Act Establishing Measures In Health Care

Original Language Title: Loi portant des mesures en matière de soins de santé

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now for only USD$20 per month, or Get a Day Pass for only USD$4.99.
Posted the: 2002-09-10 Numac: 2002022684 Ministry of Social Affairs, of the health public and of the environment 22 August 2002. -Law concerning measures ALBERT II, King of the Belgians, healthcare to all, present and to come, hi.
The Chambers have adopted and we endorse the following: title I:. -Available general Article 1. This Act regulates a matter referred to in article 78 of the Constitution.
TITLE II. -Social Affairs chapter I.
-Provisions relating to General Medicine articles 2. article 28, § 2, paragraph 6, of the law on compulsory insurance health care and benefits, co-ordinated on 14 July 1994, is supplemented as follows: «the King determines after the opinion of the national medical commission substances for which decisions within the medical technical Council must be approved by at least half of practitioners entitled to vote or doctors-specialists with the right to vote.
This notice is supposed to have been given if it is not made within one month following the request. » Art. 3. in article 36A of the Act, inserted by the law of 10 December 1997, inserted a § 3, worded as follows: ' § § 3 3» The King fixed according to the procedure laid down in the § 1, the terms and conditions of a plan whereby a bonus is granted to some doctors if they meet criteria qualitative or quantitative medical practice as laid down by the national Council for the promotion of quality in the performance or the prescription of health care benefits. It can determine that for this purpose lump intervention referred to in article 50, § 6, last paragraph is increased. » Art. 4. an article 36quinquies, worded as follows, shall be inserted in the Act: «art.» 36quinquies. The King determines the terms and conditions under which insurance compulsory health care and allowances pays availability fees to doctors who participate in organized child care.
The order is made on the proposal of the national medical Commission. The Minister may request that the Commission makes a proposal within a period of one month. If the proposal is not made within the required 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 it was not formulated in this period. » Art. 5. an article 36sexies, worded as follows, shall be inserted in the Act: «art.» 36sexies. The King determines the terms and conditions under which insurance compulsory health care and allowances grants financial intervention physicians for the use of telematics and electronic management of medical records.
The order is made on the proposal of the national medical Commission.
The Minister may request that the commission makes a proposal within a period of one month. If the proposal is not made within the required 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 it was not formulated in this period. » Art.
6. an article 36septies, worded as follows, shall be inserted in the Act: «art.» 36septies. Without prejudice to the provisions of article 35, §§ 1 and 2, the King may fix the terms and conditions under which compulsory insurance health care and compensation pay fees to the general practitioner approved for the management of the global medical folder.
» Art. 7. article 50, § 2, paragraph 4, of the Act, amended by the acts of 10 December 1994, 20 December 1995 and 10 December 1997, is completed as follows: "agreements between doctors and insurers may set the substances for which the majorities of the members representing the medical profession, referred to in this paragraph must include, as the case half of the members who serve as general practitioners or half of members who serve as doctors-specialists. » CHAPTER II. -Clinical biology, medical imaging and dialysis s.
8. in article 16, § 1, 1 °, of the Act "to approval of the Minister, the global budgets of financial resources" shall be replaced by the words "for the approval of the Minister, the overall budgets of the financial resources referred to in article 69, § 4 and § § 5 5.»
S.
9. article 59, paragraph 1, of the Act, is supplemented by the following paragraph: "lump sum fees payable by day case are part of the budget of the benefits provided to hospitalized beneficiaries. » Art. 10. in title III, chapter V, of the same Act is inserted a section XIV-bis, as follows: "Section XIV bis. -Intervention in fees for hemodialysis, peritoneal in-home dialysis and dialysis in a collective autodialysis service s. 71A. § 1. The King fixed, after receiving the opinion of the Committee of health care insurance, the conditions in which the health care insurance is involved in fees for home hemodialysis and peritoneal at home, as well as dialysis fees for dialysis in a collective service of autodialysis. It also lays down the amount of this support.
§
2. Fixed King, after the opinion of the Commission for concluding the national convention between hospitals and insurers, the conditions under which health care insurance takes place in fees for hemodialysis performed in a Center for chronic haemodialysis approved by the competent authority. It also lays down the amount of this support. » CHAPTER III. -Reference amounts s. 11. an article 56ter, worded as follows, shall be inserted in the Act: «art.» 56ter. § 1. By way of derogation from the provisions of this law and its enforcement orders, reference amounts are applied annually by admission to the intervention of insurance granted to hospitalized recipients, with regard to the groups of benefits referred to in § 8, provided that they are included in the APR - DRG groups referred to in § 9.
Is understood by group APR - DRG: classification of patients into such diagnostic groups as described in the manual "All Patient Refined Diagnosis Related Groups, manual Definition, version 15.0.
§
2. These reference amounts are calculated for the APR - DRG targeted groups in the § 1 for classes 1 and 2 of clinical severity and after removal of the 'outliers' of type 2 referred to in the orders made pursuant to section 87 of the Act on hospitals, coordinated on 7 August 1987.
§
3. The reference amounts concerned are equal to the average of expenditures by admission, plus 10%, and are based on the data referred to in article 206, § 2, of the Act and article 156, § 2, paragraph 2, of the Act of 29 April 1996 concerning the social provisions.
§
4. The reference amounts are calculated annually by the technical unit referred to in article 155 of the Act on April 29, 1996 on the basis of the data referred to in § 3, targeted benefits to the § 1 and subject to the opinion of the multi-stakeholder Structure hospital policy, referred to in article 153 of the Act of 29 April 1996 on the social provisions.
Reference by admission amounts are fixed for the first time for the year 2003 and are calculated on the basis of the data referred to in the first paragraph concerning admissions that end after October 1, 2002 and before December 31, 2003.
§
5. When actual expenditures for all covered admissions to the § 1 exceed a 10% hospital at least expenditures of reference calculated in accordance with § 4, the difference is deducted by the collection service central fees, referred to in article 135 and article 136 of the Act on hospitals, coordinated on 7 August 1987, fees charged to insurance. The King determines deadlines and fixing and communication of the amounts involved, the manner in which they are deducted by the service for the central collection of the fees and their accounting by insurers. Until the date determined by the King, this adjustment is limited to the APR - DRG groups listed in § 9, 1 °.
The Manager of the hospital and hospital doctors have a shared responsibility in accordance with the regulation referred to in article 135, 1 °, paragraph 2 or article 136, paragraph 1, of the Act on hospitals, coordinated on 7 August 1987, amended by the law of 14 January 2002.
Administrative control Service is responsible for the monitoring of the implementation of the provisions of paragraph 1.
§ 6. The King sets the arrangements and the pricing method of the amounts referred to in § 5, for the closure of the accounts of insurance health care and of the application of the provisions on financial liability of insurers.
§ 7. When, for more than half of the APR - DRG groups, referred to in § 9, identified in a hospital, actual expenditures for all covered admissions to the § 1 exceed 10% expenditures for the reference amounts calculated in accordance with § 4, data relating to the institutions concerned are, after these institutions were able to transmit their comments to the multi-stakeholder structure referred to in article 153 of the Act of 29 April 1996 for their correction possible, made public by the Institute on the Web page http://www.inami.fgov.be, without prejudice to the application of § 5.
§

(8. the following benefits groups are taken into account: 1 ° the benefits referred to in article 3, § 1, A, II, C, I, in article 18, paragraph 2, B, e), and article 24 § 1, except lump-sum refunds, of the annex to the royal decree of 14 September 1984 establishing the nomenclature of health insurance benefits mandatory health care and allowances;
2 ° the benefits referred to in article 17, § 1, 1 °, 2 °, 3 °, 4 °, 5 °, 6 °, 7 °, 8 °, 9 °, 10 °, 11 °, 12 °, 17 bis in 17ter, except lump-sum refunds and angiography, of the annex to the royal decree of September 14, 1984, supra.
3 ° the benefits referred to in article 3, except for benefits in clinical biology, in article 7, article 11, article 20 and article 22 of the annex to the royal decree of September 14, 1984, supra.
§
9. The diagnosis groups are formed on the basis of the "All patient Refined Diagnosis Related Groups, Definitions Manual, Version 15.0: 1 ° APR - DRG 73-Interventions on the lens with or without vitrectomy, APR - DRG 97-adenoidectomy and tonsillectomy, APR - DRG 179 - ligation vein stripping, APR - DRG 225 - appendectomy, APR - DRG 228 - treatments of inguinal and femoral hernia, APR - DRG 263 - laparoscopic cholecystectomy, APR - DRG 302 - Interventions major joint , connecting members of the lower extremities without trauma, if the code of nomenclature 289085 - with total prosthesis (acetabular and femoral head) hip replacement has been documented, APR - DRG 302 - Interventions major joint, connecting members of the ends lower without trauma, if the code of nomenclature 290286 - knee arthroplasty with articulated prosthetic has been attested, APR - DRG 313 - Interventions of the lower members and knees except foot If the nomenclature 300344 - therapeutic Arthroscopy (partial or total menisectomie) code has been documented, APR - DRG - 318 material removal of internal fixation, APR - DRG 482 - Prostatectomy transuretrale, APR - DRG 513 - Interventions on uterus/annexes, for carcinoma in situ, benign conditions if the nomenclature 431281 - total hysterectomy, abdominal code has been documented, APR - DRG 513 - Interventions on uterus/annexes for carcinoma in situ and benign diseases If the nomenclature code 431325 - total hysterectomy, vaginal testified, APR - DRG 516 - tubal ligation through laparoscopy, APR - DRG 540 - caesarean section in APR - DRG 560 - vaginal delivery;
2 ° APR - DRG 45-stroke with myocardial infarction, APR - DRG 46-stroke non-specific with precerebrale without infarct occlusion, APR - DRG 47 - transient ischemic attack, APR - DRG 134 - pulmonary embolism, APR - DRG 136 - malignant respiratory diseases, APR - DRG 139 - simple pneumonia, APR - DRG 190 - circulatory disorders with infarction, APR - DRG - 202 angina, APR - DRG 204 - Syncope and collapse, APR - DRG 244 - diverticulitis and diverticulosis APR - DRG 464 - urinary lithiasis, lithotripsy by ultrasound in APR - DRG 465 - urinary lithiasis with, without lithotripsy by ultrasound.
§ 10. In order to take account of developments in medical practices and differences in practices, the King may, by Decree deliberated in the Council of Ministers and after notice of the multi-stakeholder Structure referred to in article 153 of the Act of 29 April 1996, adapt the benefits referred to in section 8 and groups APR - DRG referred to the § § 9 9. ' CHAPTER IV. -Experimentation of limitation article 12. in article 56, § 2, 1 °, of the Act, the words ' prescription' are inserted after the word "special".
Chapter V. - Fines administrative s. 13. article 168, paragraph 3 of the same Act, as amended by laws of December 20, 1995 to December 24, 1999, is replaced by the following provision: "without prejudice to the provisions of section 52 of the Act of February 14, 1961, to economic expansion, social progress and financial recovery, administrative fines are imposed to physicians and practitioners of Dentistry which are not fees and other amounts resulting from the provisions of article 50. , § 11, as well as midwives, physiotherapists, nurse practitioners, auxiliary paramedical and managers of care facilities that do not meet the fees and prices resulting from the provisions of article 49, § 5.
The same administrative fine is imposed to the health care provider that has acceded to the agreement or to the convention and which does not respect the fees and prices are fixed.
The amount of the administrative fine is equal to three times the amount of the excess, with a minimum of EUR 125.
» Art. 14. in section 168bis of the Act, paragraphs 1 and 2, inserted by the law of August 10, 2001, shall be replaced by the following subparagraphs: ' for breach of the provisions of article 72bis, § 2, an administrative fine is imposed by the Service of administrative control to the firm which markets the medicinal product or the packaging (s) concerned, and charge of which the offence was established.»
The King fixed the amount of the fines the minimum cannot be less than eur 5000, and the maximum cannot exceed 100% of the turnover achieved on the Belgian market, with regard to the specialty or the packaging (s) in question, during the year preceding that in which the offence was committed. It also lays down detailed rules for the application of this penalty. » CHAPTER VI. -Provisions financial arts.
15 in article 40 of the same Act the following changes are made: 1 ° in the § 1, amended by the Act of 25 January 1999, 24 December 1999, January 14, 2002 and by the Royal Decrees of 10 December 1996 and 25 April 1997, paragraph 4 is replaced by the following provision: "from 2002, the general Council of the Institute can determine each year '. After opinion of the Committee of insurance and the Committee on budgetary control, which exceptional or special expenses are not taken into account in the calculation base for the application of this standard of maximum growth. The general Council's proposals are approved only when they get the majority of votes of the members entitled to vote, including vote of all members of the group referred to in article 15, paragraph 1, a). » 2 ° there is inserted a § 3a, as follows: "without prejudice to the competences of the Committee of insurance and the general Council, the King may, by Decree deliberated in the Council of Ministers, adapt the overall annual budget target and the partial annual budgetary targets when certain benefits or specific missions are supported from the budget of the financial resources fixed pursuant to article 87 of the hospitals Act. » Art. 16A section 136 of the Act, the following changes are made: 1 ° the § 1, replaced by the law of 24 December 1999 and amended by the Act of 12 August 2000, the following subparagraph is added: "the King fixed rules according to which the amounts which, pursuant to the international legal order, are dependants insurance, and which relate to the budget financial means attributed to hospitals. defined in article 87 of the hospitals Act are attached, charged, collected and accounted for. » 2 ° there shall be inserted a § 5, worded as follows: ' ' § § 5 5 The King lays down the rules under which the part of repair or recovery relating to the budget of the financial means allocated to hospitals, defined in article 87 of the hospitals Act, and which is included in the amounts that are paid into twelfths by insurers, is fixed, brought into account, recovered and recorded.
» Art. 17. article 164, paragraph 2, of the Act, as amended by laws of December 20, 1995 and December 24, 1999, is completed as follows: «the King lays down the rules under which unduly paid, which relate to the budget of the financial means allocated to hospitals, defined in article 87 of the hospitals Act, and benefits that are included in the amounts that are paid into twelfths by insurers. laid down, are brought into account, recovered and recorded.
» Art. 18. in article 191, paragraph 1, of the Act be replaced by the royal decree of 12 August 1994 and amended by the law of 20 December 1995, 26 July 1996, 22 February 1998, January 15, 1999, January 25, 1999, may 4, 1999, December 24, 1999, August 12, 2000, 2 January 2001 and 10 August 2001 and by the royal decree of 25 April 1997 , the following changes are made: 1 ° in 15 ° c, paragraph 1, 'the lists annexed to the royal decree of 2 September 1980 laying down the conditions under which compulsory insurance against disease and disability takes place in the cost of the pharmaceutical specialities and products similar' shall be replaced by the words «the list of reimbursable pharmaceutical specialties.»;
2 ° in 15 ° c, § 2, paragraph 1 is replaced as follows: ' pending the fixing of the additional levy referred to the § 1, 1st paragraph on overrun potential of expenditures for the year 2002, the pharmaceutical companies concerned are, in 2002, liable to pay an advance equal to 1.35 per cent of the turnover of the year 2001. '' A first part of the advance equal to 1 p.c. of the total turnover of the year 2001 shall be paid to account number 001-1950023-11 of the Institut national d'assurance maladie-invalidité before July 1, 2002, with the mention "first advance contribution additional fiscal year 2002. A second part

«advance equal to 0.35 per cent of the turnover of the year 2001 is paid to account number 001-1950023-11 of the Institut national d'assurance maladie-invalidité before December 15, 2002, with the mention "second advance fee supplementary exercise 2002;»
3 ° it is inserted a point 15 °, d, as follows: "for the year 2002, an additional contribution of 1.5 sq. ft..
turnover which was carried out during the year 2001 is introduced to the conditions and in the manner laid down in 15 °.
The declaration referred to in paragraph 4 of the 15 ° must be made before November 1, 2002.
The fee must be paid before December 1, 2002 on account n ° 001-1950023-11 the national sickness and invalidity insurance Institute, with the mention: "additional assessment 2001 turnover.
The revenue resulting from this additional contribution are charged in the accounts of the insurance mandatory healthcare for the accounting year 2002. » Art. 19A article 195, § 1, 2 °, of the same Act, replaced by the royal decree of 25 April 1997 and amended by the law of 22 February 1998, the following changes are made: 1 ° paragraph 3 is replaced by the following: "in 2002, these amounts are fixed at 732.075.000 EUR for the five national unions and 12.603.000 EUR for the Fund of the national Belgian railways company health care. These amounts are adapted annually by the King, by Decree deliberated in the Council of Ministers, taking into account:-the evolution of the average daily wage on the basis of the data of the federal Planning Bureau in the area of credit and insurance and public authority over the last three years preceding the establishment of budgets;
-half of the evolution of the standard of real growth in spending in the health care sector, referred to in article 40, § 1, paragraph 2, and the number of days compensated in the insurance sector allowances following a weighting of two thirds and one third, established for the same period.
This amount can also be adapted to take account of the new legal tasks entrusted insurers ';
2 ° in paragraph 4, 'this adaptation' shall be replaced by "these amounts."
3 ° paragraph 4 thus amended is supplemented by the following words: "in 2002 and 2003, this part amounts respectively to 49.578.700 EUR and 61.973.370 EUR for the five national unions and respectively to 852.760 EUR and 1.065.950 EUR for the Fund of the national Belgian railways company health care.
From 2004, these amounts are set at 10% of the annual amount of the administration fee. » Art. 20. in article 200 § 1 of the Act, replaced by the law of 21 December 1994, inserted a paragraph 2, as follows: "expenditure contained in these accounts, and which are accounted for by insurers on the basis of billing data provided by caregivers on magnetic media, under the scheme of the third paying referred to in article 53. are charged by insurers in receipt of accepted magnetic media. This must take place after the necessary validity checks. » Art. 21. article 217, paragraph 1, of the Act, is completed as follows: 'the accounting documentation corroborating these amounts paid in twelfths, are constituted by payment orders that the Minister, or the instance it designates for this purpose, passes to bodies insurers on the basis of the data and allocation keys set in the hospitals act coordinated on 7 August 1987. If these payment orders are not or cannot be carried out by insurers within the timeframe set by the competent Minister to fix the budget of financial means, care facilities may wear into account late payment interest insurance bodies. Such interest rate is the rate of money placed on deposit with the European Central Bank on the date of expiry of the period for payment. The burden of these interest is recognised as costs of ad ministration of the Institute health care Service where the delay is attributable to the transmission late or insufficient advances referred to in article 202. The King may lay down rules concerning the interests of delay when actual expenditures exceed the budget target. Otherwise, those interests are reimbursed by insurers to charge the amount of the administration fee referred to in article 195. The payment of these payment orders is not subject to the rules for payment according to the chronological order of registration in the billing of the entries, except for the payments made before the date of expiry of the period for payment. ' Chapter VII financing of care for elderly art. 22. in article 69, § 4, of the Act, as amended by the royal decree of March 24, 1997, the following changes are made: 1 ° A first paragraph, 'article 34, 11 ° and 12 °' shall be replaced by the words 'article 34, first paragraph, 11 °, as regards rest and nursing homes or day care centers. ', or 12 ° ";
2 ° paragraph 2 is replaced by the following: "the King may, on the proposal or after competent convention commission opinion within thirty days following the request of the Minister, set the terms and criteria for the calculation of a budget of financial means and of intervention by an institution referred to in article 34, paragraph 1 day , 11 ° in respect of rest and nursing homes and/or care day, or for an institution referred to in article 34, paragraph 1, 12 °. If an institution is accredited both as a home of rest and care and/or care centre day or as an institution referred to in article 34, paragraph 1, 12 °, the King may set terms and criteria for the calculation of a budget of financial means and of intervention by day for the entire institution. To avoid that this budget of the financial means is exceeded, the King may set the terms and additional criteria that may take into account the number of beds for which the establishment is approved, its occupancy rate, a quota of days and/or the overall budget referred to in the preceding paragraph. »;
3 ° paragraphs 3 and 4 are repealed.
CHAPTER VIII. -Representation in the organs of INAMI s. 23. article 21 § 1 of the Act, as amended by laws of December 10, 1997 and December 24, 1999, is supplemented by the following paragraph: «a representative of the control Service, referred to in article 49 of the law of 6 August 1990 on hospitals and the national Unions of mutual societies attends the meetings of the Committee with advisory voice.»
S. 24. article 79 of the Act is supplemented by the following paragraph: «a representative of the Office of control referred to in article 49 of the law of 6 August 1990 on mutual societies and the national unions of mutual societies attends the meetings of the Committee with advisory voice.»
S. 25. in article 86, paragraph 3, of the Act, the following subparagraph shall be inserted between paragraphs 4 and 5: «a representative of the Office of control referred to in article 49 of the law of 6 August 1990 on mutual societies and the national unions of mutual societies attends the meetings of the Committee with advisory voice.»
CHAPTER IX. -Podiatrists and dieticians s.
(26. in article 2, m), of the same Act, amended by the law of 24 December 1999, the words 'dietitians and chiropodists' are inserted after 'orthoptist.
S. 27 A article 23, § 2, paragraph 2, of the Act, as amended by the Act of 25 January 1999 and the royal decree of 25 April 1997, 'the nomenclature of functional rehabilitation benefits referred to in article 34, 7 °' shall be replaced by the words "the nomenclature of functional rehabilitation benefits referred to in article 34, paragraph 1, 7 °, 7 ter ° and 7 ° c.
S. 28. in article 34, paragraph first, of the act as amended by the law of 21 December 1994, 20 December 1995, February 22, 1998, January 25, 1999, December 24, 1999, August 12, 2000, 2 January 2001 and August 10, 2001, inserted a 7 ° ter and a 7 ° c, worded as follows: "7 ° ter care given by podiatrists;"
"7 ° c care given by dieticians;".
S. 29. at article 37, § 1, of the same law the following changes are made: 1 ° in the 1st paragraph, the reference 'article 34, 1 ° and 7 ° bis' is replaced by 'article 34, paragraph 1, 1 °, 7 bis, 7 ter and 7 ° ° c';
2 ° in paragraph 4, the words «in the cost of the benefits of speech therapy, kinesitherapy and physiotherapy» are replaced by the words "in the cost of the benefits of speech therapy, physiotherapy, physiotherapy, Podiatry and dietary.
Chapter x. - Provisions various arts. 30A article 35, § 1, of the Act, as amended by the law of 24 December 1999 and replaced by the law of August 10, 2001, the following changes are made: 1 ° marked '19 °' is inserted in the third sentence between the words "(and 5 °, has), ' and the words 'and 20' and the '19 °' is inserted in the fourth sentence between the words «insofar as it implants» , and the words 'and 20 °.
2 ° in the last paragraph, the words '15 °, 19 ° and 20 °' are added each time after the words 'article 34, paragraph 1, 5 °, a).
S. 31 A section 37quater of the Act, inserted by the law of December 30, 2001, the following changes are made:

1 ° to the first paragraph, the words "if it is found that this provider apply, misuse of significantly assessment instrument used to determine the response of the compulsory insurance for one or more beneficiaries' are replaced by the words"if it is found that the assessment instrument used to determine the intervention of one or more beneficiaries compulsory health care insurance is applied incorrectly significantly";
2 ° a paragraph 2, b), french text, the words "misuse" are replaced by the word "incorrectly".
S. 32A article 37sexies of the Act, inserted by the law of June 5, 2002, the first paragraph is added as follows: ' is also considered personal intervention, the contribution, required by the hospital, patients who are in a unit of emergency care, in implementation of article 107quater of the law of hospitals, coordinated on 7 August 1987.»
The King proceeds has an evaluation of this device two years after the entry into force thereof and submit a report thereon to the federal legislative chambers. » Art. 33. article 51, § 2, paragraph 5, of the same Act is supplemented as follows: 'these cuts may be a limitation of the index referred to in article 207bis, without taking into account the specific arrangements laid down by the King in pursuance of this article.'
S. 34 article 153 of the Act, as amended by the law of 20 December 1995 and 24 December 1999 and by order royal of 25 April 1997, paragraph 1 is replaced by the following subparagraphs: "the medical officers have to ensure the medical control of primary disability and health benefits, in accordance with the provisions of this Act.
Under the conditions and time limits laid down by the King, to the medical Council of disability they send the reports referred to in article 94, paragraph 1, and the jurisdiction allocated to them under sections 23, § 1, and 94, paragraph 2.
They also check if all of the conditions referred to in articles 35, paragraph 4, and 37, §§ 12 and 13, are well respected and report offences identified in the instances concerned, namely: 1 ° the Service of administrative control for the presence of staff and the conditions of remuneration;
2 ° the Service of the medical control for the effective provision of care covered by the procedures referred to in article 37, §§ 12 and 13;
3 ° the Service of healthcare for the other irregularities.
On the proposal of the Committee of insurance, the King can establish, to carry out missions of control of the benefits referred to in article 34, paragraph 1, 1 °, b), and of the establishments referred to in article 34, paragraph 1, 11 ° and 12 ° to the medical consultants, a national College of medical consultants as well as local colleges, placed under the tutelage of supra national College and which may include , in addition to least a consultant responsible for, practitioners of nursing, mandated by the physicians Council of insurers. On the proposal of the Committee on insurance, the King determines the composition, operation and missions of this national College and these local colleges. » Art. 35. in article 155, § 1, paragraph 1, 2 °, of the Act be replaced by the law of 28 December 1999, ' the rules of the insurance"or the Committee's guidelines, shall be replaced by the words" the rules of insurance, to the directives of the Committee or to the conditions and rules laid down in accordance with article 115, paragraph 3, of the Act on hospitals. " coordinated on 7 August 1987.
S. 36 article 165, paragraph 11, of the same Act, the words 'which has effect 1 July 1983', are deleted.
S.
37. in article 59, § 1, of the law of 10 August 2001 of the measures in health care, the second indent is replaced by the following text: "-articles 2 to 10 and articles 14, 16, 20, 22, which take effect January 1, 2002, on the understanding that article 6 comes into force without prejudice to the application of article 23.
' TITLE III. -Social Affairs and public health, chapter I. -Amendment of the Act on hospitals, coordinated on August 7, 1987, s. 38 § 1.
Article 4 of the law on hospitals, coordinated on 7 August 1987, amended by the law of 14 January 2002, is replaced by the following provision: «art.» 4. for the purposes of this coordinated Act are considered hospitals, hospitals which, having regard to their own function in the field of care, education and applied scientific research, satisfy the conditions laid down by the King and are designated as such by him on the proposal of the academic authorities from a Belgian University. »
§ 2. From a date to be fixed by the King and, later, March 31, 2003, section 4 of the Act, as amended in the § 1, is replaced by the following provision: "for the purposes of this coordinated Act, are considered hospitals, University Hospital, University Hospital functions, or academic programs, hospitals, hospital services Hospital functions or programs of care which, having regard to their own function in the field of care for patients, clinical education and applied scientific research, the development of new technologies and the evaluation of medical activities, satisfy the conditions laid down by the King and are designated as such by him on the proposal of the academic authorities from a Belgian university which has a medical school offering a complete curriculum.
In application of paragraph 1, only one hospital may be designated for each University which has a medical school offering a complete curriculum. » Art. 39. section 18 of the Act is supplemented by the following paragraph: "the skills of the national Council for hospital establishments, as referred to in this Act are exercised, subject to the application of articles 154 and 154ter of the Act of 29 April 1996 on the social provisions."
S. 40A article 86, paragraph 2, of the Act, as amended by the Act of 12 August 2000, 'the officials or agents' shall be replaced by the words "officials, attendants or medical consultants.
S. 41. in the same Act, it is inserted an article 86ter, worded as follows: «art.» 86ter. § 1.
Within the federal public Service health, food chain safety and environment, a Committee for the control of the registration of medical in the hospital activity data and for the evaluation of a policy justified on admissions may be created, hereinafter referred to as 'the Commission '.
§ 2. The King determines the rules of operation, the composition of the Commission, as well as the number of full and alternate members.
The members referred to in paragraph 1 are appointed by the King.
The Commission is chaired by the Director general of the Administration of health care.
§ 3. The Commission formulates, initiative or at the request of the Minister having health in his attributions or the President of the Commission or the President of the multi-stakeholder Structure with regard to the points 1 ° to 3 °, proposals relating to the following matters: 1 ° the methodology for the control of data relating to activity referred to in article 86, medical in the hospital;
2 ° the methodology for the assessment of the admission policy;
3 ° the Organization and realization of control and evaluation referred to in items 1 ° and 2 °;
4 ° the problems submitted to the Commission, relating, on the one hand, the accuracy and completeness of the records referred to the point 1 °, and this in accordance with the findings and conclusions of officials, attendants or medical consultants referred to article 115, and on the other hand, relating to the evaluation of the target admission policy to the point 2 °;
5 ° the problems submitted to the Commission with regard to the comments of interested parties subsequent to the notification of a report, as referred to in article 115 § 2, or to notification of a correction or a restraint regarding the budget of financial resources, as referred to in article 107, § 4, for as much as these documents relate to a data record related to the hospital medical activity.
The powers referred to in paragraph 1, 4 ° and 5 °, are exercised by the Commission only insofar as the issues in question were submitted by the Director-general of the Administration of health care. The Commission shall exercise the powers referred, on the basis of anonymous records by hospital.
§ 4. The methodology referred to in § 3, 1 ° and 2 ° is determined by the King.
S. 42 article 99, paragraph 2, of the Act, the words "The Minister having health in its attributions" are replaced by the words "The King".
S. 43. article 107 of the Act be replaced by the law of 14 January 2002, is supplemented by §§ 3 and 4, to read as follows: "§ § 3 3» If it is found by the persons referred to in article 115 as the recording of data relating to medical activities, referred to in article 86, does not correspond to reality or is incomplete, each impact at the level of funding is, pursuant to this Act and the Act, co-ordinated on 14 July 1994 relating to the compulsory insurance health care and benefits corrected ex officio.
To this end, the Director-general of the Administration of health care reports each infringement found to the Deputy Head of the national Institute for sickness and invalidity insurance.

The King may determine rules and procedures with regard to the application of this paragraph.
§ 4. Until the provisions referred to in §§ 1 and 3, are applied, the hospital concerned is informed.
Within a period of four weeks after the notification, the hospital can argue his remarks in writing with the Director-general of the administration of health care. » Art. 44. in the same Act, it is inserted into chapter V of title II, article 107quater, worded as follows: "§ 1.» A lump sum contribution of patients who are in an emergency care unit may be required by the hospital in accordance with the conditions laid down by the King, by a decree deliberated in the Council of Ministers. The King sets the amount of this contribution by a decree deliberated in the Council of Ministers.
§ 2. The King proceeds to an assessment of this device two years after the entry into force and submit a report thereon to the federal legislative chambers. » Art. 45A section 115 of the Act, as amended by the law of 14 January 2002, the following changes are made: 1 ° to § 2, the word 'three' is replaced by the word "ten";
2 ° § 2, is supplemented by a paragraph 2, as follows: 'Within four weeks after notification, the offenders referred to in paragraph 1 may make representations in writing to the Director-general of the Administration of health care.';
3 ° article is supplemented by a paragraph 3, reads as follows: "§ § 3 3» To control the registration of data concerning medical activity, referred to in article 86, officials or agents referred to in paragraph 1 may be assisted by medical officers of insurers, referred to in article 154 of the law on compulsory health care and benefits insurance, co-ordinated on 14 July 1994, who are appointed by the King on the proposal of the intermutualiste College.
For the accomplishment of their mission referred to in paragraph 1, the medical officers referred to in paragraph 1 have access to medical records referred to in article 15.
The King shall determine the conditions and the rules to which the medical officers referred to in paragraph 1 must respond. These conditions and rules may inter alia relate to incompatibilities with the mission referred to in this paragraph and the period during which they are made available for this mission.
Any irregularity committed by a medical officer in the exercise of his mission is reported by the Director general of the Administration of the medical health at the service of evaluation and Control Committee of the national Institute for sickness and invalidity insurance, and for the purposes of section 155, § 1, of the above-mentioned Act, co-ordinated on 14 July 1994. » Art. 46. in the same Act, title IV, chapter I, is supplemented by a Section 3, which reads as follows: "Section 3. -Transparency financial arts. 129bis. § 1. In order to guarantee financial transparency of financial flows within the hospital, a regular dialogue between the Manager and the medical Council is required.
To this end, a Finance Committee is created in each hospital, unless a permanent consultation Committee is already established and ensures the financial commission missions.
§ 2. The Financial Committee is composed jointly, on the one hand, a delegation of Manager and, secondly, a delegation of the medical Council. Delegations are respectively composed of members of management and management referred to in article 12, including at least a Manager, and hospital doctors appointed by the medical Council.
They may be assisted by a financial expert.
§ 3. The Finance Committee has all information as provided in article 128bis.
§ 4. The Financial Committee shall consider at least:-the annual budgetary estimates;
-the annual accounts;
-the reports of the company auditor referred to in articles 82 and 84;
-the nature of the fees charged.
§
5. If, as a result of the discussions referred to in § 4, measures are proposed in consensus, members of the Financial Committee shall defend them with the Manager, on the one hand, and of the medical board, other. § 6. The data referred to in paragraph 3 may be communicated to the medical Council by the delegate of the medical Council. » Art. 47. article 137 of the same Act is complemented by sections following, read: "the regulation referred to in article 135, 1 °, paragraph 2, or article 136, paragraph 1, determines including terms and conditions of allocation, with respect to individual physicians, the difference between actual expenditures and expenditures for reference scope in deduction of amounts charged, by the Central compulsory health insurance collection service. as referred to in article 56ter of the law on compulsory health care and benefits insurance, co-ordinated on 14 July 1994.
As long as the regulation, referred to in the preceding paragraph, is not included in the regulation referred to, the imputation against hospital doctors occurs according to the share of each of them in the mass of the fees of the Group of service providers to which it belongs within three months prior to imputation, the amount to be charged of the group being established on the basis of the relative share of this group in the observed excess taking into account the use of the fees listed in the implementation of article 140, to the exclusion of § 1, 2 °, and § 2. In the event that the implementation of article 140, § 1, 1 °, gives rise for concerned fees, to a 'pool' of remuneration by performance, the share of these is also charged proportionally compared to the 'pool' and following the rules in force with respect to individual hospital doctors.
For the purposes of paragraph 3, it is not taken into account the allocation referred to in article 140, § 1, 3 °, and § 3, insofar as coverage of costs is expressed on the basis of certified and real costs and in agreement with the medical Council.
in about another case, the target allocation is made in charge of the hospital doctor in competition 75 BW and the Manager of the hospital to a maximum of 25 p.c.» art. 48. at section 127 of the Act of 14 January 2002 on the measures in health care, the following changes are made: 'article 114 ceases to have effect two years after the entry into force of this Act.'
CHAPTER II. -Amendments to the Act of 29 April 1996 on the social provisions article 49. the title of chapter XII of the law of 29 April 1996 on the social provisions is replaced by the following heading: ' chapter XII. -Of the multi-stakeholder Structure hospital policy"s. 50. article 153, § 1, of the Act is replaced by the following provision: «art.» 153 § 1.
It is established with the federal public Service health, food chain safety and environment and the national sickness and invalidity insurance Institute a multi-party Structure Policy hospital, hereinafter referred to as 'Multi-stakeholder Structure.'
S. 51. article 154 of the Act is replaced by the following provision: «art.» 154. the Ministers who have public health and Social Affairs in their attributions may seek the opinion of the multi-stakeholder Structure on: 1 ° any rules regarding the use and dissemination of data on hospital activity coupled by the technical unit, referred to in article 155 of this Act;
2 ° the registration, collection, processing and utilization of statistics relating to the activities referred to in article 86 of the Act on hospitals, medical, coordinated on 7 August 1987;
3 ° the measures to be taken to ensure the reliability and the confidentialitedes data referred to 2 °, including the methodology referred to in article 86ter, § 3, 1 °, of the law on hospitals, coordinated on 7 August 1987;
4 ° offers it, accreditation standards and funding in relation to hospital activities, without prejudice to the procedures laying down and amending the nomenclature of medical benefits, referred to in article 35 of the law on compulsory health care and benefits insurance, co-ordinated on 14 July 1994;
5 ° the establishment of financial regulations and incentives to promote the effectiveness of the activities of the hospital and hospital doctors, without prejudice to the procedures laying down and amending the nomenclature of medical benefits, referred to in article 35 of the Act on compulsory insurance health care and benefits, co-ordinated on 14 July 1994;
If a notice, referred to 4 ° and 5 ° of 1 paragraph, was approved by a majority in each category of members, referred to in article 159, 2 °, 3 ° and 4 ° of the Act, any body referred to in the hospitals act shall, notwithstanding other laws on the subject, give an opinion. » Art. 52. in the same Act, is inserted an article 154bis, worded as follows: «art.» 154bis. The multi-stakeholder Structure ensures a role evaluation and information with regard to the practice in hospitals, provided that this generates costs.
It may, in the context of the assessment referred to in paragraph 1, be aware of the data compared to the benefits and conditions treated by hospital.
It establishes annually to the attention of Ministers who have public health and Social Affairs within their remit, an evaluation of the system of the reference amounts report.
The King may

secure conditions and following rules which data, where the identity of the hospital is known, are transmitted to the multi-stakeholder Structure.
The assessment referred to in paragraph 1 may give rise to actionable information and outreach for hospitals, initiated by the multi-stakeholder Structure.
The results of the evaluations referred to in this article, can be transmitted to the Service evaluation and medical control of the national Institute for sickness and invalidity insurance.
As a result of the assessments, referred to the this article, the multi-stakeholder Structure can make proposals for Ministers who have public health and Social Affairs in their powers, concerning measures to reduce unjustified differences in medical practice.
The multi-stakeholder Structure can, in relation to the above assessment, tasks to the structures of organization, referred to in article 15, § 2, of the Act on hospitals, coordinated on 7 August 1987.
The King may specify rules with regard to the implementation of this article. » Art. 53. in the Act is inserted an article 154ter, worded as follows: «art.» 154ter. § 1. The multi-stakeholder Structure formula, with respect to hospital policy, advice on the following matters: 1 ° the introduction or amendment of financial regulations, provided that these lead simultaneously to funding by budget the financial resources, referred to in article 87 of the hospitals Act, both coordinated on 7 August 1987 by the nomenclature of medical benefits referred to in article 35 of the law on compulsory health care and compensation insurance and co-ordinated on 14 July 1994, without prejudice to fixing and procedures of modification of the nomenclature of medical benefits, referred to in article 35 of the Act on compulsory insurance health care and benefits, co-ordinated on 14 July 1994;
2 ° the establishment of rules for the establishment of the reference amounts for standard interventions, such as referred to in article 56ter of the law of 14 July 1994;
3 ° compensation for inpatient drug consumption;
4 ° the General rules concerning the financing of endoscopic equipment and viscerosynthese and all other medical products used in the hospital;
(5) the methodology for the assessment of the admission policy.
If a notice referred to in 1 °, 4 ° and 5 °, 1 paragraph, was approved by a majority in each category of members, referred to in article 159, 2 °, 3 ° and 4 ° of the Act, any body referred to in the hospitals act shall, notwithstanding other legislation on the subject, give an opinion.
Two years after the appointment of the members of the Commission, referred to in article 86ter of the law on hospitals coordinated on 7 August 1987, the multi-stakeholder Structure prepares an evaluation report on the function of insurers in relation to the controls in the record, the admissions policy and medical practice. » Art. 54. in the Act is inserted an article 154quater, worded as follows: «art.» 154quater. The multi-stakeholder Structure has for mission to initiate a consultation in his breast, or at the request of at least one of the aforementioned Ministers, either on its own initiative, on all issues related to the problems of the coherence of the activities as well as the opinions and decisions formulated, on the one hand, by the organs of the federal public Service and, on the other hand , by the Institute, with regard to hospital policy. » Art. 55. at section 159 of the Act, the following changes are made: 1 ° to 1 °, the words "and a Vice President" shall be inserted between the words "of a president" and the word "appointed".
2 ° to 2 °, 3 ° and 4 °, the word 'eight' is be replaced each time by 'six '.
3 ° to 5 °, the word "four" is be replaced each time by 'five '.
4 ° to 5 °, the provision "-a member and an alternate member who are members of the Commission for the protection of private life", is replaced by the following: "-two members and two alternate members, including a representative of the federal public Service and the Institute";
5 ° to 5 °, the provision "-a full member, namely the president of the Commission for the supervision and evaluation of statistical data concerning medical hospital activities, or his representative and one substitute who is a member of the same Committee" is repealed;
6 ° article is supplemented by a paragraph 2, as follows: "on the whole of the members referred to the 2 °, 3 ° and 4 °, two third at least must be members, either national Council of hospital facilities, or medical National Commission.
These must be medical specialists. » Art. 56. article 162 of the Act is supplemented by the following provisions: "the King may specify rules for administrative of the multi-stakeholder Structure and its sections, as well as support for the funding of these.
The King may subdivide the multi-stakeholder Structure into sections, each of them carrying a part of the competences referred to in article 154, 154bis, 154ter and 154quarter, under delegation and supervision of the multi-stakeholder Structure. The multi-stakeholder Structure determines in its rules of procedure the rules relating to the composition of the sections. » Art. 57. article 164 of the Act, inserted by the law of 22 February 1998, is replaced by the following: 'Article 164. The King may specify rules for the functioning of the multi-stakeholder Structure. » Art. 58. in articles 141 and 153 to 162, the words "Department of Social Affairs, public health and the environment", the words "The Department" and the word "Department" are everytime replaced respectively by the words "the federal public Service health, food chain security and environment", the "federal public Service" and the words "federal public Service".
S. 59 § 1. In chapter XII of the Act, the word 'Consultation Structure' is replaced each time by the words "multi-party Structure".
§ 2. In the hospitals Act, coordinated on 7 August 1987, 'Consultation Structure' is replaced each time by the words "multi-party Structure".
TITLE IV. -Entry into force art. 60. this Act comes into force the day of its publication in the Moniteur belge, except:-article 4, which enters into force on 1 September 2002;
-articles 9, 20 and 37 which take effect January 1, 2002;
-of article 11, which enters into force on 1 October 2002.
-articles 38 and 48 which produce their effects on February 22, 2002;
-of article 22, which comes into force on a date determined by the King.
Promulgate this Act, order that it be under the seal of the State and published by le Moniteur.
Given at Chateauneuf-de-Grasse, August 22, 2002.
ALBERT by the King: Health Minister Mrs Mr AELVOET Social Affairs Miinistre, F. VANDENBROUCKE sealed with the seal of the State: the Minister of Justice, Mr. VERWILGHEN _ Note records of the House of representations: 50-1905-2001/2002: No. 1: Bill. -our 2-3: amendments. -No 4: report. -No 5: Text adopted by the committees. -No 6: Text adopted in plenary meeting and transmitted to the Senate.
Full report: July 12, 2002.
The Senate documents: 2-1245-2001/2002: No. 1: project referred by the Senate. -No. 2: amendments. -No. 3: report.
-No 4: Decision not to amend.
Annals of the Senate: 17 and 18 July 2002.