Framework agreement on cross-border healthcooperation and its administrative arrangement signed respectively on 30/09/2005 and 29/10/2013. Effective date: 01/03/2011
The first framework agreement and its administrative arrangement cover cross-border health cooperation.
In addition to its main provisions, this agreement defines:
a geographical scope:
the Hauts de France and Grand-Est regions in France,
the border districts of Furnes, Ypres, Courtrai, Mouscron, Tournai, Ath, Mons, Thuin, Philippeville, Dinant, Neufchâteau, Virton and Arlon in Belgium.
a personal scope:
any person eligible to benefit from the health insurance scheme of either Party, and residing in or visiting the regions listed above.
competent implementing authorities:
for France: the Hauts de France and Grand-Est regional health agencies (ARS) and the Roubaix-Tourcoing Primary Health Insurance Fund as the single point of contact for both region;
for Belgium: the National Institute for Health and Disability Insurance in Brussels, the various insurance bodies and the healthcare providers.
• 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,
organisation of 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.
law applicable to the cross-border activities of healthcare professionals and their liability:
the personnel authorised to practice cross-border activities are required to comply with the law in force within the other Party's territory,
they must comply with the law in force within the territory in which the services are provided, notably as regards medical liability,
professionals, establishments and health services must necessarily take out civil liability insurance that covers any damage that may be caused by their activities during cross-border cooperation,
the Parties must take all necessary measures to facilitate the crossing of shared borders for implementation of this framework agreement.
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 cover 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.
Framework agreement with the Walloon region of the Kingdom of Belgium on accommodation for people with disabilities and its administrative arrangement signed on 21/12/2011. Effective date: 01/03/2011.
The second framework agreement and its administrative arrangement cover cross-border health cooperation in the medical social sector: accommodation of and support to persons with disabilities governed by the French scheme.
In addition to its main provisions, this agreement defines:
a geographical scope:
the French republic,
the Walloon region of the Kingdom of Belgium.
a material and personal scope:
all establishments legally performing their activities in the Walloon region of the Kingdom of Belgium and providing services to any underaged or adult person with a disability recognised by the competent French institution and benefiting as such from financial cover pursuant to French legislation.
competent implementing authorities:
the content of the cooperation agreements:
they coordinate cooperation between medical social structures and resources located in the Walloon region, with an anchor point in said region or part of a network operating in this area,
to this end, they may provide for complementarity between existing medical social structures and resources, and the creation of cooperation entities or joint structures,
they set out the terms and conditions for the intervention of medical social structures and entities providing care to persons with disabilities.
the exchange of administrative information:
The Hauts de France ARS is tasked with centralising the data on the information note.
law applicable to the cross-border practice of medical social establishments and their responsibilities:
the signatories to the agreement undertake to implement an efficient Franco-Walloon joint inspection system,
inspections must comply with the law in force within the territory in which the services are provided,
medical social establishments and services must necessarily take out civil liability insurance covering any losses that may be caused by their activity,
that data on the information note are used for the exclusive purpose of listing and identifying disabled persons accommodated in the establishments and are subject to compliance with national and European data protection legislation.
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 1231/2010, on the basis of a Community document certifying the activation of rights and a referral to an establishment by the French institution responsible for recognition of a disability,
payment of services by the patient and direct cover by the State of affiliation according to its own rates,
option for the State of affiliation to directly cover the costs of the services based on specific rates negotiated between the signatories of local medical social cooperation agreements.
deadline for compliance:
where necessary, existing cooperation agreements must be brought into compliance with the framework agreement within 18 months of its entry into force.
terms for assessment of the agreement:
creation of a joint commission comprised of representatives of signatories' competent authorities, meeting whenever necessary at the request of either Party. This commission is tasked wit
overseeing the application of the framework agreement and proposing amendments,
settling any difficulties relating to the application or interpretation of this framework agreement.
Agreement on the implementation of joint inspections signed on 03/11/2014, pursuant to article 4 of the framework agreement of 21/11/2011.
Competent implementing authorities for joint inspections:
the officers of the Walloon Agency for the Integration of Persons with Disabilities (AWIPH);
the officers of the Hauts de France ARS;
the officers of another ARS or Départemental General Council may be involved by agreement;
the officers of health insurance body as regards the terms for cover by a social security scheme.
Exhaustive list of criteria selected for joint inspections
terms of admission and accommodation;
terms of medical, social and educational programmes, notably the implementation of personalised support programs, in combination with individual learning plans for youths;
terms of cover by a social security scheme;
promotion of welfare;
updating of professionals' knowledge;
sharing of data contained on the information note under the framework agreement.
law applicable to the cross-border activities of medical and social establishments and their liabilities:
inspections must comply with the law in force within the territory in which the services are provided
medical and social establishments must:
provide the officers tasked with the checks with the identities of accommodated persons,
provide them with access to their premises and present all accommodated persons to them,
provide all necessary information for the assessment of the material and moral conditions under which the establishment operates.
Terms for the implementation of joint inspections:
inspections may be triggered by the Hauts de France ARS or AWIPH, or by the Ministries in charge of persons with disabilities or social security;
they may be triggered in the event of a serious threat to the health, safety and well-being of the persons accommodated or as part of the inspection plan defined under the annual works programme mutually agreed on by the Hauts de France ARS and the AWIPH;
the AWIPH's departments prepare, propose and implement the inspection process and provide the inspecting officers with the legal basis for the intervention, the purpose and the context of the task, the date and place of the intervention, and the establishment's main characteristics;
if the inspection reveals management or organisation offences or malfunctions likely to affect the care or support provided to users or compliance with their rights, a joint report is drafted;
AWPIH is tasked with following up inspections and informing the ARS. It notifies the establishments and the complainants of any measures decided to resolve the malfunctions observed. Where a disagreement persists between the competent authorities tasked with the inspections, they may refer the matter to the joint committee.
conditions of cover of inspection costs:
costs arising from joint inspections (travel expenses, accommodation, etc.) are covered by the authorities in charge of the inspecting officers
terms for assessment of the agreement:
where necessary, the agreement is assessed by the parties.