French Public Health Code
In forceThe decisions of the Supervisory Board referred to in Article L. 6143-1 and the acts of the Director referred to in Article L. 6143-7 are enforceable subject to the following conditions:
1° The decisions of the Supervisory Board referred to in 2°, 5°, 7° and 8° of article L. 6143-1 are enforceable if the Director General of the Regional Health Agency does not object within two months of either the meeting of the Supervisory Board if he attended it, or receipt of the decision in other cases. The decisions referred to in 3° of the same article are automatically enforceable upon receipt by the Director General of the Regional Health Agency;
2° The decisions of the Director referred to in 1° to 10° and 12° to 16° of Article L. 6143-7 are automatically enforceable upon receipt by the Director General of the Regional Health Agency, with the exception of the decisions referred to in 1° and 5° of the same Article;
2° bis The statement of projected income and expenditure, excluding annexes, and the multi-year global financing plan, mentioned in 5° of Article L. 6143-7, are deemed to be approved if the Director General of the Regional Health Agency has not made his opposition known within a period and on grounds determined by decree.
For health care institutions subject to a recovery plan in application of article L. 6143-3, the statement of projected revenue and expenditure and its appendices, as well as the multi-year global financing plan, mentioned in 5° of article L. 6143-7, are subject to the express approval of the Director General of the Regional Health Agency.
In the case provided for in the second paragraph of this 2° bis, the statement of projected income and expenditure may not be approved by the Director General of the Regional Health Agency if the increase in staff numbers is manifestly incompatible with the increase in the activity of the health care organisation.
The terms and conditions for the application of the second and third paragraphs of this 2° bis are set by decree;
For each of the health care institutions that are part of a regional hospital grouping, the Director General of the Regional Health Agency takes into account all the budgets of the institutions in the regional hospital grouping when assessing the statement of projected income and expenditure and the multi-annual global funding plan referred to in 5° of Article L. 6143-7 ;
3° The decisions of the Director of Assistance publique-hôpitaux de Paris relating to the investment programme and the multiannual global financing plan mentioned in 4° and 5° of Article L. 6143-7 are deemed to have been approved if the Director General of the Regional Health Agency and the Ministers responsible for Health, Social Security and the Budget have not made their opposition known within the time limits laid down by regulation, on the grounds that they do not comply with the laws and regulations in force or are incompatible with maintaining the balance or the recovery of the institution.
When Assistance publique-hôpitaux de Paris' revenue and expenditure forecasts are presented as unbalanced, the Director General of the Regional Health Agency may approve them under the conditions laid down in 2°a of this article, after receiving the assent of the Ministers for Health, Social Security and the Budget.
The contract referred to in 1° of article L. 6143-7 is enforceable as soon as it has been signed by all the parties.
The Inter-regional Health and Social Pricing Tribunal, referred to in article L. 351-1 of the Code de l'action sociale et des familles, has jurisdiction at first instance to rule on appeals lodged against the opposition of the Director General of the Regional Health Agency to the approval of the statement of projected income and expenditure or its amendments in application of 2° bis of this article. It also has jurisdiction over decisions taken by the Director General of the Regional Health Agency pursuant to Articles L. 6145-1, L. 6145-2, L. 6145-3, L. 6145-4 and L. 6145-5.
The Director General of the Regional Health Agency shall refer to the Administrative Court the deliberations and decisions relating to these matters, with the exception of those covered by 5° of Article L. 6143-7, which he considers to be illegal within two months of receipt. It shall inform the institution without delay and provide it with details of the grounds for illegality cited. He may include in his appeal an application for a stay of execution.
