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Decree Of March 30, 2007 Relative To The Terms Of Payment Of The Resources Of The Public Institutions Of Health And Private Healthcare Institutions Referred To In B And C Of Article L. 162-22-6 Of The Code Of Social Security By The Fund...

Original Language Title: Arrêté du 30 mars 2007 relatif aux modalités de versement des ressources des établissements publics de santé et des établissements de santé privés mentionnés aux b et c de l'article L. 162-22-6 du code de la sécurité sociale par les caisse...

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JORF n ° 87 of April 13, 2007 page 6782
text n ° 50




Order dated March 30, 2007, on how to pay the resources of public health institutions and private health care facilities Referred to in Article L. 162-22-6 of the Social Security Code by the sickness insurance funds referred to in Article L. 174-2 of the Social Security Code

NOR: SANH0721300A ELI: https://www.legifrance.gouv.fr/eli/arrete/2007/3/30/SANH0721300A/jo/texte


The Minister of Health and Solidarity, the Minister of Agriculture and Fisheries, and the Minister Delegate to the Budget and State Reform, Government Spokesperson,
In view of the Public Health Code, including Article R. 6145-26;
Seen the Safety Code Articles L. 162-16-6, L. 162-22-6, L. 162-22-7, L. 162-22-10, L. 165-7, L. 174-2, R. 162-32, R. 162-42-4, R. 162-51, R. 174-1-9, D. 162-12 and D. 162-13;
In view of law n ° 2003-1199 of 18 December 2003 for financing security 2004 amended, in particular Article 33;
In view of Decree No. 2005-30 of 14 January 2005 on the budget of health care institutions and amending the Public Health Code and the Social Security Code, in particular Article 9 thereof ;
In view of Decree No. 2007-82 of 23 January 2007 amending the transitional provisions of the decree of 30 November 2005 on the statement of income and expenditure forecasts of health institutions and of the decree of 10 January 2007 on the Budgetary and financial provisions relating to health care institutions and amending the Public Health Code, the Social Security Code and the Social Action and Family Code;
In view of the Decree of 23 July 2004 on Packages relating to the voluntary termination of pregnancy;
In view of the decree of 22 December 2006 adopted for the application of A du V of Article 33 of Act No. 2003-1199 of 18 December 2003 for the financing of social security;
In view of the Board of the National Insurance Fund for Workers' Compensation dated 14 March 2007;
In view of the opinion of the Board of Directors of the Central Agency of Social Security Organizations as of 16 March 2007, Stop:

Item 1
The credit union designated pursuant to Article L. 174-2 of the Social Security Code shall pay each month:
1 ° A monthly allowance equal to one twelfth of the annual funding allocation fixed in Application of section R. 6145-26 of the Public Health Code, divided under the following conditions:
a) 60 % of the allowance, the twenty-fifth day of the month, or, if that day is not opened, the last working day before that date;
(b) 15 % of the allowance on the fifth day of the following month or, if that day is not opened, on the last working day before that date;
(c) 25 % of the allowance, the fifteenth day of the following month, or, if that day is not opened, the last working day Prior to that date;
2 ° One twelfth of the financing of missions of general interest and assistance in the contractualization and the amount of the package (s) fixed pursuant to Article R. 162-42-4 of the Social Security Code, the Twenty-fifth day of the month or, if that day is not opened, on the last working day preceding that date;
3 ° A monthly allowance equal to one twelfth of the supplementary annual allocation laid down pursuant to Article 9 of the Decree of the January 14, 2005, broken down under the following conditions:
a) 75 % of the allowance, the twenty-fifth day of the month, or, if not opened, the last working day before that date;
b) 25 % of the allowance, on the fifteenth day Of the following month or, if that day is not opened, the last working day preceding that date.
Such payments shall be made without prejudice to the application of Article R. 174-1-9 of the Social Security Code or Article 1 of the Decree of 23 January 2007 mentioned above.

Article 2 Read more about this Article ...


Activity data in medicine, surgery, obstetrics and odontology and those relating to the consumption of pharmaceutical specialities and products and services mentioned in article L. 162-22-7 of the code Of social security are transmitted monthly to the regional hospital agency by each health institution accompanied by the administrative information made anonymous about the patient. Such data shall be transmitted before the end of the calendar month following the end of the month under consideration.
The establishment shall also transmit the data relating to the activity or consumption of the preceding financial year, as well as those of the preceding month or months, With the exception of data relating to external acts and consultations for the financial year 2006, which could not be transmitted to the deadline referred to in the preceding paragraph or which are subject to correction. The valuation of these files is carried out under the conditions in force at the end of stay.
These data are valued under the following conditions:
1 ° For the activities covered by the hospitalisation benefits mentioned Article L. 162-22-6 of the Social Security Code by applying national tariffs laid down in accordance with the provisions of Article L. 162-22-10 of the same Code, affected where appropriate the geographical coefficient mentioned in the same Article And, except for the packages mentioned at 4 ° below, the rate of care of the patient;
2 ° For pharmaceutical specialities and the products and services invoiced in addition to the first paragraph of this Article, by application Rates of liability established pursuant to the provisions of Article L. 162-16-6 and Article L. 165-7 of the Social Security Code, affected by the rate of care of the patient and, where applicable, the rate of reimbursement Reduced in accordance with the provisions of Article L. 162-22-7 of the same code;
3 ° For the consultations and external acts referred to in the first subparagraph of Article R. 162-51 of the Social Security Code and those carried out in a responsible service For non-hospitalized patients, by applying the rates referred to in the second paragraph of the same section of the patient care rate.
4 ° For the Home and Emergency Treatment Package mentioned in c, for the Package of small equipment referred to in d, the packages of voluntary termination of pregnancy referred to in the f as well as the safety plan and hospital environment referred to in the 1st of Article 3 of this Order, by application, according to National tariffs laid down pursuant to the provisions of Article L. 166-22-10 of the Social Security Code or the tariffs laid down in the abovementioned Decree of 23 July 2004 on an average rate of assumption of health insurance coverage Stopped at 94 %.
Data relating to hospital services, the consumption of pharmaceutical specialities and products and services and to external consultations and acts not covered by health insurance Are not valued.

Item 3 Learn more about this Article ...


The valuation of the activity distinguishes the amount from the recovery described in Article 2 for each of the following items:
1 ° The fee charged to the activity by identifying amounts due under the Following items:
a) Packages " Homogeneous groups of stay " (GHS) and possible supplements;
b) Dialysis packages (D);
c) Packages " Reception and handling of emergencies " (ATU);
d) Package " Small equipment " (FFM);
e) Packages " Homogeneous groups of rates " (GHT);
f) Voluntary terminations for pregnancy;
g) External acts and consultations, including technical packages;
h) Packages " Organ samples " (PO);
i) Package " Safety and hospital environment " (SE).
2 ° The share of the pharmaceutical specialities mentioned in the 2 ° of the previous article.
3 ° The share of the products and services mentioned in the 2 ° of the previous article.

Article 4 Read more about this article ...


For each of the items mentioned in Article 3, the amount due by sickness insurance is calculated as follows:
1 ° For the packages mentioned in a, b, C, d, f, g and i, the amount owed by the sickness insurance shall be determined by applying to the amounts determined pursuant to Article 2 of this Order the fraction of the tariff referred to in paragraph 1 of A of Article 33 of the Act of 18 December 2003 Above. The sickness insurance amount for the benefits referred to in the a and f of 1 ° of Article 3 of this Order shall be reduced, where applicable, by the amount due by the patient in respect of the hospital package.
2 ° For the packages mentioned in the And h of 1 ° of Article 3 of this Order and, by way of derogation from 1 ° above, for the GHS packages mentioned in Article 1 of the decree of 22 December 2006 referred to above, the amount due by sickness insurance shall be that resulting from the application of the Article 2 of this Order.
The decision of the Regional Hospital Agency shall, where appropriate, distinguish the amount due from sickness insurance in respect of the month in respect of the amount due under the preceding month or months.

Item 5 Learn more about this Article ...


The amounts determined pursuant to Article 4 shall be determined by the Director of the Regional Hospital Agency and notified, within 15 days of receipt of the activity data and For consumption, to the health establishment concerned and to the body designated pursuant to Article L. 174-2 of the Social Security Code.

Article 6 Read more about this article ...


The credit union designated pursuant to Article L. 174-2 of the Social Security Code makes the payment of amounts notified to it pursuant to Article 5, On the fifth of the month following the notification or, if that day is not opened, on the last working day preceding that date.

Article 7 Read more about this Article ...


Transitional provisions for the first quarter of 2007:
I.-Until May 2007 included, the credit union designated pursuant to Article L. 174-2 of the Social Security Code continues to pay the twelfths Of the annual supplementary allocation set for 2006. The difference between the total amounts paid in respect of the supplementary annual allocation by the credit union, for the months of January to May 2007, and the amounts due in the same period for the same period are recovered from the payments referred to in Section 6 of this Order is 40 % on July 5 and 60 % on August 5, 2007.
II. -By way of derogation from the provisions of Articles 2 and 5 of this Order, data of activity in medicine, surgery, obstetrics and odontology and those relating to the consumption of medicinal products and products and services Referred to in Article L. 162-22-7 of the Social Security Code, relating to the first quarter of 2007, shall be transmitted to the Regional Hospital Agency by each health institution by the end of April 2007 at the latest. Such data shall be valued within the fifteen-day period under the conditions referred to in Articles 2 to 4 and III of this Article. The amounts thus determined shall be stopped and notified by the DARH under the conditions laid down in Article 5.
The establishment shall also forward the activity data relating to the previous financial year, with the exception of data relating to acts And external consultations, which could not be transmitted before the end of the fiscal year under consideration or subject to correction. The valuation of these files is carried out under the conditions in force at the end of stay.
III. -The decision of the regional hospital agency distinguishes, where appropriate, payments relating to the reimbursement of care in respect of the current year of care reimbursements in respect of the preceding financial
. -The credit union designated pursuant to Article L. 174-2 of the Social Security Code shall make the payment of amounts notified to it under Article II of this Article in three equal fractions under the following
: The first payment is made on June 5, 2007;
2 ° The second payment is made on July 5, 2007;
3 ° The third payment is made on August 5, 2007.

Article 8 Read more about this article ...


The advances made by the health insurance in 2005 and 2006 for the implementation of the activity rate are the subject of a partial reimbursement for health insurance, 15 % on 5 July 2007 and 10 % on 5 August 2007. The decision of the regional hospital agency referred to in Article 7 above shall mention the amount so determined.

Article 9 Read more about this Article ...


The order of 30 May 2005 concerning the payment terms for the financial year 2005 of the resources of the public health institutions and private health institutions referred to in Article L. 162-22-6 The Social Security Code by the sickness insurance funds referred to in Article L. 174-2 of the Social Security Code is repealed.

Article 10 Read more about this Article ...


The Director of Hospitalization and Care Organization, the Director of Social Security and the Director General of the Forest and Rural Affairs are responsible, each as far as it is concerned, for The execution of this Order, which will be published in the Official Journal of the French Republic.


Done at Paris, March 30, 2007.


The Minister of Health and Solidarity,

Philippe Bas

Minister of Agriculture and Fisheries,

Dominique Bussereau

The minister delegated to the

budget and state reform,

spokesman for the Government,

Jean-François Copé


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