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)

Read the untranslated law here: http://www.ejustice.just.fgov.be/cgi/article_body.pl?numac=2012022488&caller=list&article_lang=F&row_id=1300&numero=1397&pub_date=2012-12-31&dt=LOI&language=fr&fr=f&choix1=ET&choix2=ET&fromtab=+moftxt&trier=publication&sql=dt+=+'LOI'&tri=pd+AS+RANK+

Posted the: 2012-12-31 Numac: 2012022488 SERVICE PUBLIC FEDERAL security social 27 December 2012. -Miscellaneous Provisions Act accessibility to healthcare (1) ALBERT II, King of the Belgians, to all, present and to come, hi.
The Chambers have adopted and we endorse the following: Chapter 1. -Disposition introductory Article 1. This Act regulates a matter referred to in article 78 of the Constitution.
CHAPTER 2. -Amendments to the law on compulsory health care and benefits, insurance co-ordinated on 14 July 1994 Section 1st. -Unaccompanied foreign minors art.
2. at article 32, paragraph 1, 22 °, of the law on compulsory insurance health care and benefits, co-ordinated on 14 July 1994, inserted by the law of December 13, 2006, 1st paragraph is completed with the following sentence: "the King may determine the periods which are assimilated to periods of attendance at the Basic or secondary level education.
' Section 2. -Withdrawal stop smoking article 3. in article 34, paragraph 1, of the Act, as amended, as last amended by the Act of December 23, 2009, 24 ° is replaced by the following: '24 ° intervention in smoking cessation assistance. The King may extend the intervention of smoking cessation drug assistance insurance; ».
Section 3. -Prosthetics hair art.
4. in article 34, paragraph 1, of the Act, as last amended by the Act of December 23, 2009, is inserted the 20 ° bis worded as follows: '20 ° bis the provision of hair prostheses;'.
S. 5. in article 35, § 1, paragraph 8, of the Act, replaced by the law of August 10, 2001 and amended by law of August 22, 2002 and December 22, 2003, the words 'and 20 °' are each time replaced by the words ", 20 ° and 20 ° bis '.
S. 6. in article 37, § 20, paragraph 1, of the Act, inserted by the law of 22 February 1998 and amended by the law of 27 April and 27 December 2005, 'the benefits referred to in article 34, 14 °, 24 ° and 25 °' shall be replaced by the words "the benefits set out in article 34, 14 °, 20 °, 24 ° and 25 °.
Section 4. -Radioisotope article 7. in article 18, paragraph 4, of the Act, replaced by the law of January 25, 1999 and amended by laws of December 24, 1999 and August 10, 2001, «a note summarizing changes to the list referred to in article 35bis» shall be replaced by the words "two summary notes, the first containing the amendments to the list referred to in article 35. «, § 2B, and the second amendments to the list referred to in article 35A.
S. 8. in article 22, paragraph 1, 4 °, of the same Act, replaced by the law of 27 December 2005, the words ' referred to in articles 23, § 2, 35, § 1, and 35, § 2B» are replaced by the words ' referred to in articles 23, § 2 and 35, § 1.
S. 9. in article 27, paragraph 4, of the Act, replaced by the law of 24 December 1999, and amended by the law of 10 August 2001 and December 24, 2002, "referred to in paragraph 2" shall be replaced by the words "provided for in article 35 § 2.
S. 10. in article 35 of the same Act, paragraph 2b, replaced by the law of 27 December 2005 and amended by the law of December 13, 2006, is replaced by the following: "§ 2B.» The King confirms the list of reimbursable radioisotopes referred to in article 34, paragraph 1, 5 °, d). On proposal of the technical Council of the radioisotopes, or after notice of it, the Minister shall amend the list of reimbursable radioisotopes referred to in article 34, paragraph 1, 5 °, d), as well as the conditions for reimbursement y related. On proposal of the technical Council of radioisotopes, the King determines the procedure to be followed by those seeking admission, alteration or deletion of a product on the list of reimbursable radioisotopes. It also defines the deadlines and obligations in the event of application for admission, change, or delete. For the purposes of this paragraph, the King can equate with refundable radioisotopes of radioactive materials or radioactive renditions that belong to other categories of health benefits. » Art. 11. in article 37, paragraph 3, of the Act, as amended by laws of 22 December 2003, 27 December 2005 and 13 December 2006, article 6 is repealed.
S.
12. in title III, chapter V, of the Act, there shall be inserted a section XXI with a 77quinquies article as follows: "Section XXI. -Bonds of firms which put radiopharmaceuticals on the Belgian market and request their admission repayment s.
77quinquies. § 1. The firm that puts produce radiopharmaceuticals on the Belgian market and who has requested a refund is required, from the introduction of an application for refund, guarantee that the radiopharmaceutical product concerned will be actually available at the latest at the date of entry into force of the refund and guarantee the continuity of the availability of the product.
When the firm that puts produce radiopharmaceuticals on the Belgian market and which has requested the refund is unable to supply the market for packaging, packaging is considered to be unavailable. The firm shall notify the start date, the presumed end date and the reason for the unavailability the technical Council of the radioisotopes.
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2. If the Institute health care Service is informed of the unavailability of a radiopharmaceutical otherwise than by the firm, it asks for confirmation to the firm that the product is actually unavailable.
The firm has 14 days from the receipt of this request to confirm or refute the unavailability by sending recommended with acknowledgement of receipt. If it reverses it, she attached to sending evidence attesting that the product is available. If the firm confirms the unavailability, it specifies the start date, the presumed end date and the reason for unavailability.
If the firm does not respond within the time limit, or if elements provided by the firm are insufficient to establish with certainty the availability of the product, the specialty is removed as soon as possible the list of right and without taking into account the procedures determined under article 35 § 2B.
§ 3. If the firm communicates that conditioning is going to be unavailable for more than three months, or if the absence lasts longer than three months, concerned packaging is removed from right of the list, without taking account of the procedures determined under article 35 § 2B, respectively the first day of the month following the expiry of a period of 10 days from the receipt of the notification or the first day of the fourth month of downtime.

§ 4. If the downtime is the result of a proven cases of force majeure, the packaging is of right to new registrant on the list the first day of the month following the end of the unavailability, without taking account of the procedures determined under article 35, § 2B. » Section 5. -Maximum charging s. (13A article 37sexies, paragraph 8 (1) of the Act, inserted by the law of June 5, 2002 and amended by the law of 27 December 2005 and December 22, 2008, the following changes are made: 1 ° in the a), the words "personal interventions laid down pursuant to article 37, § 2 (b), for proprietary medicinal products which are classified into categories A. ", Refundable B and C in the list of medicinal products" shall be replaced by the words "personal interventions for proprietary medicinal products which are classified into categories A, B, C, Fa and Fb in list of proprietary medicinal products reimbursable."
2 ° 1 ° is supplemented by g) worded as follows: ' g) the lump sum personal intervention which is supported in accordance with article 37, § 3/3, by recipients who stay in rest and nursing homes and care centres by day, approved by the competent authorities, or in nursing for elderly homes or short stay centres. approved by the competent authority, or in institutions which, without be approved as rest homes, constitute the home or the common residence of the elderly, and which meet the conditions laid down by the King. » Art.
14A article 37septies, paragraph 1, first indent, of the Act, inserted by the law of June 5, 2002 and amended by the acts of 24 December 2002, 27 December 2005 and 22 December 2008, the following changes are made: 1 ° the words "pharmaceutical specialities of categories A, B and C ' are replaced by the words" pharmaceutical specialities of categories A. ', B, C, Fa and Fb.
2 ° the words ' the lump sum personal intervention which is supported by the recipients who stay in rest and nursing homes and care centres day, approved by the competent authorities, or in nursing for elderly homes or centres of short stay, approved by the competent authority, or in institutions which, without be licensed as nursing homes. ", are the home or the common residence of the elderly, and which meet the conditions laid down by the King" shall be inserted between the words "House of psychiatric care", and the words "and any difference."
S. 15. articles 13 and 14 shall take effect March 1, 2012.
Section 6. -Status chronic s.
16. in title III of the Act, it is inserted a chapter IIIter: "chapter IIIter. Chronic disease status.

S. 17. in chapter IIIter, inserted by article 16 article be inserted a 37vicies/1 as follows: «art.» 37vicies/1. The King establishes, on a proposal from the Working Group insurability under article 31bis, or after notice of this group of work made at the request of the Minister of Social Affairs within the time fixed by him and following the opinion of the Committee on insurance, by Decree deliberated in the Council of Ministers, a chronic disease status to which it binds the rights that it determines. In the preparation of this status, particular account shall be taken of one or more of the following criteria: 1 ° a minimum amount of health expenses of a beneficiary fixed by the King, on a period of time determined by the King;
2 ° the benefit of the allocation referred to in article 37 § 16A, 2 °;
3 ° be achieved a rare or orphan disease.
On proposal of the insurability working group referred to in article 31bis and following the opinion of the Committee on insurance, the King determines, by Decree deliberated in the Council of Ministers, the conditions for opening, maintenance, withdrawal of chronic disease and the rights associated status.
It also specifies what is meant by "health costs" referred to in paragraph 1, 1 ° and «rare or orphan disease» for the purposes of paragraph 1, 3 °.
"Section 7. -Third fee art. 18. at article 53, § 1, of the Act, as amended by the law of 22 February 1998, January 25, 1999, December 24, 1999, June 26, 2000, January 14, 2002, December 27, 2004, 27 December 2005 and 19 December 2008, the following changes are made: 1 ° paragraph 8 is supplemented by the following sentence: "the King may, subject to the situations where the application of the system of the third party paying is mandatory. also specify the conditions and terms under which an application of the system of the third party paying ban is pronounced against individual providers. »;
2 ° two paragraphs worded as follows shall be inserted between paragraphs 8 and 9: "from January 1, 2015, the obligation for implementing the third paying system is introduced for beneficiaries of the intervention increased the insurance referred to in article 37, § 19, and the beneficiaries of the chronic disease status referred to in article 37vicies/1 for medical benefits determined by the King. , either: 1 ° on the basis of a proposal by the commission competent agreements or conventions that decides its transmission to the Committee of insurance;
2 ° on the basis of the proposal made by the commission of agreements or competent agreements at the request of the Minister; These proposals shall be communicated to the Committee of insurance;
3 ° on the basis of the proposal of the Minister.
The procedure referred to in paragraph 9, 3 °, can be followed when the proposals of the Committee of conventions or agreements do not meet the objectives contained in the application referred to in article 9 (2).
In this case, the refusal of the proposal of the competent Committee of conventions or agreements must be motivated. » Section 8. -Sanctions art. 19. in article 37, § 6, paragraph 3, of the Act, 'the sanctions referred to in article 170' shall be replaced by the words "a level 2 sanction referred to in article 101 of the social Criminal Code.
Section 9. -Liaison Pediatric art.
20. in article 22, paragraph 1, 6 ° ter, of the same Act, replaced by the law of March 18, 2009, the words ", and referred to in article 34, 21 ° bis pediatric palliative home care teams" are repealed.
S. 21. in article 23 § 3A of the Act, inserted by the law of 22 February 1998 and amended by the Act of March 18, 2009, the words "and with the in-home pediatric palliative care teams referred to in article 34, 21 ° bis," are repealed.
S.
22. in article 34, paragraph 1, of the same Act, the 21 ° bis, inserted by the Act of March 18, 2009, is repealed.
CHAPTER 3. -Hospitals and other institutions Section 1. -Amendments to the Act relating to hospitals and other care facilities, coordinated on July 10, 2008, s. 23. in title I of the Act relating to hospitals and other care facilities, coordinated on July 10, 2008, inserted a chapter VI entitled "financial accessibility of the hospital.
S. 24. in chapter VI, inserted by article 23, there is an article inserted 30/1 as follows: «art.» 30/1. This article shall apply to hospital patients, including patients admitted to hospital of day for the services defined by the King.
Regarding the imputation of supplements, the King may, by Decree deliberated in the Council of Ministers, extend the provisions referred to in article 152, paragraph 2, subparagraphs 1 and 2, and article 152, § 4, for other categories of professionals of health referred to in the royal decree No 78 of 10 November 1967 on the practice of the professions of health care, in the hospital.
For the purposes of paragraph 2, means supplements, the amounts claimed in excess of mandatory tariffs if the conventions or agreements as referred to in title III, chapter V, sections Ire and (II) of the Act on insurance compulsory health care and benefits, co-ordinated on 14 July 1994 shall apply, or rates that are the basis for the calculation of the intervention of the insurance if such conventions or agreements are not in force. » Art. 25. in article 98, paragraph 2, of the Act, the words ", paragraph 3" are repealed.
S. 26. article 152 of the Act is replaced by the following: «art.» 152 § 1. This article shall apply to hospital patients, including patients admitted to hospital of day for the services defined by the King after the opinion of the Commission nationale Medico-mutualiste.
The Minister may request the Board to form an opinion within a period of one month. If notice is not formulated within the desired time or the Minister may join, it can submit its own proposal to the Commission. The Commission then renders an opinion on this proposal within a period of one month. This notice is considered have been given if notice has not been formulated in this period.
§ 2. Hospital doctors can charge rates that deviate from the rates of the agreement in the event that an agreement referred to in article 50 of the Act on compulsory health care and benefits insurance, co-ordinated on 14 July 1994, is in force, or rates that deviate from the rates which serve as basis for the calculation of the intervention of insurance in case such an agreement is not in force , as for admission to single room.
For the purposes of this article, supplements, means the rates that deviate.
By way of derogation from paragraph 1, hospital doctors can charge supplements for admission to single room in the cases provided for in article 97, paragraph 2.
By way of derogation from paragraph 2, hospital doctors can charge supplements for admission to single room referred to in article 97, § 2, d), provided that: 1 ° the parent accompanying expressly opts in the manner referred to in paragraph 6, for admission in single room;
2 ° the number of beds that the hospital makes available for the accommodation of patients wishing to be admitted without supplement, in application of article 97, § 1, has enough beds for children staying in the hospital with one accompanying parent.
Hospital doctors cannot, pursuant to paragraphs 1 and 3, charge supplements that maximum rates are set out in the General rules referred to in article 144. This element of the General Regulation is, before its application, provided by the Manager to the Commission paritaire nationale doctors-hospitals and, through the national Institute for sickness and invalidity, to insurers.
§ 3. The Manager and the medical Council guarantee that patients admitted in double room or in the common room, as well as patients admitted in a single room in the cases referred to in article 97, paragraph 2, with the exception of the derogation provided for in paragraph 2, subparagraph 3, receive care without that supplements are charged to them by hospital doctors. The Manager, after consultation with the medical Council, takes the necessary measures to this end and shall inform the medical Council.
The King may establish detailed rules for the application of paragraph 1.
§ 4. The King may, by Decree deliberated in the Council of Ministers, define additional categories of patients that hospital doctors cannot, under subsection 2, charge supplement in case of admission in a single room.
§ 5. For admission in twin or shared room, hospital doctors may apply supplements to the lump sum fees payable by admission or hospitalization day for clinical biology or medical imaging benefits on all the fees such components.
For admission to single room, hospital doctors can apply supplements on the lump sum fees payable by admission or hospitalization day for clinical biology or medical and imaging services on the lump-sum portion fees said.
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6. In the case of admission of a child accompanied by a parent referred to in article 97, § 2, d), a separate document is subject to the signature of the parent at the same time that the statement of admission. This document provides the opportunity to choose an admission to hospital doctors to charge

supplements, namely an admission in twin bedroom or common room.
In this document, the parent accompanying can renounce the possibility of choice referred to in paragraph 1 and opt for a stay in a single room.
In the absence of the signed document, in which the parent accompanying makes a choice, hospital doctors cannot under any circumstances charge supplements. » Art. 27. article 153 of the Act is supplemented by a paragraph worded as follows: "hospital doctors do know the Manager if they are bound under the agreement referred to in article 50 of the Act on compulsory insurance health care and benefits, co-ordinated on 14 July 1994. '' The manager shall inform the medical Council. ' Section 2. -Provision repealing art. 28. the royal decree of 29 September 2002 implementing article 138 of the hospitals Act, coordinated on August 7, 1987, is repealed.
Section 3. -Entry into force art. 29. articles 23 to 28 come into force January 1, 2013.
Section 4. -Opinion of the Commission nationale Medico-mutualiste arts. 30. the opinion of the Commission nationale Medico-mutualiste, pursuant to the terms defi ned in article 50, § 2, of the law on compulsory health care and benefits, co-ordinated on 14 July 1994, insurance is required on any amendment of article 152 of the Act relating to hospitals and other care facilities, coordinated on July 10, 2008, or its orders for execution.
CHAPTER 4. -Relief by the C.P.A.S. Section 1st. -Amendments to the Act of 2 April 1965 support for relief by the public centres for social action article
31. in the Act of 2 April 1965 support for relief by the public social welfare centres, it is inserted an article 9bis worded as follows: «art.» 9bis. where the costs are borne by the State in accordance with articles 4 or 5, a social survey finds that the existence and extent of the need for assistance.
The King may determine the elements of social survey to be submitted to the control organized by the Minister. ».
S. 32. in the same Act inserted an article 9ter as follows: «art.» 9B. § 1. Articles 9 and 10, § 1, are not applicable when the public social welfare centre shall take a decision concerning medical and pharmaceutical aid with or without hospitalization, custodial care, granted to indigent persons, does not benefit from health insurance covering the risks in Belgium and could not be insured on the basis of the law on compulsory health care and compensation insurance co-ordinated on 14 July 1994, and of the royal decree of 3 July 1996 on the execution thereof.
The King may, by Decree deliberated in the Council of Ministers extend the scope of this article:-to indigent persons benefiting from health insurance covering the risks in Belgium or; or provided on the basis of the above-mentioned Act,
(- in medical and pharmaceutical aid granted by caregivers out of care referred to in article 2, n), of the aforementioned Act.
§ 2. The decision referred to in paragraph 1 may not bear on aid granted during a period that started more than forty-five days prior to that decision.
§ 3. When the public social welfare centre shall take a decision referred to in paragraph 1, he introduces him to the database determined for this purpose with the manner set by the Minister and no later than when the communication to the party concerned of the decision of the centre.
§ 4. In the absence of having introduced the decision pursuant to paragraph 3, the public social welfare centre supports these costs within the limits of article 11, § 1, from the ninth day of the date of decision until the moment where he introduced this decision in the database.
§ 5. In the case referred to in paragraph 1, the auxiliary sickness and invalidity insurance is responsible for carrying out controls and the reimbursement of the abovementioned aid in the name and on behalf of the State.
An advance will be paid to the auxiliary sickness and invalidity insurance.
Each month, on the basis of a monthly electronic State, the State reimburses the auxiliary sickness and invalidity insurance payments.
The King determines the terms of checks and refunds.
On proposal of the Insurance Committee of the national Institute of invalid insurance, the Service public fédéral of programming Social Integration, fight against poverty, social economy and urban policy fixed the invoicing instructions electronically for the billing of medical and pharmaceutical aid referred to in paragraph 1.
» Art. 33. article 10 of the Act, including the current text will form the 1st paragraph, is supplemented by a paragraph 2, to read as follows: ' ' § § 2 2 In the absence of such social survey as provided for in article 9A, the Minister recovers, with the public Center of social action, the costs borne by the State. ».
S. 34. in article 11, § 1, of the Act, section 2, inserted by the law of 27 December 2005, is hereby repealed.
S. 35. in article 11, § 2, of the Act, as amended by the Act of 22 December 2003, the words "insofar as an investigation social advance has revealed the existence and extent of the need for social assistance" are repealed.
S. 36. in article 12, paragraph 1, of the Act, the words "recoverable costs are" are replaced by the words "excluding the costs provided for in article 9ter, recoverable costs are."
Section 2. -Entry into force art. 37. the King successively determines the dates of entry into force of article 32 and article 36 for the public social welfare centres and institutions concerned care.
Promulgate this Act, order that it self under the seal of the State and published by le Moniteur.
Given in Brussels, December 27, 2012.
ALBERT by the King: the Minister of Social Affairs and public health, Beliris and Federal Cultural Institutions, Ms. L. ONKELINX. the Minister of Justice, Ms. A. TURTELBOOM. the Secretary of State to asylum and Migration, Social Integration and the fight against poverty Ms. M. BLOCK sealed with the seal of the State: to the Minister of Justice absent, the 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 meeting and transmitted to the Senate, 53-2524 - No. 8.
Compte rendu intégral. -19 and December 20, 2012.
Senate.
Documents.
-Project mentioned in the Senate, 5-1895 - No. 1. -Report 5-1895 - No. 2. -Decision not to amend, 5-1895 - No. 3.
Annals of the Senate. -21 December 2012.