Section 2: National protocols

I.-A national committee for inter-professional cooperation is responsible for the strategy, promotion and deployment of inter-professional cooperation. It proposes a list of national protocols to be drawn up and deployed throughout France, supports healthcare professionals in developing these protocols and their economic model, and issues an opinion on their funding by the health insurance scheme. It monitors and assesses authorised protocols on an annual basis. To this end, it is sent the relevant data for each of the protocols implemented on an annual basis.

The National Committee for Interprofessional Cooperation may propose that exceptional procedures be included within the regulatory remit of professionals. It will propose their definitive financing and remuneration arrangements by including them on the list provided for in article L. 162-1-7 of the Social Security Code.

The committee is made up of representatives of the Union nationale des caisses de l'assurance maladie, the Haute Autorité de santé, the ministers responsible for social security, health and disability, and the regional health agencies, in accordance with procedures specified by decree. The national professional councils, the orders of the professions concerned and the National Union of Health Professionals are involved in the work of this committee.

II.Funding may derogate from the following provisions:

1° Articles L. 162-5, L. 162-9, L. 162-11, L. 162-12-2, L. 162-12-9, L. 162-14, L. 162-14-1 and L. 162-32-1 of the Social Security Code and Article L. 2112-7 of this Code, insofar as they concern the tariffs, fees, remuneration and ancillary costs payable to healthcare professionals by the insured persons and by the health insurance scheme;

2° 1°, 2°, 5° and 6° of Article L. 160-8 of the Social Security Code, insofar as they concern costs covered by the health insurance scheme;

3° Article L. 162-2 of the Social Security Code, insofar as it concerns direct payment of fees by the patient;

4° Articles L. 160-13 and L. 160-14 of the Social Security Code, relating to the insured person's contribution to the tariffs used as a basis for calculating benefits.

Expenditure charged to all compulsory basic health insurance schemes resulting from the financing of national protocols is taken into account in the national health insurance expenditure target referred to in 3° of D of I of article LO 111-3 of the same code.

III -The national protocol and its economic model are drafted by a drafting team selected following a national call for expressions of interest, with the support of the national professional councils and orders of the professions concerned. The national protocol is authorised throughout France by decree of the ministers responsible for health and social security, after receiving the opinion of the Haute Autorité de santé, which gives its opinion on its compatibility with the decree referred to in article L. 4011-2 of the present code. The ministers responsible for health and social security may suspend or withdraw a protocol for reasons relating to the safety and quality of treatment.

The National Committee for Interprofessional Cooperation may, after consulting the national professional councils concerned and after obtaining the opinion of the French National Authority for Health, adapt the authorised national protocols in order to update them in line with changes in recommendations for good practice, to modify the scope of practice and to adjust the terms and conditions under which healthcare professionals are authorised to implement them. Protocols adapted in this way are authorised by order of the ministers responsible for health and social security.

IV - The employment or practice structures of professionals wishing to implement a national protocol must declare, jointly if necessary, to the competent regional health agency that it is being implemented under their responsibility. The agency may suspend the implementation of this protocol in one or more structures for reasons relating to the quality and safety of care and in the event of non-compliance with the provisions of the same protocol.

V.-The conditions for the application of this article shall be specified by regulation.