Key Benefits:
ARRANGEMENTS FOR IMPLEMENTING ARRANGEMENTS FOR THE IMPLEMENTATION OF CONVENTIONS BETWEEN COMPLEMENTARY DISEASE INSURANCE ORGANIZATIONS AND OCCUPATIONAL GROUPS, ESTABLISHMENTS AND HEALTH SERVICES
Under the conditions laid down in the second paragraph of Article 61 of the Constitution of the Constitution, the Act on the manner of implementing the agreements concluded between the supplementary health insurance bodies and the Health professionals, institutions and services, on December 26, 2013, by MM. Christian JACOB, Damien ABAD, Bernard ACCOYER, Yves ALBARELLO, Julien AUBERT, Jean-Pierre BARBIER, Jacques-Alain BÉNISTI, Sylvain BERRIOS, Etienne BLANC, Mme Valérie BOYER, MM. Dominique BUSSEREAU, Yves CENSI, Dino CINIERI, Eric CIOTTI, Jean-François COPÉ, François CORNUT-GENTILLE, Jean-Louis COSTES, Edouard COURTIAL, Mme Marie-Christine DALLOZ, MM. Gérald DARMANIN, Bernard DEFLESSELLES, Lucien DEGAUCHY, Patrick DEVEDJIAN, Nicolas DHUICQ, Jean-Pierre DOOR, Dominique DORD, David DOUILLET, Daniel FASQUELLE, Mme Marie-Louise FORT, MM. Yves FOULON, Laurent FURST, Sauveur GANDOLFI-SCHEIT, Hervé GAYMARD, Bernard GÉRARD, Alain GEST, Philippe GOSSELIN, Jean-Jacques GUILLET, Michel HEINRICH, Patrick HETZEL, Guénhaël HUET, Sébastien HUYGHE, Christian KERT, Charles de LA VERPILLIÈRE, Mme. Valérie LACROUTE, M. Guillaume LARRIVÉ, Mme Isabelle LE CALLENNEC, M. Dominique LE MÈNER, Mme Geneviève LEVY, Véronique LOUWAGIE, MM. Lionnel LUCA, Gilles LURTON, Jean-François MANCEL, Hervé MARITON, Damien MESLOT, Philippe MEUNIER, Yannick MOREAU, Pierre MOREL-A-L ' HUISSIER, Alain MOYNE-BRESSAND, Yves NICOLIN, Jacques PÉLISSARD, Jean-Frédéric POISSON, Didier QUENTIN, Franck RIESTER, Mrs Sophie ROHFRITSCH, MM. Martial SADDIER, François SCELLIER, André SCHNEIDER, Thierry SOLÈRE, Claude STURNI, Lionel TARDY, Michel TERROT, Dominique TIAN, François VANNSON, Mme Catherine VAUTRIN, MM. Jean-Sébastien VIALATTE, Jean-Pierre VIGIER, Philippe VITEL, Eric WOERTH and Ms Marie-Jo ZIMMERMANN, MPs;
The Constitutional Council,
Given the Constitution;
Seen Order n ° 58-1067 of 7 November 1958 as amended by the Organic Law on the Constitutional Council;
Seen Social Security Code ;
Seen mutuality code ;
Due to the Government's observations, recorded on January 15, 2014;
The reporter was heard;
1. Considering that the requesting members of the House of Commons defected to the Constitutional Council the law on the arrangements for implementing the agreements concluded between supplementary health insurance bodies and professionals, institutions and services Whereas
1 of the Law referred to modifies last paragraph of Article L. 112-1 of the Code Mutuality to allow mutuals, unions, and Federations under this code and exercising an insurance activity to introduce differences in the level of benefits according to the choice of the insured person to make use of a health professional, a health care facility or a service The health with which they have concluded an agreement under the conditions referred to in Article L. 863-8 of the Social Security Code;
3. Considering that Article 2, paragraph 1, of the Act refers to a Chapter IIa in Title VI of Book VIII of the Code of Social Security, including a new Article L. 863-8 relating to agreements concluded between the bodies of Complementary social protection and health professionals, services and institutions; that it provides that such agreements may include commitments relating to the insurer, the level or nature of the guarantees, or, For the professional, establishment or service, services rendered or It also provides that these agreements may not include any stipulation that violates the fundamental right of each patient to the free choice of the professional, the institution or the service Health and the principles of equality and proximity in access to health care; that the accession of professionals, institutions or services to such agreements is carried out on the basis of objective, transparent and non-discriminatory criteria and cannot Have an exclusivity clause; and, furthermore, the fourth paragraph of the Article L. 863-8 states that any professional, establishment or service meeting the criteria for accession as defined by the Convention may accede to it; that the last sentence of this paragraph provides: However, conventions concerning the profession of lunar optician may provide for a limited number of adhesions " ; that the agreements may not contain tariff provisions relating to the acts and benefits referred to in articles L. 162-1-7 to L. 162-14-1 of the Social Security Code for health professionals for whom the share of the expenditure supported by the health insurance is the majority; that, finally, the level of management of acts and benefits Medical cannot be modulated according to the choice of the insured person Whether or not a medical practitioner has entered into an agreement; that section 2, paragraph II, provides for the application of the provisions of paragraph I to agreements entered into or renewed as of the date of enactment of the Act; and
4. Considering that Article 3 provides for the annual return of a report by the Government to Parliament for a period of three years, taking stock and evaluation of the conventions referred to in Article L. 863-8 of the Social Security Code;
5. Considering that the applicants submit that by allowing mutual societies, unions and federations under the mutuality code to introduce differences in the Level of benefits according to the choice of whether or not to use a health care professional, health care facility or health service with which they have concluded a convention, the legislator entrusts these bodies with the role of regulator of Certain areas of care without providing a framework at the same time Sufficient to preserve access to patient care and the patient's freedom to choose his health care provider; that, through this delegation of powers to regulate health and health care expenses, the legislator would have Unknown to the extent of its competence;
6. Considering that the applicants also submit that the difference in treatment instituted between the lunetiers and other health professionals is not in conformity with the principle of equality before the law; that the power of limitation of the Number of accessions to the convention would also affect the freedom to undertake lunetian opticians;
7. Considering, first, that under Article 34 of the Constitution: The law determines basic principles ... civil and commercial obligations " ; that it is at any time open to the legislature, acting in the field of its competence, to adopt new provisions of which it is up to the legislator to assess the opportunity and to amend previous texts or to repeal them in their hands Substituting, where appropriate, other provisions; that, in so doing, it cannot deprive legal guarantees of constitutional requirements;
8. Considering that, by the contested provisions of Articles 1 and 2, the legislature has laid down the rules to be complied with by the conventions concluded between the complementary social protection bodies and health professionals, Health facilities and health services; that it has also agreed to allow mutual societies, unions or federations under the mutuality code to modulate Benefits paid to their insured persons according to the stipulations shown In those agreements; that it has provided for the application of these new provisions to the agreements concluded or renewed only after the entry into force of the provisions; that, in so doing, it has not disregarded the extent of its jurisdiction;
9. Considering, second, that, on the one hand, under Article 6 of the Declaration of Human Rights and the Citizen of 1789, the law: Must be the same for all, either protecting or punishing " ; that the principle of equality does not preclude the legislator from treating different situations differently nor does it derogate from equality for reasons of public interest provided that, in either case, the difference in treatment Resulting from it being directly related to the object of the law that establishes it;
10. Considering that, however, there is no constitutional requirement that the different categories of health professionals be subject to the same rules for accession to the conventions concluded with the Supplementary social protection; that, as a result, the complaint alleging infringement of the principle of equality must be rejected;
11. Considering that, on the other hand, the freedom to undertake derives from Article 4 of the 1789 Declaration; that it is open to the legislator to bring to this freedom limitations related to constitutional requirements or justified by the interest General, provided that it does not result in disproportionate damage to the objective pursued;
12. Considering that by allowing the conventions concerning the profession of lunetier to provide for a limited number of accessions, the contested provisions do not affect the freedom of the lunetiers to practise their profession; that, Therefore, the complaint about the infringement of the freedom to undertake must be rejected;
13. Considering that the provisions of the law referred to, which do not ignore any other constitutional requirements, must be declared in conformity with the Constitution,
Decides:
The law on the arrangements for implementing conventions concluded between supplementary health insurance bodies and Professionals, institutions and health services is constitutionally compliant.
This decision will be published in the Journal Official of the French Republic.
Issued by the Council Mr Jean-Louis DEBRÉ, President, Mr Jacques BARROT, Mrs Claire BAZY MALAURIE, Nicole BELLOUBET, MM. Guy CANIVET, Michel CHARASSE, Renaud DENOIX de SAINT MARC, Valéry GISCARD d' ESTAING, Hubert HAENEL and Nicole MAESTRACCI.
The President,
Jean-Louis Debré
