made it possible to see the existence and extent of the need for social assistance" are repealed.
Art. 36. In article 12, paragraph 1er, from the same law, the words "Recoverable fees are" are replaced by the words "With the exclusion of the costs provided for in section 9ter, the recoverable costs are".
Section 2. - Entry into force
Art. 37. The King successively determines the dates of entry into force of section 32 and section 36 for the public social action centres and the care institutions concerned.
Promulgation of this law, let us order that it be clothed with the seal of the State and published by the Belgian Monitor.
Given in Brussels, 27 December 2012.
ALBERT
By the King:
The Minister of Social Affairs and Public Health, in charge of Beliris and Federal Cultural Institutions,
Ms. L. ONKELINX
The Minister of Justice,
Ms. A. TURTELBOOM
The Secretary of State for Asylum and Migration, Social Integration and Poverty Reduction
Ms. M. DE BLOCK
Seal of the state seal:
For the Minister of Justice, absent,
Deputy Prime Minister and Minister of Pensions
A. DE CROO
___
Note
(1) Session 2012-2013.
House of Representatives.
Documents. - Bill, 53-2524 - No. 1. - Report (Social Affairs), 53-2524 - No. 2. - Amendments, 53-2524 - No. 3. - Report (Public Health), 53-2524 - No. 4. - Text adopted by the commission, 53-2524 - No. 5. - Amendment, 53-2524 - No. 6. - Text adopted by the commission, 53-2524 - No. 7. - Text adopted in plenary and transmitted to the Senate, 53-2524 - No. 8.
Full report. - 19 and 20 December 2012.
Senate.
Documents. - Project referred to in the Senate, 5-1895 - No. 1. - Report, 5-1895 - No. 2. - Decision not to amend, 5-1895 - No. 3.
Annales of the Senate. - 21 December 2012.