Key Benefits:
Public concerned: regional health agencies, health institutions, health insurance.
Subject: adaptation of the rules relating to the contract for good use of drugs and products and benefits between hospitals, regional health agencies (RAS) and health insurance.
Entry into force: the decree comes into force on the day after its publication. However, as a transitional measure, the rates set in 2014 under section D. 162-13 remain applicable until 30 June 2015.
Notice: This decree draws the consequences of the merger, which was carried out by the Social Security Financing Act for 2014, of procedures for regulating the use of medicines and health products. Action plans are now replaced by the conclusion of an Avender to the Good Use Contract proposing the necessary measures to improve and improve the efficiency of prescription practices. The decree also amends the annual starting point for the application of the rate of reimbursement of the share covered by the mandatory health insurance schemes of the pharmaceutical specialties and the products mentioned in article L. 1622-22-7 of the Social Security Code (the so-called "in addition" list).
References: this decree is taken for the application of theArticle 51 of Act No. 2013-1203 of 23 December 2013 Social Security Funding for 2014. The provisions of Social Security Code Amended by this decree may be consulted, in their writing resulting from this amendment, on the website Légifrance (http://www.legifrance.gouv.fr).
The Prime Minister,
On the report of the Minister of Social Affairs, Health and Women ' s Rights,
Vu le Social Security Codeincluding article L. 162-22-7;
Considering the advice of the Board of the National Health Insurance Fund of Employees dated 28 October 2014;
Considering the opinion of the Central Board of Directors of the Agricultural Social Mutuality of 13 November 2014;
Considering the advice of the National Union of Health Insurance Funds Board of 11 December 2014,
Decrete:
Article D. 162-10-1 of the Social Security Code is amended as follows:
1° The words: "to a temporary recommendation of use referred to in 1° of Article I of Article L. 5121-12-1 prepared by the National Agency for the Safety of Medicine and Health Products or to the provisions of 2° of Article I of Article L. 5121-12-1" are replaced by the words: "or to provisions of Article L. 5121-12-1 of the Public Health Code » ;
2° The last paragraph is deleted.
Section D. 162-10-2 of the same code is repealed.
The last two sentences of the second paragraph of Article D. 162-13 of the same code are replaced by the following: "The rate of reimbursement is determined annually by the Director General of the Regional Health Agency no later than 15 June. It is applicable for the period of July 1 of the current year as of June 30 of the following year. »
After article D. 162-13 of the same code, an article D. 162-13-1 is inserted as follows:
"Art. D. 162-13-1. - The reduction in the rate of reimbursement, in the event of a refusal by the establishment to sign the Avender referred to in II of Article L. 162-22-7 or in the event of manifest non-compliance, is applied under the conditions referred to in the second paragraph of Article D. 162-13. »
In section D. 162-16 of the same code, the third paragraph shall be replaced by the following provisions:
"The observatory defines the evaluation criteria, based on regional indicators and themes. »
As a transitional measure, the rates established in 2014 under section D. 162-13 of the Social Security Code are applicable until 30 June 2015.
The Minister of Finance and Public Accounts, the Minister of Social Affairs, Health and Women's Rights and the Secretary of State responsible for the budget are responsible, each with regard to him, for the execution of this decree, which will be published in the Official Journal of the French Republic.
Done on March 27, 2015.
Manuel Valls
By the Prime Minister:
Minister of Social Affairs, Health and Women ' s Rights,
Marisol Touraine
Minister of Finance and Public Accounts,
Michel Sapin
The Secretary of State in charge of the budget,
Christian Eckert