Signed on July 30 by the Health Insurance and the unions, amendment 9 to the medical convention was published in the Official Journal of September 25, allowing the measures it ratified on March 25, 2022 to come into force.
Latest amendment to the 2016 convention, this text eagerly awaited by city medicine endorses tariff measures amounting to 786 million euros, including 165 million euros for general practitioners, an equivalent sum for other specialists, 150 million euros for unscheduled care and 300 million euros euros for the development of digital health.
On the general practitioner side, the amendment notably extends the long visit (60 euros + MD) to all patients over 80 years of age in ALD, within the limit of one quotation per quarter and per patient. Likewise, the annual quota for VL goes from 3 to 4 for patients with neurodegenerative disease and for palliative care.
A complex consultation (46 euros) for the entry of young patients within the framework of Social Assistance to Children (ASE) is created for general practitioners, as for pediatricians.
For these two specialties, very complex consultations (60 euros) may be listed for the management of autism spectrum disorders and neurodevelopment. In addition, the completion of the first MDPH application file will be valued as a very complex consultation.
Finally, the rider introduces a “white consultation”, listed as the reference consultation, which is understood “as the scheduled meeting time between the patient living with a disability and the practitioner as well as his or her place of consultation” or will apply for a consultation during which “the planned care could not be carried out given the patient’s disability”.
On the specialist side, the rider revalues the one-off consultant opinion up to 55 euros and provides for specific pricing measures for psychiatrists (+3.5 euros for the CNPSY), endocrinologists, pediatricians (+5 euros for the NFP) and medical gynecologists.
While experiments have been launched in 22 departments, amendment 9 also fixes the remuneration of physicians participating in the access to care service (SAS): for regulators, 90 euros per hour with payment of social contributions for sector 1 doctors; for the effectors, a flat-rate remuneration in stages according to the number of unscheduled treatments insured per quarter (up to 360 points of structural flat rate + 150 points for participation). A remuneration deemed insufficient by certain local players, who announced a boycott of the experiments in progress.
The text also opens up the field of telemedicine, by lifting the requirement of territoriality of the teleconsultation for patients residing in a sub-dense area and by removing the rule conditioning the reimbursement of the teleconsultation to a face-to-face consultation within 12 months. previous ones. Tele-expertise, now available to all patients, will be remunerated at 20 euros per act for the required doctor and 10 euros for the requesting doctor, up to a limit of four per year and per patient.
Indicators for the use of digital tools are included in the structure fee, in particular to remunerate the completion of the medical summary section.
Finally, the amendment sets up an incentive scheme for the prescription of biosimilar drugs.
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