Key Benefits:
The Prime Minister,
On the report of the Minister of Health and Solidarity,
Given the Civil Code, including articles 205, 206, 207 and 212;
Given the code of action Social security code;
Given the social security code;
Given Act No. 2003-1199 of 18 December 2003 on the financing of social security for 2004, in particular Article 33;
In view of the Ordinance No. 2005-1112 of 1 September 2005 laying down various provisions relating to health care institutions and certain staff of the hospital public service;
Having regard to Decree No. 2005-30 of 14 January 2005 on the budget of establishments of Health, in particular Articles 9 and 12;
In view of the opinion of the National Insurance Fund for Workers' Compensation dated 23 August 2006;
In view of the opinion of the National Union of sickness insurance funds as of 25 August 2006;
Vu The opinion of the Board of Governors of the Regional Boards of Auditors as of 4 October 2006;
In view of the referral to the Committee on Accidents at Work and Occupational Diseases of 3 August 2006;
The Council of State (Social Section) Heard,
Clipping:
Title IV of the book Ier of Part 6 of the Public Health Code is thus amended:
I.-Article R. 6145-6 is thus amended:
1 ° The third paragraph is completed With the following provisions:
" The comparative statement of the first quadrimaster shall be transmitted within two months of the end of the quadrennial. The comparative statement for the second quadrennial is communicated at the same time as the preliminary report. The status of the last quadrennial is transmitted before March 15 of the following fiscal year. "
2 ° In the fourth paragraph, the words:" The latter " Are replaced by the words: " The Director of the Regional Hospital Agency ".
II. -In the third paragraph of Article R. 6145-14, Articles R. 6145-34 and R. 6145-35, the reference to Article L. 6145-3 is replaced by the reference to Article L. 6145-2.
III. -The first sentence of Article R. 6145-32 is supplemented by the following words: Within 30 days of notification by the director of the regional agency of hospitalization for refusal of approval ".
IV. -In R. 6145-42, the words: The second paragraph "
V.-In R. 6145-43, the words: " The consolidated result " Are replaced by the words: " The result from all activities ".
VI. -Article R. 6145-46 is supplemented by a paragraph worded as follows:
" If the board of directors has not taken any deliberation before 30 June, the director of the regional hospital agency stops the accounts and earmarking the results In accordance with the provisions of the second paragraph of Article L. 6145-2. "
VII. -After sub-section 8 of Section I of Chapter V, a sub-section 9 is created as follows:
"Subsection 9
" Regional Chamber Reference Accounts
" Art. R. 6145-62. -Where the Director of the Regional Hospital Agency requests the Management Board to submit a recovery plan in accordance with the first paragraph of Article L. 6143-3, he shall fix in his application the period within which the plan shall be Be adopted. This period may not exceed three months. If at the end of this period no plan has been adopted, or if the director of the regional hospital agency is of the opinion that the recovery plan is not adapted to the financial situation of the institution, he shall refer the matter to the Regional Board of Auditors Without delay.
" It shall attach to its reasoned reference the request for the presentation of the recovery plan, the comparative statements of the activity, revenue and expenditure in relation to the forecasts referred to in the second paragraph of Article R. 6145-6, Relating to the current fiscal year and the establishment's financial accounts for the last three fiscal years.
" The two-month period available to the Regional Board of Auditors in formulating its proposals shall be counted from the Receipt at the Registry of all documents required to be produced.
" The President of the Regional Board of Auditors shall inform the Director of the establishment of the time limit to which his observations may be made, or In writing, or orally.
" The reasoned opinion of the Chamber shall be transmitted to the regional hospital agency and to the establishment. "
VIII. -In R. 6146-62, the reference to R. 6146-11 is replaced by the reference to R. 6146-68.
IX. -In R. 6146-63, the reference to R. 6146-5 is replaced by the reference to R. 6146-62.
X. -Article R. 6146-65 is thus amended:
1 ° At 1 °, the term: 6 ° " Is replaced by the word: " 7 ° ".
2 ° At 3 °, the Reference to R. 6146-7 is replaced by the reference to section R. 6146-64.
XI. -In R. 6146-67, the reference to R. 6146-6 is replaced by the reference to R. 6146-63.
XII. -In R. 6147-10, the words: Ministers responsible for budget and health " Are replaced by the words: " The Minister of Health ".
XIII. -In R. 6147-17, the words: , the Director General of Health and the Director of Budget " Are replaced by the words: " And the Chief Health Officer ".
XIV. Article R. 6161-9 is thus amended:
1 ° After the words: " R. 6145-40 ", are inserted the words:" , of the last three paragraphs of Article R. 6145-43, of Articles R. 6145-45 ".
2 ° It is added to the I a second subparagraph thus drafted :
" However, the decrees provided for in Articles R. 6145-43 and R. 6145-45 shall be taken by the Ministers responsible for health and social security. "
XV. -Article R. 6161-12 is amended as follows:
1 ° In the first subparagraph, the words: Or the settlement agreement " Are deleted.
2 ° In the second paragraph, the words: " Or settlement agreement " Are deleted and the word: " Approved " Is Replaced with the word: " Approved ".
The Public Health Code is modified as follows:
I. Section R. 6145-4 is replaced by the following:
" Art. R. 6145-4. -In the event that the costs of residence, consultation or hospital costs of the sick are not eligible for care, either by a sickness insurance body or by the Minister responsible for veterans and Victims of war, or by any other public body, the persons concerned or, failing that, their debtors or the persons designated by Articles 205, 206, 207 and 212 of the Civil Code agree to pay the costs of any related nature To the chosen regime. They shall be obliged, except in cases of urgency, to pay at the time of entry of the sick person into the establishment a revolving allowance calculated on the basis of the estimated duration of the stay, the costs of consultations, acts or an average tariff Estimate of the stay agreed by the ministers responsible for health and social security. Where the allowance paid is greater than the amount owing, the difference is returned to the person who made the allowance. "
II. -In R. 6145-25, the words: Private sector " Are replaced by the words: " Framework for liberal activity ".
III. -In the first paragraph of Article R. 6146-71, before the word: In accordance with ", are inserted the words:" For psychiatric and follow-up or rehabilitative activities, ".
IV. -Article R. 6146-72 is thus amended:
1 ° Before the words: Benefit rates " Are inserted the words: " For psychiatric and follow-up or rehabilitation activities, ".
2 ° The words:" To R. 6145-26 " Are replaced by The words: " And R. 6145-22 ".
V.-After R. 6146-72, an R. 6146-72-1 is inserted as follows:
" Art. R. 6146-72-1. -For the activities referred to in Article L. 162-22-6 of the Social Security Code, the public health institution shall pay the fees of doctors and midwives, under the conditions laid down in the second, third, fourth, fifth And the sixth paragraphs of Article R. 6146-71, on the basis of a monthly statement of the consultations and acts signed by them. This statement mentions, where appropriate, the overruns of fees charged by the hospital centre on behalf of the doctor. The institution shall communicate these statements to the primary health insurance fund for which each physician or midwife is
. The rate of hospitalization fixed pursuant to the provisions of Article L. 162-22-10 of the code of the Social security is the basis for calculating the insured's participation. "
The social security code is thus modified:
I.-In Articles R. 162-30 and R. 162-40, the reference to Article L. 710-16-2 is replaced by the reference to Article L. 6114-1.
II. -Article R. 162-51 is replaced by the following:
" Art. R. 162-51. -Health institutions may organise consultations and external actions referred to in Article L. 162-26 to enable the sick, injured and pregnant women to move either to receive care or to have the Diagnosis of a condition and prescribe appropriate treatment.
" The rates of the acts and consultations referred to in the first subparagraph shall be those determined in accordance with this Section and Articles L. 162-1-7 and L. 162-14-1. The rate increases provided for in these Articles shall apply to consultations and acts under conditions laid down by the Ministers responsible for health and social security. "
III. -Article R. 174-22-1 is replaced by the following:
" Art. R. 174-22-1. -The payment to private health institutions referred to in Article L. 162-22-6 of the amount of annual packages and the financing of missions of general interest and assistance to the contract, fixed under the conditions Referred to in Article R. 162-42-4, shall be provided by the Central Payment Fund referred to in Article L. 174-18.
" The payment of each monthly allowance is made on the 5 of each month or, if the day is not opened, the first Day after that date.
" Pending the fixing of the amount of the annual plan and, where appropriate, the funding of the general interest and assistance to the contract of the current year, the fund responsible for the Payment of monthly instalments equal to one-twelfth of the amount of the previous year's package or endowment. The difference between the amounts thus paid and those fixed for the current year shall be charged against the payment made on the 5 of the second month following the month in which the amount of the package or of the allocation is fixed. "
IV. -Article R. 174-22-2 is amended as follows:
1 ° In the first paragraph, the words: Under the annual package fixed in the framework of the tariff amendment provided for in Article L. 162-22-5 " Are replaced by the words: " For annual packages And the allocation of funding for missions of general interest and assistance for contracts ".
2 ° In the second subparagraph, after the words: Annual packages ", are inserted the words:" And the funding of missions of interest
V.-Section R. 174-22-3 is amended as follows:
1 ° In the first paragraph, after the words: " In Article L. 162-22-8 ", insert the following words: And the funding of missions of interest General and aid for the contractualization provided for in Article L. 162-22-14 ".
2 ° In the second paragraph, the words: In Article L. 6114-3 of the Public Health Code " Are replaced by the words: " To Article L. 162-22-6 " And the words: " Of R. 162-42-1 " Are replaced by the words: " Section R. 162-42-2 ".
VI. R. 174-23, R. 174-25, R. 174-28, R. 174-30, R. 174-31 and R. 174-34, the words: " Annual annual funding allocation " Are replaced by the words: " Annual funding allocation ".
The decree of 14 January 2005 referred to above is thus amended:
I.-The provisions of Article 12 shall be preceded by a" I ".
II. -After the I, it is added a II thus written:
" II. -By way of derogation from the provisions of Article 9 of this Decree, for the first year of participation in the public hospital service of an establishment falling within the scope of Article L. 162-22-6 of the Social Security Code, prior to its Admission, the amount of the supplementary annual allocation shall be determined on the basis of the difference between, on the one hand, the sum of the amounts reimbursed by the sickness insurance in the period preceding the application for admission to the Hospitalisation benefits referred to in Article R. 162-32 of the Social Security Code and in respect of the fees of the practitioners corresponding to those activities and, on the other hand, the product of the tariffs applicable for the same financial year to the Private health facilities referred to in the b of Article L. 162-22-6 of the same code, by the activity found in the same year and to which the fraction of the tariff referred to in Article 33 of the Law of 18 December 2003 is applied Above, fixed for the year of admission to the public hospital service. This amount is reduced by the amount of the reimbursement of the pharmaceutical specialities and the products and services referred to in Article L. 162-22-7 of the same code, invoiced in addition for the year preceding the application for admission, as well as the packages And the funding of missions of general interest and assistance for the contract paid for the same year.
" This amount is adjusted according to the items mentioned in Article 9, 2 ° to 4 °. It shall take into account the rate of progress of the objective referred to in Article L. 162-22-9 of the Social Security Code for the current year.
I. -Subsection 1 of Section 4 of Chapter III of Title I of Book I of Part Six of the Public Health Code is
. Article R. 6113-29 is repealed.
III. -The second and third paragraphs of R. 6113-30 are repealed.
IV. -In Article R. 6113-31, the words: The Commission on Information Systems on Health Care Facilities and " Are deleted
Section 3 of Chapter V of Title IV of Book I of Part Six of the Code of Public Health is supplemented by an article R. 6145-72 worded as follows: :
" Art. R. 6145-72. -Interhospital trade unions are subject to the provisions applicable to public health institutions for their public contracts. "
The social action code is thus modified:
I.-In R. 314-72, the words:" And are the object of Procedure for postponement laid down by the order for the application of Article R. 714-3-39 of the Public Health Code " Are replaced by the words: " Are carried forward to the next fiscal year ".
II. -Article R. 314-75 is thus amended:
1 ° In the first subparagraph, the reference: In R. 714-3-9 " Is replaced by the reference: " In Article R. 6145-12 ".
2 ° In the third paragraph, the words: Of subsection 3 " Are replaced by The words: " Sub-sections 3, 5 and 6 " And the words: " Title VI " Are replaced by the words: " Title IV ".
III. -In the third paragraph of Article R. 314-188, the words: Several related budgets referred to in R. 714-3-9, b and d." Are replaced by the words: " Several provisional results accounts referred to in Article R. 6145-12 " And the word: " Budgets " Is replaced by the words: " Forecast result accounts ".
The following provisions apply for the year 2006:
" I.-The regional hospital agency carries out the recovery of the share assumed by the health insurance of the activity of each Establishment in accordance with the provisions of Article 33 of the Act of 18 December 2003 referred to above. Regulation of the institutions shall be provided by the credit union designated pursuant to Article L. 174-2 of the Social Security Code in one or more
. II. -Regulation of the institutions in twelve monthly allowances for annual packages, the allocation of funding for missions of general interest and assistance for contractualization and the supplementary annual allocation is provided by the credit union Designated pursuant to Article L. 174-2 of the Social Security Code. The payment of each monthly allowance shall be made in one or more times according to a schedule set by the Ministers responsible for health and social
. III. -The provisions of Articles R. 174-1-1 to R. 174-1-6 of the Social Security Code shall apply to payments made by the caisses designated pursuant to Article L. 174-2 of the same Code, in respect of annual packages and allocations of Funding for missions of general interest and assistance for contracts and supplementary annual allocations.
" IV. -By way of derogation from the provisions of Article 9 of the Decree of 14 January 2005 referred to above, the credit union referred to in Article L. 174-2 of the Code of Social Security shall pay monthly instalments equal to one twelfth of the Annual supplementary allocation from the previous year. The arrangements for the regularisation of the difference between the amounts thus paid and the sums due in respect of the supplementary annual allocation shall be fixed by order of the Ministers responsible for health and social
. V.-The Provisions of Article R. 6146-72 of the Public Health Code shall apply in their drafting prior to this Decree.
The Minister of Economy, Finance and Industry, the Minister of Health and Solidarity, the Minister of Agriculture and fisheries and the Minister responsible for the budget and the reform of the State, a spokesman for the Government, shall each have responsibility for the implementation of this Decree, which shall be published in the Official Journal of the Republic French
Done at Paris, January 10, 2007.
Dominique de Villepin
By the Prime Minister:
The Minister of Health and Solidarities,
Xavier Bertrand
Minister of Economy,
Finance and Industry,
Thierry Breton
Minister of Agriculture and Fisheries,
Dominique Bussereau
The Minister Delegate to the
budget and state reform,
Government Spokesperson,
Jean-François Copé
