Framework agreement on cross-border healthcare cooperation and its administrative arrangement signed signed respectively on 22/07/2005 and 09/03/2006. Effective date: 01/04/2007
These documents cover cross-border health cooperation, including as regards medical emergency services.
They set out the main provisions and define:
a geographical scope:
the Grand-Est region in France,
the Baden-Württemberg, Rhineland-Palatinate and Saarland Länder in Germany.
a personal scope:
any person eligible to benefit from the health insurance scheme of either Party, and habitually residing in or temporarily visiting the regions listed above,
any person habitually residing or temporarily visiting the regions listed above and requiring emergency care.
competent implementing authorities:
for France: the Grand-Est Regional Health Agency, and the Moselle, Bas-Rhin and Haut-Rhin health insurance funds (CPAM),
for Germany: the respective Ministries, their subordinated authorities, the self-governed authorities under their legal supervision and other healthcare institutions.
the content of the cooperation agreements:
they coordinate cooperation between health structures and resources located in the regions listed above, with an anchor point in said regions or part of a network operating in this area,
to this end, they may provide for complementarity between existing health structures and resources, and the creation of cooperation entities or joint structures,
they set out the terms and conditions applicable to care structures, social security bodies and the intervention of healthcare professionals, as well as care to patients; these terms and conditions may cover the following topics:
cross-border intervention of healthcare professionals, notably aspects relating to status as regards the French side,
organisation of emergency services and healthcare transport for patients,
guarantee of continuity of care, particularly as regards the reception and information provided to patients, criteria for assessment and inspection of the quality and safety of care,
financial means required to implement cooperation, notably for the reimbursement of expenses incurred as part of the mobilisation of resources to treat patients.
law applicable to the cross-border activities of healthcare professionals:
the personnel authorised to exercise a professional activity in the medical emergency sector within a Party's territory do not need authorisation to exercise a professional activity from the other Party if these activities are performed on a temporary basis as part of cross-border interventions relating to medical emergency services and are dispensed from compulsory membership with a professional chamber in the other country,
they are required to comply with the law in force within the other Party's territory,
the Parties take all necessary measures to facilitate the crossing of shared borders for implementation of this framework agreement.
healthcare providers' liability:
compliance with the law in force, notably as regards medical liability, within the territory in which the services are provided,
compulsory civil liability insurance for professionals, establishments and health departments with cover for any damage that may be caused by their activities during cross-border cooperation.
conditions of care and reimbursement of care:
care provided by the country of care, according to the rates applied by said State, under Regulations (EC) No 883/2004 and (EC) No 987/209, after issuance of prior authorisation (S2 form),
payment of care by the patient and direct coverage by the State of affiliation according to its own rates,
option for the State of affiliation to directly cover the costs of care based on specific rates negotiated between the signatories of local health cooperation agreements.
deadline for compliance:
where necessary, existing cooperation agreements must be brought into compliance with the framework agreement within one year of its entry into force;
terms for assessment of the agreement:
creation of a joint commission comprised of representatives of both States' competent authorities, which must meet at least once a year or whenever necessary at the request of either Party. This commission is tasked with
overseeing the application of the framework agreement,
settling any difficulties relating to the application or interpretation of this framework agreement,
producing a yearly report on the cross-border health cooperation scheme.