« Transcards » agreement: cross-border healthcare cooperation in the Thiérache region (signed on 22/11/2002. Effective date: 01/01/2003)
The agreement signed on organizes relations between hospitals located on both sides of the border (appendix 1) and applies to members of the general insurance scheme residing permanently in the areas described in appendix II corresponding to the Thiérache region.
It organizes the coverage of outpatient and hospital-based care pursuant to European regulations 883/2004 and 987/2009. However, no S2 prior approval is required since each country's health insurance card can be read in the other country (France's Vitale card in Belgium and Belgium's Sis card in France) to process patient records.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies. An assessment is conducted each year (statistics and financial data).
An annual report on the agreement is drawn up by the social security funds (volume of care provided).
- France-Belgium agreement on emergency medical assistance, signed on and effective date on 20/03/2007
- Appendices for France's Nord Pas de Calais region signed on 02/04/2008
- Appendices for France's Lorraine region (amendment 1) signed 30/04/2009. Effective date 08/06/2009
The agreement covers emergency medical assistance with the aim of shortening emergency response times by not restricting responses to each country's national borders when there are no available responders in the requesting country. This agreement covers the entire border between France and Belgium. It does not cover psychiatric commitments.
Responses are always launched by the call assignment center: SAMU in France or SMUR on the Belgian side of the border. During a response in the neighboring country, emergency services are only authorized to perform procedures that they are licensed to carry out in their home country.
The agreement sets up coverage for transportation to hospitals that are equipped for emergencies. Appendix 1, which is drawn up by each region applying the agreement, lists the geographical areas (towns) covered.
Coverage of expenses is granted pursuant to EU regulations 883/2004 and 987/2009, but no S2 prior approval is required. Expenses are paid by the country in which the patient is staying, after which one country reimburses the other through their social security liaison bodies.
An assessment is conducted each year (statistics and financial data, quality of care evaluations) and presented to the joint committee of the France-Belgium healthcare cooperation framework agreement. It should be noted that the agreement sets out specific rates that are listed in appendix III.
Amendment 1 to the agreement's appendices, which was signed on April 30, 2009, allows the Longwy mobile emergency service SMUR to respond to the town of Aubange (Belgium), and take patients to the Arlon (Belgium) hospital.
Pursuant to the agreement of May 9, 2011, the Luxemburg national Health insurance fund (« Caisse nationale de santé du Luxembourg ») recognized the France-Belgium agreement as being applicable to members of the Luxembourg scheme who are residing in either France or Belgium.
« MRTW » agreement establishing an organized cross-border healthcare access area for Mouscron-Roubaix-Tourcoing-Wattrelos (signed on and effective date : 02/04/2008) and its amendments
The agreement organizes relations among the hospitals located in Mouscron (Belgium) and Tourcoing, Roubaix, and Wattrelos (France) and applies to members of the Tourcoing, Roubaix, Armentières, and Lille health insurance funds, the agricultural social mutual fund (« MSA du Nord »), and the Nord Pas de Calais region self employed workers' insurance fund («RSI du Nord Pas de Calais »), who are permanent residents of any of the towns located in the district of Mouscron or the town of Estaimpuis (Belgium), or of any of the towns covered by the Tourcoing, Roubaix, Armentières, or Lille (France) health insurance funds.
It sets up coverage of outpatient and hospital-based care, including the cost of transport to the assigned hospital, and of out-of-pocket fees (« tickets modérateurs ») for exempt patients, pursuant to the provisions of European regulations 883/2004 and 987/2009, but no S2 prior approval is required.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An assessment of the agreement is drawn up and presented to the joint committee of the France-Belgium healthcare cooperation framework agreement each year (statistics and financial data, quality of care evaluations) (appendix 4).
« ARLWY » agreement establishing an organized cross-border healthcare access area between Belgium's Southern Luxemburg province and France's Longwy Basin (effective date : 01/07/2008)
This agreement organizes cooperation between the hospitals of Belgium's Southern Luxemburg province in Arlon and the Longwy Basin Hospital Association (« Association Hospitalière du Bassin de Longwy ») in France and covers customers belonging to all social security schemes who are permanent residents of towns in the Arlon and Virton districts in Belgium and the French towns located in the districts of Audun-le-Roman, Briey, Chambley- Bussières, Conflans-en-Jarnisy, Herserange, Homecourt, Longuyon, Mont-Saint-Martin, and Villerupt, and the town of Longwy.
It organizes coverage of outpatient and inpatient care, with the exception of fertility treatment, but including the cost of transport to the hospital, as well as the daily flat-rate charge for customers who are exempt, pursuant to European regulations No. 883/2004 and 987/2009, but no S2 prior approval is required.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An annual assessment of the agreement is drawn up and presented to the joint committee on the health care cooperation framework agreement between France and Belgium (statistics and financial data, quality of care assessment) (appendix 4).
Amendment 1: the « ARLWY » agreement is renamed « LORLUX » and extended to new facilities and new geographical areas.
By an agreement dated May 9, 2011, Luxemburg's National Health insurance Fund recognized the above agreement between France and Belgium as applicable to customers insured in Luxembourg and residing in either France or Belgium.
« DUNKERQUE-KEI » agreement on cross-border health care cooperation with regard to post-acute and rehabilitation care (effective date: 01/11/2008)
This agreement organizes relations between the « Centre hospitalier de Dunkerque » (Dunkirk hospital) and the Koningin Elisabeth Instituut (KEI) in Oostduinkerque, where patients covered by a French scheme can be transferred for post-acute or rehabilitation care if no other solution can be found locally.
Those covered are customers belonging to the « CPAM de Dunkerque », « MSA du Nord », and « RSI du Nord Pas de Calais ».
It organizes coverage for post-acute or rehabilitation care pursuant to European regulations 883/2004 and 987/2009 but no S2 for prior approval is required, even for coverage of transportation to the patient's facility and the daily flat-rate charge (coverage is capped at the reimbursement rates that are applicable in France for the same services with regard to length and quality of care).
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An assessment is conducted each year and presented to a committee tasked with evaluating the agreement (statistics and financial data).
Lorraine cross-border healthcare cooperation agreement between France and Belgium with regard to intensive care (effective date: 01/01/2013)
This agreement organizes coverage of intensive care provided by the « Centre Hospitalier Vivalia Clinique du Sud Luxembourg (Belgium) and the « Centre Hospitalier Alpha Santé Hôtel Dieu » in Mont Saint Martin (France) and applies to customers belonging to any scheme who are permanent residents of towns located within the district of Arlon and Virton (Belgium) and the towns located in the districts of Audun-le-Roman, Briey, Chambley-Bussières, Conflans-en-Jarnisy, Herserange, Homecourt, Longuyon, Mont-Saint-Martin, and Villerupt, and the town of Longwy (France).
This agreement only covers circumstances where the patient's facility is over capacity. As soon as the facility that set up the transfer is again able to admit the patient, the patient is returned there if there is no risk to his/her health.
It sets up coverage of care pursuant to EU regulations 883/2004 and 987/2009, but no S2 prior approval is required, even for coverage of transportation to the patient's facility and the daily flat-rate charge.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An assessment is conducted each year and presented to a cross-border oversight committee (statistics and financial data and quality of care).
Tournai-Valenciennes agreement setting up an organized cross-border healthcare access area (effective date: 01/05/2010) and its amendment 1 (effective date: 01/01/2014)
This agreement organizes cooperation between the « Centre Hospitalier de Wallonie Picardie » in Tournai (Belgium) and the « Centre hospitalier régional de Valenciennes (France) and applies to customers insured under any scheme who are permanent residents of the towns located in the district of Tournai (Belgium) and the towns covered by the Valenciennes local health insurance fund (« CPAM de Valenciennes ») in France.
It organizes coverage of outpatient and inpatient care, with the exception of fertility treatment, but including the cost of transport to the hospital, as well as the daily flat-rate charge for customers who are exempt, pursuant to European regulations 883/2004 and 987/2009, but no S2 prior approval is required.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An assessment is conducted each year and presented to a cross-border oversight committee (statistics and financial data and quality of care).
Amendment 1: addition of the L'Espoir specialized Rehabilitation Center (« Centre de Rééducation et de Réadaptation Fonctionnelle Spécialisées ») in Hellemmes (Belgium) to appendix 1.
« Ardennnes » agreement setting up an organized cross-border healthcare access area for the South Namur and Luxembourg provinces (Belgium) and the northern Ardennes department (France) (effective date: 01/01/2012)
The agreement organizes relations between the hospitals located on both sides of the border (appendix 1) and covers members of any social security scheme who are permanent residents of the towns located in the districts of Dinant Philippeville and the town of Bouillon (Belgique) and the towns located in the districts of Charleville Mézières and Sedan (France).
It organizes coverage of outpatient and inpatient care, with the exception of fertility treatment, but including the cost of transport to the hospital, as well as the daily flat-rate charge for customers who are exempt, pursuant to European regulations No. 883/2004 and 987/2009, but no S2 prior approval is required.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An assessment is conducted each year and presented to a cross-border oversight committee (statistics and financial data and quality of care). These data are submitted to joint committee on the health care cooperation framework agreement between France and Belgium.
CSL Vivalia-CHRU NANCY cross-border healthcare cooperation agreement on electrophysiology (effective date 01/01/2012)
The agreement organizes relations between the Vivalia clinics in Arlon in Belgium's South Luxemburg province and the Nancy Regional Hospital (« Centre Hospitalier régional de Nancy ») in France and covers Belgian customers who are permanent residents of the districts of Arlon and Virton (Belgium) and authorized to receive electrophysiology care at the Nancy Regional Hospital (CHRU de Nancy).
It organizes coverage of hospital-based care through the issuance of an « S2 » form (entitlement to scheduled treatment) pursuant to EU regulations 883/2004 and 987/2009.
Expenses are paid by the country in which the patient is staying, after which one country reimburses the other by way of the liaison bodies.
An assessment is conducted each year (number of people receiving coverage and cost of treatments received) and presented to the Lorraine regional health agency (« ARS Lorraine ») and to the Belgian liaison body (INAMI).
Cross-border cooperation agreement on paediatric cardiac surgery (signed on 05/12/2016, having entered into force on 01/01/2017) and its amendment no. 1 having entered into force on 01/01/2022 )
This agreement coordinates the relations between the Regional University Hospital Centre (CHRU Lille) and the Saint-Luc university clinics in Brussels in order to develop paediatric cardiac surgical skills. It is applicable to beneficiaries of French health insurance (all schemes included), including Community residents and those referred to in a bilateral social security agreement who reside in the Hauts de France and Normandy regions on a permanent basis.
It coordinates cover for hospital care provided by the Saint-Luc university clinics in Brussels, including transfer costs. In the event of death, fees incurred to repatriate the body are not covered by the agreement.
Bills are sent directly to the relevant French funds through the Liaison fund (CPAM of Roubaix-Tourcoing) and must be settled within 30 days. The CPAM is tasked with checking these bills and subsequently collecting any sums overpaid where applicable.
An oversight committee ensures implementation of the agreement and proposes any amendments. An assessment report is drafted every year (number of persons concerned, statistics and financial data) and presented to the Hauts de France regional health agency (ARS).
The initial agreement which was valid up until 31/12/2021 was extended by amendment no. 1 until 31/12/2026.
Cross-border agreements on the cover of disabled children, teens and young adults enrolled in Belgian establishments by the Roubaix-Tourcoing health insurance fund (CPAM)
These various agreements provide for cover for:
You may view the list of relevant Belgian medical and social establishments here.
The content of these agreements is similar; only the number of persons admitted by these structures and the associated budgets are different. For example, these include the agreements signed with the Notre Dame de La sagesse Institute in LEERS (children and teens) and the ABSL Le Saulchoir in Kain (adults).
The Roubaix-Tourcoing CPAM is the central fund for implementation of these agreements which define and set out the conditions for admission and assistance to these persons, as well as the terms for financial cover and reimbursement of expenses. Inspections may be conducted in accordance with the agreement on the implementation of joint inspections signed on 03/11/2014.
These agreements set out certain technical conditions for the admission of disabled persons, such as the creation of an establishment programme, a personalised support plan for the disabled person, the keeping of an individual medical, social and educational record, the keeping of a record of admitted persons, a training programme for establishment personnel, a protocol for reporting undesirable events and exceptional or dramatic circumstances within the establishment to administrative authorities, the condition of buildings, the structure of medical, paramedical, psychological and educational teams, the rights of the persons admitted and particularly adults under court protection.
Every year, these agreements set out the number of persons that may be admitted either for residential accommodation or day accommodation, after referral by the Départemental Office for Persons with Disabilities (MDPH), and the total number of days of cover. By multiplying these two factors, the Hauts de France ARS is able to determine a total annual package for the accommodation structure. This package is subject to change if the structure admits disabled adults for which general committees are responsible and is paid on a monthly basis in twelfths to the host establishment. When the establishment agrees to admit the disabled person, cover is provided by the Roubaix-Tourcoing CPAM.
The rates of services provided are set by the ARS which determines their amount. A global daily rate is applied to the various services required by the disabled persons to care for their disabilities, including any care and monitoring provided by external providers when they are linked to the disability for which the referral was made. This daily rate includes all accommodation costs, the remuneration of all categories of staff in charge of providing care and treatment, observation, rehabilitation and education of the patients, transport costs and all medical and paramedical costs incurred by the structure. The care provided in establishments other than the host structure are covered by the relevant funds after approval by the latter when such care is linked to the disability. Any care medically-required or scheduled in another State are covered under Community regulations 883/2004 and 987/2009, based on European health insurance cards (medically-required care) or an S2 form (scheduled care).