Key Benefits:
Publics concerned: public and private health institutions mentioned in a, b and c of Article L. 162-22-6 of the Social Security Code organizations responsible for the management of compulsory health insurance.
Subject: determination of the deadlines for the implementation by health institutions of the individual billing of consultations and stays to compulsory health insurance funds.
Entry into force: the text comes into force on the day after its publication.
Notice: the personal billing provided by the Social Security Financing Act for 2004 allows health facilities to address directly to compulsory health insurance, for each episode of care, an invoice for the reimbursement of the care expenses provided to a social insured person, on the part of these expenses covered by compulsory health insurance organizations. However, this law has developed specific implementation deadlines for public and private non-profit health institutions, in accordance with the terms to be specified by decree. The purpose of this decree is to set the deadlines for this implementation, particularly by distinguishing the categories of institutions concerned.
References: This decree and the texts that it amends, in their drafting, are available on the website Légifrance (http://www.legifrance.gouv.fr). This decree is taken for the application of theArticle L. 174-2-1 of the Social Security Code and amended section 33 of the Social Security Financing Act, 2004.
The Prime Minister,
On the report of the Minister of Finance and Public Accounts and the Minister of Social Affairs and Health,
Vu le Public Health Codeincluding articles L. 6141-2 and R. 6147-1;
Vu le Social Security Codearticles L. 162-22-6 and L. 174-2;
Vu la Act No. 2003-1199 of 18 December 2003 the financing of social security for 2004, including amended article 33;
Considering the opinion of the representative organizations of health facilities dated 6 November 2013;
Having regard to the advice of the Board of the National Health Insurance Fund of Employees dated 19 November 2013;
Having regard to the advice of the Council of the National Health Insurance Union dated 21 November 2013;
Considering the advice of the Board of Directors of the Central Fund for Agricultural Social Mutuality dated November 27, 2013,
Decrete:
The exemption provided for in section 33, as amended, of the Social Security Financing Act for 2004 referred to above and relating to the billing of external acts and consultations shall be terminated by the latest:
1° As of March 1, 2016 for public health institutions mentioned inArticle R. 6147-1 of the Public Health Code ;
2° As of January 1, 2016 for the regional hospital centres mentioned at theArticle L. 6141-2 of the Public Health Code other than those of the 1° above;
3° As of January 1, 2015 for public health institutions mentioned in a of Article L. 162-22-6 of the Social Security Code other than those of the 2° above;
4° As of September 1, 2014 for health care facilities b and c of Article L. 162-22-6 of the Social Security Code.
By derogation from Article 1 of this Order, the deadlines set at 2°, 3° and 4° of this Article are deferred, respectively, to March 1, 2016, to January 1, 2016 and to September 1, 2015, for health facilities that meet one of the following conditions:
1° The establishment results from a merger of establishments between July 1, 2012 and the date of publication of this decree;
2° The establishment acquired hospital billing software between 1 July 2012 and the date of publication of this Order;
3° The establishment shall, on the date of publication of this Order, use a hospital billing software that does not have, as of January 1, 2013, a certificate of quality issued by the National Centre for Deposits and Accreditations of the National Fund for Health Insurance of Employees.
Derogation I of amended section 33 of Act No. 2003-1199 Social Security Funding for 2004 referred to above and relating to the billing of hospital benefits other than acts and external consultations will end no later than March 1, 2018.
The Minister of Finance and Public Accounts, the Minister of Social Affairs and Health and the Secretary of State responsible for the budget are responsible for the execution of this decree, which will be published in the Official Journal of the French Republic.
Done on 8 July 2014.
Manuel Valls
By the Prime Minister:
Minister of Social Affairs and Health,
Marisol Touraine
Minister of Finance and Public Accounts,
Michel Sapin
The Secretary of State in charge of the budget,
Christian Eckert
