Soins de transition. Adapter les règles de financement à

!
!
"#$%&'%()*$(+**%!,-.!/0123,,!4%(&%.!5-,!2,!2,3!3,!63.!7&89:;#(+8#$#(+<;=.!>>><;#(+8#$#(+<;=!
,!
!
!
!
"#$%&!'(!)*#$!$%!+,-.$/!
?@7&7$7+$7A%!B+(C%D%&$+7(%!,-<--6!E%D+&E%!C+!(FD#&F(+$79&!E%!C@%&*%D'C%!E%*!B(%*$+$79&*!E%!*97&*!+7)#*!
%$!*97&*!E%!$(+&*7$79&<!G#$(%!C%*!B(%*$+$79&*!E%!*97&*.!C%*!8(+7*!E@=F'%()%D%&$!E%A(+7%&$!EF*9(D+7*!+#**7!
H$(%!B(7*!%&!;=+()%<!
?%*!*97&*!+7)#*!%$!C%*!*97&*!E%!$(+&*7$79&!*9&$!E%*!B(%*$+$79&*!E%!*97&*!I#7!*@+AJ(%&$!7&E7*B%&*+'C%*!+B(J*!
#&!*FK9#(!*$+$79&&+7(%!L!C@=MB7$+C<!N%!$%CC%*!B(%*$+$79&*!*9&$!&9$+DD%&$!89#(&7%*!B+(!C%*!=9D%*!%$!
F$+'C7**%D%&$*!DFE7;91*9;7+#O.!D+7*!F)+C%D%&$!B+(!E@+#$(%*!B(%*$+$+7(%*!PE9&$!C%*!*%(A7;%*!E@+7E%!%$!E%!
*97&*!L!E9D7;7C%Q<!?%*!;9R$*!*9&$!(%D'9#(*F*!*%C9&!C%*!(J)C%*!E#!87&+&;%D%&$!=9*B7$+C7%(S!C%!;+&$9&!
+**#D%!+#!D97&*!TTU!E%*!;9R$*!E%*!B(%*$+$79&*!E%!*97&*.!C%!(%*$%!F$+&$!B+VF!B+(!C@+**#(+&;%1D+C+E7%<!
!
0#+$/$#1!'(!2*3-4*/*3-!
567896:678!7;<;::;!=,>?>:>8:>@;!A87=;B;?:8>7;C!?%!87&+&;%D%&$!E%D+&EF!E%!C@7&$F)(+C7$F!E%*!*97&*!+7)#*!%$!
E%*!*97&*!E%!$(+&*7$79&!;9&$(%E7$!C%!87&+&;%D%&$!E%*!B(%*$+$79&*!E%!*97&*!87)#(+&$!L!C@+($7;C%!WT+!E%!C+!C97!
8FEF(+C%!*#(!C@+**#(+&;%1D+C+E7%!P?XY+CQ<!Z!;%$!F)+(E.!C%!B(7&;7B%!%&!A7)#%#(!A%#$!I#%!C%*!8(+7*!
E@=F'%()%D%&$!&%!*9&$!B+*!B(7*!%&!;=+()%!EJ*!C9(*!I#%!C+!&F;%**7$F!E@#&%!=9*B7$+C7*+$79&!&@%*$!BC#*!
+AF(F%<!N%!BC#*.!#&!87&+&;%D%&$!E%!C@7&$F)(+C7$F!E%*!;9R$*!7DBC7I#%(+7$!#&%!7&F)+C7$F!E%!$(+7$%D%&$!B+(!
(+BB9($!+#O!*97&*!E%!C9&)#%!E#(F%<![9#(!;%*!*97&*.!C@+**#(+&;%!9'C7)+$97(%!E%*!*97&*!PXG\Q!&%!B(%&E!B+*!
&9&!BC#*!%&!;=+()%!C%*!8(+7*!E@=F'%()%D%&$.!$9#K9#(*!%&!(+7*9&!E@#&%!&F;%**7$F!E@=9*B7$+C7*+$79&!&9&!
+AF(F%<!
!
D*+/$4$2-/$#1!
EFG!08H!I,>?JK8=>:J!I;!:78>:;B;?:!@>HLML@>H!I;H!A8:>;?:H!NJ?J9>5>8?:!I;!HO>?H!I;!=O?K6;!I67J;!
?%!87&+&;%D%&$!E%*!*97&*!+7)#*!%$!E%*!*97&*!E%!$(+&*7$79&!(%B9*%!*#(!C%!B(7&;7B%!*%C9&!C%I#%C!+#;#&*!8(+7*!
E@=F'%()%D%&$!&%!B%#A%&$!H$(%!B(7*!%&!;=+()%<!/%!B(7&;7B%!%*$!I#+&$!L!C#7!89&EF!*#(!C+!&F;%**7$F!
E@=9*B7$+C7*+$79&.!I#7!&@%*$!BC#*!+AF(F%!EJ*!C9(*!I#%!C%*!;(7$J(%*!DFE7;+#O!B9#(!#&!*FK9#(!*$+$79&&+7(%!L!
C@=MB7$+C!&%!*9&$!BC#*!(F#&7*<!G(.!C+!&F;%**7$F!E@=9*B7$+C7*+$79&!&@%*$!+AF(F%!&7!B9#(!C%*!B+$7%&$*!'F&F87;7+&$!
E%!*97&*!+7)#*!9#!E%!*97&*!E%!$(+&*7$79&.!&7!B9#(!;%#O!'F&F87;7+&$!E%!*97&*!E%!C9&)#%!E#(F%<!?@XG\!89#(&7$!
+C9(*!#&%!;9&$(7'#$79&!+#O!*97&*!P+($<!WT+!?XY+CQ.!D+7*!&%!B(%&E!B+*!%&!;=+()%!C%*!8(+7*!E@=F'%()%D%&$<!
/%$$%!7&7$7+$7A%!B+(C%D%&$+7(%!7&*$+#(%(+7$!#&!87&+&;%D%&$!E788F(%&$!B9#(!E%#O!E9D+7&%*!E%!B(%*$+$79&*!
I#7!*9&$!;9DB+(+'C%*!E@#&!B97&$!E%!A#%!DFE7;+C!PB+*!E%!&F;%**7$F!E@=9*B7$+C7*+$79&Q<!?%*!*97&*!E%!C9&)#%!
E#(F%!;9&$7&#%(+7%&$!+7&*7!L!H$(%!*9#D7*!L!#&!87&+&;%D%&$!E%!C+!;9&$(7'#$79&.!+C9(*!I#%!C%*!*97&*!+7)#*!%$!
C%*!*97&*!E%!$(+&*7$79&!*%(+7%&$!87&+&;F*!%&!7&$F)(+C7$F<!?@7&7$7+$7A%!B+(C%D%&$+7(%!,-<--6!)F&J(%!+7&*7!#&%!
&9#A%CC%!*7$#+$79&!B(9'CFD+$7I#%.!L!*+A97(!#&%!7&F)+C7$F!E%!$(+7$%D%&$!%&!D+$7J(%!E%!87&+&;%D%&$!E%*!
B(%*$+$79&*!E%!*97&*<!
]9;#*!
P+O>?H!I;!:78?H>:>O?C!-I8A:;7!=;H!7QK=;H!I;!9>?8?5;B;?:!M!=8!A78:>R6;S!
^&7$7+$7A%!B+(C%D%&$+7(%!,-<--6!
!
!
"#$%&'%()*$(+**%!,-.!/0123,,!4%(&%.!5-,!2,!2,3!3,!63.!7&89:;#(+8#$#(+<;=.!>>><;#(+8#$#(+<;=!
W!
_&!;%!I#7!;9&;%(&%!C+!&F;%**7$F!E@=9*B7$+C7*+$79&.!7C!V!+!F)+C%D%&$!C7%#!E%!B(%&E(%!%&!;9&*7EF(+$79&!C+!
B9**7'7C7$F!E%!(F+E+B$+$79&*!*$+$79&&+7(%*<!?%*!B+$7%&$*!I#7!&F;%**7$%&$!%&;9(%!#&%!=9*B7$+C7*+$79&!+B(J*!
+A97(!*FK9#(&F!E%!D+&7J(%!*$+$79&&+7(%!E+&*!#&!=MB7$+C!B9#(!*97&*!+7)#*!*9&$!%&!%88%$!$(+&*8F(F*!A%(*!#&%!
;C7&7I#%!E%!(F+E+B$+$79&!B9#(!V!(%;%A97(!E%*!*97&*!*$+$79&&+7(%*<!Z!C@7&A%(*%.!E%*!988(%*!+C$%(&+$7A%*!
E@+BB(9A7*79&&%D%&$!%&!*97&*!*9&$!+#**7!%&A7*+)%+'C%*!*7!C+!&F;%**7$F!E@=9*B7$+C7*+$79&!&@%*$!B+*!+AF(F%.!
B+(!%O%DBC%!C@+7E%!%$!C%*!*97&*!L!E9D7;7C%<!\%C9&!C+!*7$#+$79&!E%!;=+I#%!B+$7%&$.!E7A%(*%*!*$(#;$#(%*!*9&$!%&!
D%*#(%!E%!B(9E7)#%(!E%!D+&7J(%!+EFI#+$%!E%*!*97&*!+B(J*!#&!*FK9#(!*$+$79&&+7(%!L!C@=MB7$+C<!
ETG!08H!I;!HO7:>;!A7J5O5;!AO67!=;H!A8:>;?:H!H:8:>O??8>7;H!
?@7&7$7+$7A%!B+(C%D%&$+7(%!(%B(%&E!C@+()#D%&$!EFKL!D+7&$%*!897*!+A+&;F!E%*!*9($7%*!B(F;9;%*!E9&$!8%(+7%&$!
C@9'K%$!C%*!B+$7%&$*!*$+$79&&+7(%*<!?@7&$(9E#;$79&!L!C@F;=%C9&!&+$79&+C!E%*!89(8+7$*!B+(!;+*!+OF*!*#(!C%*!
B(%*$+$79&*!B9#(!C%*!=9*B7$+C7*+$79&*!%&!F$+'C7**%D%&$*!B9#(!*97&*!+7)#*!PN`"Q!%&!W3,W!+#(+7$!;9&E#7$!L!;%!
I#%!E%*!B+$7%&$*!I#7$$%&$!C@=MB7$+C!E%!D+&7J(%!B(F;9;%<!
?+!*$+$7*$7I#%!DFE7;+C%!E%*!=MB7$+#O.!E(%**F%!B+(!C@G887;%!8FEF(+C!E%!C+!*$+$7*$7I#%!PG]\Q.!7&E7I#%!$9#$%897*!
I#%!;%$$%!+887(D+$79&!&@%*$!I#@#&%!+CCF)+$79&S!%&$(%!W3,,!%$!W3,W!P+&&F%!E@7&$(9E#;$79&!E%*!N`"Q.!C+!
E#(F%!E%!*FK9#(!D9V%&&%!E+&*!C%*!=MB7$+#O!E%!*97&*!+7)#*!%*$!E%D%#(F%!I#+*7D%&$!;9&*$+&$%<!?+!8+7'C%!
'+7**%!;9&*$+$F%!E%!T.6!L!T.a!K9#(*!;9((%*B9&E!L!#&%!$%&E+&;%!BF(%&&%!Pb.6!K9#(*!%&!W33-c!T.b!K9#(*!%&!
W3,-Q<,!N%*!*9($7%*!B(F;9;%*!E%!C@=MB7$+C!E%A(+7%&$!+BB+(+d$(%!E+&*!;%$$%!*$+$7*$7I#%.!I#7!%&(%)7*$(%(+7$!
+C9(*!#&%!'+7**%!*7)&787;+$7A%<!?+!$=J*%!+A+&;F%!E+&*!C@7&7$7+$7A%!B+(C%D%&$+7(%.!*%C9&!C+I#%CC%!C%*!B+$7%&$*!
I#7$$%(+7%&$!E%!D+&7J(%!B(F;9;%!C@=MB7$+C.!&@%*$!E9&;!B+*!;9((9'9(F%<!
EUG!08H!I;!9=O6H!;?!:;7B;H!=JK>H=8:>9H!
N+&*!*9&!EFA%C9BB%D%&$.!C@7&7$7+$7A%!B+(C%D%&$+7(%!B(F;7*%!I#%!C9(*!E%!C@7&$(9E#;$79&!E#!&9#A%+#!
87&+&;%D%&$!E%*!*97&*!%&!W3,,.!C%!CF)7*C+$%#(!*9#=+7$+7$!#&!87&+&;%D%&$!7&$F)(+C!E%*!*97&*!+7)#*!%$!E%*!
*97&*!E%!$(+&*7$79&!P=F'%()%D%&$!;9DB(7*Q<!?%*!8+7$*!(FAJC%&$!;%B%&E+&$!#&%!7D+)%!'7%&!E788F(%&$%S!C%!
,3!K#7&!W33e.!C%!/9&*%7C!8FEF(+C!F;(7A+7$!+7&*7.!E+&*!C@9B$7I#%!E%!C+!(FA7*79&!E%!C@9(E9&&+&;%!*#(!C%*!
B(%*$+$79&*!E+&*!C@+**#(+&;%!9'C7)+$97(%!E%*!*97&*!%&!;+*!E%!D+C+E7%!PG[X\Q.!;%!I#7!*#7$!L!B(9B9*!E%!
C@+($7;C%!a'S!
«Prise'en'charge'des'soins'aigus'et'de'transition'(art.'7b).'
Cet$article$décrit$la$prise$en$charge$des$soins$aigus$et$de$transition.$La$rémunération(est(définie(aux(al.(1(et(2(
selon&les&dispositions&légales&sur&le&financement&hospitalier.&Il&s’agit&ici&uniquement&de&la&prise&en&charge&des&
prestations*de*soins*au*sens*de*l’art.*7,*al.*2*OPAS,*ces*prestations*étant*de*type*ambulatoire*les'frais$
d’hôtellerie*ne*sont*pas*pris*en*charge*par*l’assurance8maladie!
/7&I!+&*!+B(J*!C@7&$(9E#;$79&!E#!&9#A%+#!87&+&;%D%&$!E%*!*97&*.!C+!/9DD7**79&!E%!C+!*F;#(7$F!*9;7+C%!%$!
E%!C+!*+&$F!B#'C7I#%!E#!/9&*%7C!E%*!f$+$*!P/\\\1_Q!B(F;7*+7$!B+(!+7CC%#(*!E+&*!*9&!(+BB9($!%OBC7;+$78!*#(!
C@7&7$7+$7A%!B+(C%D%&$+7(%!,-<-,a!gXD%&E%(!C%!(F)7D%!E%!87&+&;%D%&$!E%*!*97&*h!;%!I#7!*#7$!S!
«Le$canton$de$résidence$de$l’assuré$et$les$assureurs$prennent$proportionnellement$en$charge$les$coûts$des$
prestations'des'soins'aigus'et"de"transition,"la"part"cantonale"s’élevant"au"moins"à"55%."Les"fournisseurs"de"
prestations'et'les'assureurs'doivent'convenir'de'forfaits'pour%ces%prestations%qui,%en%termes%de%contenu,%
correspondent*à*l’art.*7*OPAS!(art.&25a,&al.&2,&LAMal).&La&réglementation'légale'est'donc'suffisamment'claire.»!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!! !
,!\9#(;%S!G'*%(A+$97(%!*#7**%!E%!C+!*+&$F!PG'*+&QS!=$$BSii>>><9'*+&<+ED7&<;=i8(i7&E7;+$%#(*iE#(%%1E%1*%K9#(1E+&*1
C%*1=9B7$+#O1E%1*97&*1+7)#*!j;9&*#C$+$79&!C%!,3<32<W3,bk!
!
!
"#$%&'%()*$(+**%!,-.!/0123,,!4%(&%.!5-,!2,!2,3!3,!63.!7&89:;#(+8#$#(+<;=.!>>><;#(+8#$#(+<;=!
2!
^C!&@%*$!7;7!&#CC%D%&$!I#%*$79&!E@#&!87&+&;%D%&$!7&$F)(+C!E%*!;9R$*!E%*!*97&*!+7)#*!%$!E%*!*97&*!E%!
$(+&*7$79&<!X#!;9&$(+7(%S!C%!/9&*%7C!8FEF(+C!%$!C%!/9&*%7C!E%*!f$+$*!+88%;$%&$!;9((%;$%D%&$!C%*!*97&*!+7)#*!%$!
C%*!*97&*!E%!$(+&*7$79&!L!C+!;+$F)9(7%!E%*!+#$(%*!B(%*$+$79&*!E%!*97&*.!E9&$!C%*!8(+7*!E@=F'%()%D%&$!&%!*9&$!
B+*!B(7*!%&!;=+()%!B+(!C@XG\<!
!
!
!
4%(&%.!D+(*!W3,b!
1 / 3 100%
La catégorie de ce document est-elle correcte?
Merci pour votre participation!

Faire une suggestion

Avez-vous trouvé des erreurs dans linterface ou les textes ? Ou savez-vous comment améliorer linterface utilisateur de StudyLib ? Nhésitez pas à envoyer vos suggestions. Cest très important pour nous !