French Public Health Code
In forceI. - Only practitioners who have signed the agreement governing relations between the health insurance organisations and doctors referred to in article L. 162-5 of the Social Security Code, and who are not practising private practice outside of public health establishments, may engage in private practice.
In the event of suspension of the possibility of practising within the framework of this agreement, resulting from a decision by the director of a health insurance organisation, and after expiry of the appeal procedures, the authorisation referred to in article L. 6154-4 of this code is suspended for the duration of the suspension.
Practitioners who are the subject of such a measure may not sit on the local and regional commissions for liberal professions, referred to, respectively, in articles L. 6154-5 and L. 6154-5-1, for the remainder of the term of their contract.
The conditions for application of these provisions are set by decree in the Conseil d'Etat.
II.Private practice may include consultations, procedures and inpatient care; it is organised in such a way as to guarantee that patients are informed and that their choice between private practice and public practice is neutral; it is carried out within the establishment to which the practitioner has been appointed or, in the case of shared practice, in the establishments of the groupement hospitalier de territoire in which he/she practices, on the threefold condition :
1° That the practitioner personally and on a principal basis carries out an activity of the same nature in the public hospital sector;
2° That the duration of the self-employed activity does not exceed 20% of the weekly hospital service to which the practitioner is obliged;
3° That the total number of consultations and procedures carried out as part of the self-employed activity is less than the total number of consultations and procedures carried out as part of the public activity within the establishment or establishments in which he/she works.
For the application of 2°, hospital practitioners mentioned in 1° of article L. 6152-1 working eight or nine half-days per week may carry out a self-employed activity within the limit of one half-day per week; hospital practitioners working ten half-days per week may carry out a self-employed activity within the limit of two half-days per week.
In the event of shared activity, freelance activity may only be carried out on a maximum of two sites.
No bed or medical-technical facility may be reserved for freelance activity.
Regulatory provisions, which may, where applicable, derogate from the provisions of 4° of I of article L. 6112-2, set out the terms and conditions for carrying out freelance activity.
III.-In the event of temporary or permanent departure, only the clauses provided for in IV of this article apply to practitioners authorised to carry out private practice, with the exception of the provisions of article L. 6152-5-1.
IV. - The contract referred to in article L. 6154-4 includes a clause obliging the practitioner, in the event of temporary or permanent departure, except when he ceases his duties in order to claim his pension rights, not to set up practice, for a period of at least six months and no more than twenty-four months, and within a radius of at least three kilometres and no more than ten kilometres, in the vicinity of the public health establishment(s) in which he was practising on a self-employed basis.
In the event of non-compliance with this clause, a compensatory indemnity is payable by the practitioner. The amount of this compensation, the calculation of which is set out in the contract, may not exceed 30% of the average monthly amount of fees received for professional activity over the last six months, multiplied by the number of months during which the clause provided for in the first paragraph of this IV was not complied with.
As soon as non-compliance with this clause has been duly noted, in accordance with the adversarial procedure, on a proposal from the director of the establishment to which the practitioner is assigned and the chairman of the establishment's medical committee, and after obtaining the opinion of the regional consultative committee for freelance activity, the director general of the regional health agency will notify the practitioner, by any appropriate means, of the reasoned decision applying the indemnity provided for in the contract and determining the amount thereof.
These provisions do not apply to practitioners working at the Assistance publique-hôpitaux de Paris, the Hospices civils de Lyon and the Assistance publique-hôpitaux de Marseille, due to the specific configuration of healthcare provision in these urban areas.
The conditions for the application of these provisions are laid down by decree in the Conseil d'Etat.
