{ "article": { "LEGIARTI000019945424": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "42", "TYPE": "ENTIEREMENT_MODIF", "DATE_FIN": "2999-01-01", "DATE_DEBUT": "2999-01-01" } }, "META_COMMUN": { "ID": "LEGIARTI000019945424", "URL": "article/LEGI/ARTI/00/00/19/94/54/LEGIARTI000019945424.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "LIENS": { "LIEN": [ { "@id": "LEGIARTI000019954056", "@num": "L162-1-7", "#text": "Code de la sécurité sociale. - art. L162-1-7 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000019954048", "@num": "L315-2", "#text": "Code de la sécurité sociale. - art. L315-2 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" } ] }, "CONTEXTE": { "TEXTE": { "TM": { "TM": { "TITRE_TM": [ { "@id": "LEGISCTA000019945320", "@fin": "2999-01-01", "#text": "SECTION 1 : DISPOSITIONS RELATIVES AUX DEPENSES D'ASSURANCE MALADIE", "@debut": "2008-12-19" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000019945330", "@fin": "2999-01-01", "#text": "QUATRIEME PARTIE : DISPOSITIONS RELATIVES AUX DEPENSES POUR 2009", "@debut": "2008-12-19" } ] }, "@cid": "JORFTEXT000019942966", "@nor": "BCFX0823210L", "@num": "2008-1330", "@nature": "LOI", "TITRE_TXT": [ { "@fin": "2999-01-01", "#text": "LOI n° 2008-1330 du 17 décembre 2008 de financement de la sécurité sociale pour 2009 (1)", "@debut": "2999-01-01", "@id_txt": "JORFTEXT000019942966", "@c_titre_court": "LOI n°2008-1330 du 17 décembre 2008" }, { "@fin": "2999-01-01", "#text": "LOI n° 2008-1330 du 17 décembre 2008 de financement de la sécurité sociale pour 2009 (1)", "@debut": "2008-12-19", "@id_txt": "LEGITEXT000019945312", "@c_titre_court": "LOI n° 2008-1330 du 17 décembre 2008" } ], "@date_publi": "2008-12-18", "@date_signature": "2008-12-17" } }, "VERSIONS": { "VERSION": [ { "LIEN_ART": { "@id": "LEGIARTI000019945424", "@fin": "2999-01-01", "@num": "42", "@debut": "2999-01-01", "@origine": "LEGI" } }, { "LIEN_ART": { "@id": "JORFARTI000019943206", "@fin": "2999-01-01", "@num": "42", "@debut": "2999-01-01", "@origine": "JORF" } } ] }, "BLOC_TEXTUEL": { "CONTENU": "
A modifié les dispositions suivantes :

- Code de la sécurité sociale.
\n Art. L162-1-7, Art. L315-2\n
\n

\n
" } }, "LEGIARTI000019954048": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L315-2", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2016-01-01", "DATE_DEBUT": "2008-12-19" } }, "META_COMMUN": { "ID": "LEGIARTI000019954048", "URL": "article/LEGI/ARTI/00/00/19/95/40/LEGIARTI000019954048.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "LIENS": { "LIEN": [ { "@id": "LEGIARTI000046813093", "@num": "20-5-6", "#text": "Ordonnance n°96-1122 du 20 décembre 1996 - art. 20-5-6 (VD)", "@sens": "cible", "@cidtexte": "JORFTEXT000000368749", "@nortexte": "DOMX9600135R", "@numtexte": "96-1122", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1996-12-20" }, { "@id": "LEGIARTI000006684619", "@num": "124", "#text": "Décret n°2003-1010 du 22 octobre 2003 - art. 124 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000000610356", "@nortexte": "SOCA0323026D", "@numtexte": "2003-1010", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2003-10-22" }, { "@id": "LEGIARTI000006726174", "@num": "35", "#text": "Décret n°2004-942 du 3 septembre 2004 - art. 35 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000000253592", "@nortexte": "SANS0422327D", "@numtexte": "2004-942", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2004-09-03" }, { "@id": "LEGIARTI000026930574", "@num": "Annexe", "#text": "Arrêté du 21 juin 2006 - art. Annexe (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000609522", "@nortexte": "SANS0622624A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2006-06-21" }, { "@id": "LEGIARTI000006252691", "@num": "3", "#text": "Arrêté du 26 juin 2006 - art. 3 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000792699", "@nortexte": "SANS0622660A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2006-06-26" }, { "@id": "LEGIARTI000006760041", "@num": "83", "#text": "Ordonnance n° 2006-1588 du 13 décembre 2006 - art. 83 (VT)", "@sens": "cible", "@cidtexte": "JORFTEXT000000616196", "@nortexte": "SANX0600142R", "@numtexte": "2006-1588", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "2006-12-13" }, { "@id": "LEGIARTI000019945424", "@num": "42", "#text": "LOI n°2008-1330\n du 17 décembre 2008 - art. 42", "@sens": "cible", "@cidtexte": "JORFTEXT000019942966", "@nortexte": "BCFX0823210L", "@numtexte": "2008-1330", "@typelien": "MODIFIE", "@naturetexte": "LOI", "@datesignatexte": "2008-12-17" }, { "@id": "LEGIARTI000029736056", "#text": "ARRÊTÉ du 27 octobre 2014 - art. (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000029735834", "@nortexte": "AFSS1425785A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2014-10-27" }, { "@id": "LEGIARTI000030458287", "@num": "1", "#text": "DÉCRET n°2015-391 du 3 avril 2015 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000030456722", "@nortexte": "AFSS1428496D", "@numtexte": "2015-391", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2015-04-03" }, { "@id": "LEGIARTI000033343923", "#text": "Décret n°2016-1494 du 4 novembre 2016 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000033342215", "@nortexte": "AFSS1626934D", "@numtexte": "2016-1494", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2016-11-04" }, { "@id": "LEGITEXT000037138681", "#text": "Décret n°2018-557 du 30 juin 2018 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037132316", "@nortexte": "SSAS1816711D", "@numtexte": "2018-557", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2018-06-30" }, { "@id": "LEGITEXT000037258085", "#text": "Décret n°2018-661 du 26 juillet 2018 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037256925", "@nortexte": "SSAS1816707D", "@numtexte": "2018-661", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2018-07-26" }, { "@id": "LEGIARTI000050506990", "@num": "R314-122", "#text": "Code de l'action sociale et des familles - art. R314-122 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006074069", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000037138716", "@num": "D315-5", "#text": "Code de la sécurité sociale. - art. D315-5 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006736472", "@num": "D323-3", "#text": "Code de la sécurité sociale. - art. D323-3 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000038622128", "@num": "D613-27", "#text": "Code de la sécurité sociale. - art. D613-27 (Ab)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006741148", "@num": "L141-1", "#text": "Code de la sécurité sociale. - art. L141-1", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000046812411", "@num": "L162-1-7", "#text": "Code de la sécurité sociale. - art. L162-1-7 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000042685903", "@num": "L162-4", "#text": "Code de la sécurité sociale. - art. L162-4 (VD)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000042686286", "@num": "L314-1", "#text": "Code de la sécurité sociale. - art. L314-1 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006742459", "@num": "L315-1", "#text": "Code de la sécurité sociale. - art. L315-1", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000036393643", "@num": "L315-3", "#text": "Code de la sécurité sociale. - art. L315-3 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006742902", "@num": "L321-1", "#text": "Code de la sécurité sociale. - art. L321-1", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000041412191", "@num": "L323-6", "#text": "Code de la sécurité sociale. - art. L323-6 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006742522", "@num": "L324-1", "#text": "Code de la sécurité sociale. - art. L324-1", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000017844914", "@num": "L442-5", "#text": "Code de la sécurité sociale. - art. L442-5 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006743632", "@num": "L613-13", "#text": "Code de la sécurité sociale. - art. L613-13 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006743632", "@num": "L613-13", "#text": "Code de la sécurité sociale. - art. L613-13 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "TXT_ASSOCIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006743597", "@num": "L615-13", "#text": "Code de la sécurité sociale. - art. L615-13 (T)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006743597", "@num": "L615-13", "#text": "Code de la sécurité sociale. - art. L615-13 (T)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "TXT_ASSOCIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000046844912", "@num": "R147-6", "#text": "Code de la sécurité sociale. - art. R147-6 (VD)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000046844852", "@num": "R147-8", "#text": "Code de la sécurité sociale. - art. R147-8 (VD)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000047502404", "@num": "R147-9-2", "#text": "Code de la sécurité sociale. - art. R147-9-2 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000048630417", "@num": "R161-48", "#text": "Code de la sécurité sociale. - art. R161-48 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000050670554", "@num": "R162-20-5-1", "#text": "Code de la sécurité sociale. - art. R162-20-5-1 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000043413468", "@num": "R162-52-1", "#text": "Code de la sécurité sociale. - art. R162-52-1 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006749191", "@num": "R315-1-3", "#text": "Code de la sécurité sociale. - art. R315-1-3 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006585500", "@num": "L732-5", "#text": "Code rural - art. L732-5 (V)", "@sens": "cible", "@cidtexte": "LEGITEXT000006071367", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006580926", "@num": "1106-2", "#text": "Code rural ancien - art. 1106-2 (Ab)", "@sens": "cible", "@cidtexte": "LEGITEXT000006071366", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006797149", "@num": "L251-2", "#text": "Code de l'action sociale et des familles - art. L251-2", "@sens": "source", "@cidtexte": "LEGITEXT000006074069", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000006797164", "@num": "L254-1", "#text": "Code de l'action sociale et des familles - art. L254-1", "@sens": "source", "@cidtexte": "LEGITEXT000006074069", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" } ] }, "CONTEXTE": { "TEXTE": { "TM": { "TM": { "TM": { "TM": { "TITRE_TM": [ { "@id": "LEGISCTA000006156082", "@fin": "2999-01-01", "#text": "Chapitre 5 : Contrôle médical", "@debut": "1996-04-25" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006141616", "@fin": "2999-01-01", "#text": "Titre I : Généralités", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006126889", "@fin": "2999-01-01", "#text": "Livre III : Dispositions relatives aux assurances sociales et à diverses catégories de personnes rattachées au régime général", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006106050", "@fin": "2999-01-01", "#text": "Partie législative", "@debut": "1985-12-21" } ] }, "@cid": "LEGITEXT000006073189", "@nature": "CODE", "TITRE_TXT": [ { "@fin": "2999-01-01", "#text": "Code de la sécurité sociale", "@debut": "1958-10-16", "@id_txt": "LEGITEXT000006073189", "@c_titre_court": "Code de la sécurité sociale." } ], "@date_publi": "2999-01-01", "@date_signature": "2999-01-01" } }, "VERSIONS": { "VERSION": [ { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006742465", "@fin": "2001-12-26", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "1996-04-25", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006742466", "@fin": "2003-12-19", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2001-12-26", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006742467", "@fin": "2004-08-17", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2003-12-19", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006742468", "@fin": "2007-12-22", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2004-08-17", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000017844895", "@fin": "2008-12-19", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2007-12-22", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000019954048", "@fin": "2016-01-01", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2008-12-19", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000031687215", "@fin": "2018-01-01", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2016-01-01", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000036393651", "@fin": "2019-12-28", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2018-01-01", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000045065557", "@fin": "2021-07-01", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2019-12-28", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000042686005", "@fin": "2021-12-25", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2021-07-01", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000045065602", "@fin": "2022-01-01", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2021-12-25", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000041398082", "@fin": "2023-12-28", "@num": "L315-2", "@etat": "MODIFIE", "@debut": "2022-01-01", "@origine": "LEGI" } }, { "@etat": "VIGUEUR", "LIEN_ART": { "@id": "LEGIARTI000048687768", "@fin": "2999-01-01", "@num": "L315-2", "@etat": "VIGUEUR", "@debut": "2023-12-28", "@origine": "LEGI" } } ] }, "BLOC_TEXTUEL": { "CONTENU": "

Les avis rendus par le service du contrôle médical portant sur les éléments définis au I de l'article L. 315-1 s'imposent à l'organisme de prise en charge.

Le bénéfice de certaines prestations mentionnées au I de l'article L. 315-1 peut être subordonné à l'accord préalable du service du contrôle médical. Cet accord préalable peut être exigé pour les prestations dont :

-la nécessité doit être appréciée au regard d'indications déterminées ou de conditions particulières d'ordre médical ;

-la justification, du fait de leur caractère innovant ou des risques encourus par le bénéficiaire, doit être préalablement vérifiée eu égard notamment à l'état du bénéficiaire et aux alternatives thérapeutiques possibles ;

-le caractère particulièrement coûteux doit faire l'objet d'un suivi particulier afin d'en évaluer l'impact sur les dépenses de l'assurance maladie ou de l'Etat en ce qui concerne les prestations servies en application des articles L. 251-2 et L. 254-1 du code de l'action sociale et des familles.

Il est précisé lors de la prise en charge des prestations mentionnées au I de l'article L. 315-1 que leur bénéfice est, le cas échéant, subordonné à l'accord préalable mentionné ci-dessus.

Les conditions d'application des alinéas précédents sont fixées par décision du collège des directeurs de l'Union nationale des caisses d'assurance maladie.

Si, indépendamment des dispositions des deuxième à cinquième alinéas, le service du contrôle médical estime qu'une prestation mentionnée à l'article L. 321-1 n'est pas médicalement justifiée, la caisse, après en avoir informé l'assuré ou le bénéficiaire de l'aide médicale de l'Etat ou de la prise en charge des soins urgents mentionnée à l'article L. 254-1 du code de l'action sociale et des familles, en suspend le service. En cas de suspension du service des indemnités mentionnées au 5° de l'article L. 321-1, la caisse en informe l'employeur. Lorsque le praticien-conseil procède à l'examen du patient et qu'à l'issue de celui-ci il estime qu'une prescription d'arrêt de travail n'est pas ou n'est plus médicalement justifiée, il en informe directement l'intéressé. Sauf si le praticien-conseil en décide autrement, la suspension prononcée par la caisse prend effet à compter de la date à laquelle le patient a été informé. Les contestations d'ordre médical portant sur cette décision donnent lieu à l'expertise médicale mentionnée à l'article L. 141-1.

Sous réserve des dispositions de l'article L. 324-1, tout assuré ou bénéficiaire de l'aide médicale de l'Etat ou de la prise en charge des soins urgents mentionnée à l'article L. 254-1 du code de l'action sociale et des familles est tenu de se soumettre aux contrôles organisés par le service du contrôle médical. La caisse suspend le versement des indemnités journalières lorsque l'assuré qui en bénéficie ne respecte pas cette obligation.

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Tableau II (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000027352831", "@num": "Tableau III", "#text": "Arrêté du 2 avril 2013 - art. Tableau III (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000027352832", "@num": "Tableau IV", "#text": "Arrêté du 2 avril 2013 - art. Tableau IV (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000027352837", "@num": "Tableau IX", "#text": "Arrêté du 2 avril 2013 - art. Tableau IX (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000027352833", "@num": "Tableau V", "#text": "Arrêté du 2 avril 2013 - art. Tableau V (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000027352834", "@num": "Tableau VI", "#text": "Arrêté du 2 avril 2013 - art. Tableau VI (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000029640695", "@num": "Tableau VII", "#text": "Arrêté du 2 avril 2013 - art. Tableau VII (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000029640727", "@num": "Tableau VIII", "#text": "Arrêté du 2 avril 2013 - art. Tableau VIII (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000027347647", "@nortexte": "DEFK1310181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-04-02" }, { "@id": "LEGIARTI000028241820", "@num": "1", "#text": "Arrêté du 19 novembre 2013 - art. 1 (VT)", "@sens": "cible", "@cidtexte": "JORFTEXT000028240762", "@nortexte": "JUSE1328519A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2013-11-19" }, { "@id": "LEGIARTI000031930945", "@num": "2", "#text": "LOI n°2013-1118\n du 6 décembre 2013 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000028279423", "@nortexte": "AFSX1316565L", "@numtexte": "2013-1118", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2013-12-06" }, { "@id": "LEGIARTI000028375915", "@num": "36", "#text": "LOI n°2013-1203\n du 23 décembre 2013 - art. 36 (M)", "@sens": "cible", "@cidtexte": "JORFTEXT000028372809", "@nortexte": "EFIX1324269L", "@numtexte": "2013-1203", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2013-12-23" }, { "@id": "LEGIARTI000050232015", "@num": "4", "#text": "Arrêté du 7 mai 2014 - art. 4 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000028927989", "@nortexte": "AFSH1317250A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2014-05-07" }, { "@id": "LEGIARTI000031310180", "@num": "1", "#text": "DÉCRET n°2014-1523 du 16 décembre 2014 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000029917882", "@nortexte": "AFSS1416423D", "@numtexte": "2014-1523", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2014-12-16" }, { "@id": "LEGIARTI000041733050", "@num": "11", "#text": "ARRÊTÉ du 19 février 2015 - art. 11 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000030280539", "@nortexte": "AFSH1504915A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2015-02-19" }, { "@id": "LEGIARTI000030561990", "#text": "ARRÊTÉ du 30 avril 2015 - art. (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000030558910", "@nortexte": "AFSH1510674A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2015-04-30" }, { "@id": "LEGIARTI000030962314", "@num": "13", "#text": "DÉCRET n°2015-937 du 30 juillet 2015 - art. 13 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000030959185", "@nortexte": "AFSH1511616D", "@numtexte": "2015-937", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2015-07-30" }, { "@id": "LEGIARTI000031027830", "#text": "ARRÊTÉ du 30 juin 2015 - art. (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000030992401", "@nortexte": "DEFK1515805A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2015-06-30" }, { "@id": "LEGIARTI000031666036", "@num": "71", "#text": "LOI n°2015-1702 du 21 décembre 2015 - art. 71", "@sens": "cible", "@cidtexte": "JORFTEXT000031663208", "@nortexte": "FCPX1523191L", "@numtexte": "2015-1702", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2015-12-21" }, { "@id": "LEGIARTI000031935878", "@num": "1", "#text": "Décret n°2016-46 du 26 janvier 2016 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000031922237", "@nortexte": "AFSP1526854D", "@numtexte": "2016-46", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2016-01-26" }, { "@id": "LEGIARTI000041671829", "@num": "3", "#text": "Arrêté du 25 février 2016 - art. 3 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000032112881", "@nortexte": "AFSH1605919A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2016-02-25" }, { "@id": "LEGIARTI000049704273", "@num": "5", "#text": "Arrêté du 6 octobre 2016 - art. 5 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000033253661", "@nortexte": "AFSH1628559A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2016-10-06" }, { "@id": "LEGIARTI000033685394", "@num": "60", "#text": "LOI n° 2016-1827 du 23 décembre 2016 - art. 60 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000033680665", "@nortexte": "ECFX1623944L", "@numtexte": "2016-1827", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2016-12-23" }, { "@id": "LEGIARTI000034113926", "@num": "11", "#text": "Arrêté du 27 février 2017 - art. 11", "@sens": "cible", "@cidtexte": "JORFTEXT000034104388", "@nortexte": "AFSH1706291A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2017-02-27" }, { "@id": "LEGIARTI000034113928", "@num": "12", "#text": "Arrêté du 27 février 2017 - art. 12", "@sens": "cible", "@cidtexte": "JORFTEXT000034104388", "@nortexte": "AFSH1706291A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2017-02-27" }, { "@id": "LEGIARTI000034366125", "@num": "3", "#text": "Décret n°2017-471 du 3 avril 2017 - art. 3", "@sens": "cible", "@cidtexte": "JORFTEXT000034365559", "@nortexte": "AFSP1631140D", "@numtexte": "2017-471", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2017-04-03" }, { "@id": "LEGIARTI000034479788", "#text": "Arrêté du 19 avril 2017 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000034475010", "@nortexte": "AFSS1709690A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2017-04-19" }, { "@id": "LEGIARTI000036523880", "@num": "2", "#text": "Arrêté du 19 avril 2017 - art. 2 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000034475023", "@nortexte": "AFSS1709691A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2017-04-19" }, { "@id": "LEGIARTI000036524056", "@num": "2", "#text": "Arrêté du 30 décembre 2017 - art. 2 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000036341608", "@nortexte": "SSAS1736152A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2017-12-30" }, { "@id": "LEGIARTI000036702254", "@num": "1", "#text": "Arrêté du 22 février 2018 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000036701197", "@nortexte": "SSAS1805305A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-02-22" }, { "@id": "LEGIARTI000037417930", "#text": "Arrêté du 1er août 2018 - art.", "@sens": "cible", "@cidtexte": "JORFTEXT000037306389", "@nortexte": "SSAS1821639A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-01" }, { "@id": "LEGIARTI000037341717", "@num": "Annexe I", "#text": "Arrêté du 20 août 2018 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037335538", "@nortexte": "SSAS1821640A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-20" }, { "@id": "LEGIARTI000037341720", "@num": "Annexe III", "#text": "Arrêté du 20 août 2018 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037335538", "@nortexte": "SSAS1821640A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-20" }, { "@id": "LEGIARTI000037341725", "@num": "Annexe V", "#text": "Arrêté du 20 août 2018 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037335538", "@nortexte": "SSAS1821640A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-20" }, { "@id": "LEGIARTI000037341742", "@num": "Annexe XIII", "#text": "Arrêté du 20 août 2018 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037335538", "@nortexte": "SSAS1821640A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-20" }, { "@id": "LEGIARTI000037341746", "@num": "Annexe XVI", "#text": "Arrêté du 20 août 2018 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037335538", "@nortexte": "SSAS1821640A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-20" }, { "@id": "LEGIARTI000037341790", "@num": "4", "#text": "Arrêté du 20 août 2018 - art. (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000037335538", "@nortexte": "SSAS1821640A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2018-08-20" }, { "@id": "LEGIARTI000037341750", "@num": "16", "#text": "Arrêté du 20 août 2018 - art. 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art. 8", "@sens": "cible", "@cidtexte": "JORFTEXT000041661407", "@nortexte": "SSAH2006254A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-02-28" }, { "@id": "LEGIARTI000041700431", "@num": "1", "#text": "Arrêté du 7 mars 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041698000", "@nortexte": "SSAS2006844A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-07" }, { "@id": "LEGIARTI000041700230", "@num": "1", "#text": "Décret n°2020-223 du 7 mars 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041697880", "@nortexte": "PRMX2006992D", "@numtexte": "2020-223", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2020-03-07" }, { "@id": "LEGIARTI000041737932", "@num": "1", "#text": "Arrêté du 19 mars 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000041737443", "@nortexte": "SSAZ2008066A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-19" }, { "@id": "LEGIARTI000041867006", "@num": "4-1", "#text": "Arrêté du 23 mars 2020 - art. 4-1 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000041746744", "@nortexte": "SSAX2007864A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-23" }, { "@id": "LEGIARTI000041891791", "@num": "8", "#text": "Arrêté du 23 mars 2020 - art. 8 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000041746744", "@nortexte": "SSAX2007864A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-23" }, { "@id": "LEGIARTI000041891785", "@num": "8-1", "#text": "Arrêté du 23 mars 2020 - art. 8-1 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000041746744", "@nortexte": "SSAX2007864A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-23" }, { "@id": "LEGIARTI000041756295", "@num": "1", "#text": "Arrêté du 25 mars 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000041755801", "@nortexte": "SSAZ2008363A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-25" }, { "@id": "LEGIARTI000041774693", "@num": "1", "#text": "Arrêté du 31 mars 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000041774063", "@nortexte": "SSAZ2008819A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-03-31" }, { "@id": "LEGIARTI000041807647", "@num": "1", "#text": "Arrêté du 16 avril 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000041807257", "@nortexte": "SSAZ2009852A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-04-16" }, { "@id": "LEGIARTI000041811410", "@num": "3", "#text": "Arrêté du 15 avril 2020 - art. 3 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000041810621", "@nortexte": "SSAH2009797A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-04-15" }, { "@id": "LEGITEXT000041871933", "#text": "Arrêté du 12 mai 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041869967", "@nortexte": "SSAZ2011557A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-05-12" }, { "@id": "LEGIARTI000041871937", "@num": "1", "#text": "Arrêté du 12 mai 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041869967", "@nortexte": "SSAZ2011557A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-05-12" }, { "@id": "LEGIARTI000041871391", "@num": "1", "#text": "Décret n°2020-550 du 12 mai 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041869658", "@nortexte": "PRMX2011791D", "@numtexte": "2020-550", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2020-05-12" }, { "@id": "LEGITEXT000041890381", "#text": "Arrêté du 18 mai 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041889362", "@nortexte": "SSAZ2011564A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-05-18" }, { "@id": "LEGIARTI000041890409", "@num": "1", "#text": "Arrêté du 18 mai 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000041889362", "@nortexte": "SSAZ2011564A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-05-18" }, { "@id": "LEGITEXT000041924857", "#text": "Arrêté du 27 mai 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041923558", "@nortexte": "SSAZ2012672A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-05-27" }, { "@id": "LEGIARTI000041924863", "@num": "1", "#text": "Arrêté du 27 mai 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041923558", "@nortexte": "SSAZ2012672A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-05-27" }, { "@id": "LEGIARTI000041924900", "@num": "1", "#text": "Décret n°2020-635 du 27 mai 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041923279", "@nortexte": "PRMX2012687D", "@numtexte": "2020-635", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2020-05-27" }, { "@id": "LEGITEXT000041976357", "#text": "Arrêté du 8 juin 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000041976098", "@nortexte": "SSAZ2014294A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-06-08" }, { "@id": "LEGITEXT000042433098", "#text": "Arrêté du 10 juillet 2020 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000042106233", "@nortexte": "SSAZ2018110A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-07-10" }, { "@id": "LEGIARTI000043418141", "@num": "17", "#text": "Arrêté du 10 juillet 2020 - 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art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000042607794", "@nortexte": "SSAZ2033724A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-03" }, { "@id": "LEGITEXT000042671706", "#text": "Arrêté du 12 décembre 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000042660111", "@nortexte": "SSAS2035127A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-12" }, { "@id": "LEGIARTI000042671715", "@num": "1", "#text": "Arrêté du 12 décembre 2020 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000042660111", "@nortexte": "SSAS2035127A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-12" }, { "@id": "LEGIARTI000049704331", "@num": "3", "#text": "Arrêté du 7 décembre 2020 - art. 3 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000042660034", "@nortexte": "SSAH2034287A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-07" }, { "@id": "LEGIARTI000042704121", "@num": "1", "#text": "Décret n°2020-1623 du 18 décembre 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000042702359", "@nortexte": "SSAS2028916D", "@numtexte": "2020-1623", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2020-12-18" }, { "@id": "LEGITEXT000042842776", "#text": "Arrêté du 30 décembre 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000042841279", "@nortexte": "SSAZ2037116A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-30" }, { "@id": "LEGIARTI000042842793", "@num": "1", "#text": "Arrêté du 30 décembre 2020 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000042841279", "@nortexte": "SSAZ2037116A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-30" }, { "@id": "LEGITEXT000042906448", "#text": "Arrêté du 28 décembre 2020 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000042855919", "@nortexte": "SSAS2036905A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2020-12-28" }, { "@id": "LEGIARTI000042906452", "@num": "1", "#text": "Arrêté du 28 décembre 2020 - 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art. 6 (Ab)", "@sens": "cible", "@cidtexte": "JORFTEXT000047396757", "@nortexte": "SPRH2308496A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2023-03-31" }, { "@id": "LEGIARTI000047527497", "#text": "Arrêté du 11 avril 2023 - art.", "@sens": "cible", "@cidtexte": "JORFTEXT000047524161", "@nortexte": "SPRS2312181A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2023-04-11" }, { "@id": "LEGIARTI000049093974", "@num": "2", "#text": "Arrêté du 2 février 2024 - art. 2", "@sens": "cible", "@cidtexte": "JORFTEXT000049092554", "@nortexte": "TSSS2402961A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2024-02-02" }, { "@id": "LEGITEXT000049194455", "#text": "Arrêté du 23 février 2024 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000049190970", "@nortexte": "TSSS2405583A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2024-02-23" }, { "@id": "LEGIARTI000049221073", "@num": "1", "#text": "Arrêté du 29 février 2024 - art. 1", "@sens": "cible", "@cidtexte": "JORFTEXT000049219412", "@nortexte": "TSSH2403717A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2024-02-29" }, { "@id": "LEGIARTI000049350863", "@num": "2", "#text": "Décret n°2024-290 du 29 mars 2024 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000049345711", "@nortexte": "TSSH2335206D", "@numtexte": "2024-290", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2024-03-29" }, { "@id": "LEGIARTI000049431389", "@num": "4", "#text": "Arrêté du 17 avril 2024 - art. 4 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000049430007", "@nortexte": "TSSH2410986A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2024-04-17" }, { "@id": "LEGIARTI000050063490", "@num": "5", "#text": "Arrêté du 29 juillet 2024 - art. 5 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000050060115", "@nortexte": "TSSS2421153A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2024-07-29" }, { "@id": "LEGIARTI000050399892", "@num": "1", "#text": "Arrêté du 23 octobre 2024 - 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La prise en charge ou le remboursement par l'assurance maladie de tout acte ou prestation réalisé par un professionnel de santé, dans le cadre d'un exercice libéral ou d'un exercice salarié auprès d'un autre professionnel de santé libéral, ou en centre de santé ou dans un établissement ou un service médico-social, ainsi que, à compter du 1er janvier 2005, d'un exercice salarié dans un établissement de santé, à l'exception des prestations mentionnées à l'article L. 165-1, est subordonné à leur inscription sur une liste établie dans les conditions fixées au présent article.L'inscription sur la liste peut elle-même être subordonnée au respect d'indications thérapeutiques ou diagnostiques, à l'état du patient ainsi qu'à des conditions particulières de prescription, d'utilisation ou de réalisation de l'acte ou de la prestation. Lorsqu'il s'agit d'actes réalisés en série, ces conditions de prescription peuvent préciser le nombre d'actes au-delà duquel un accord préalable du service du contrôle médical est nécessaire en application de l'article L. 315-2 pour poursuivre à titre exceptionnel la prise en charge, sur le fondement d'un référentiel élaboré par la Haute Autorité de santé ou validé par celle-ci sur proposition de l'Union nationale des caisses d'assurance maladie.

La hiérarchisation des prestations et des actes est établie dans le respect des règles déterminées par des commissions créées pour chacune des professions dont les rapports avec les organismes d'assurance maladie sont régis par une convention mentionnée à l'article L. 162-14-1. Ces commissions, présidées par une personnalité désignée d'un commun accord par leurs membres, sont composées de représentants des syndicats représentatifs des professionnels de santé et de représentants de l'Union nationale des caisses d'assurance maladie. Un représentant de l'Etat assiste à leurs travaux.

Les conditions d'inscription d'un acte ou d'une prestation, leur inscription et leur radiation sont décidées par l'Union nationale des caisses d'assurance maladie, après avis de la Haute Autorité de santé et de l'Union nationale des organismes d'assurance maladie complémentaire.L'avis de la Haute Autorité de santé n'est pas nécessaire lorsque la décision ne modifie que la hiérarchisation d'un acte ou d'une prestation.

Les décisions de l'Union nationale des caisses d'assurance maladie sont réputées approuvées sauf opposition motivée des ministres chargés de la santé et de la sécurité sociale. Le ministre chargé de la santé peut procéder d'office à l'inscription ou à la radiation d'un acte ou d'une prestation pour des raisons de santé publique par arrêté pris après avis de la Haute Autorité de santé. Dans ce cas, il fixe la hiérarchisation de l'acte ou de la prestation dans le respect des règles mentionnées ci-dessus. Les tarifs de ces actes et prestations sont publiés au Journal officiel de la République française.

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Article 42 ENTIEREMENT_MODIF (LOI n° 2008-1330 du 17 décembre 2008 de financement de la sécurité sociale pour 2009 (1))