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Le montant des remises prévues aux articles L. 162-16, L. 162-18 et L. 165-4 est versé à l'assurance maladie du régime général des travailleurs salariés qui les répartit entre les divers régimes d'assurance maladie selon des modalités fixées par décret.

" } }, "LEGIARTI000006740596": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L162-14", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "1991-08-01", "DATE_DEBUT": "1985-12-21" } }, "META_COMMUN": { "ID": "LEGIARTI000006740596", "URL": "article/LEGI/ARTI/00/00/06/74/05/LEGIARTI000006740596.xml", "NATURE": "Article", "ORIGINE": "LEGI", "ANCIEN_ID": "SSAXXXXXXXX1X162L14AXXAA" } }, "NOTA": { "CONTENU": "

\n
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Les rapports entre les caisses primaires d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue entre la caisse nationale de l'assurance maladie des travailleurs salariés et une ou plusieurs des organisations syndicales nationales les plus représentatives de la profession.
\n
Cette convention détermine :
\n
1°) les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;
\n
2°) les tarifs des honoraires applicables aux analyses et les tarifs des frais accessoires dus à ces laboratoires.
\n
Elle peut également prévoir que les directeurs de laboratoires s'engagent à faire bénéficier la caisse nationale de l'assurance maladie des travailleurs salariés d'une remise assise sur le montant des analyses et frais accessoires qu'ils facturent.
\n
Elle n'entre en vigueur qu'après approbation par arrêté interministériel ; il en est de même de ses annexes et avenants.
\n
Dès son approbation, la convention est applicable à l'ensemble des laboratoires privés d'analyses médicales ; toutefois ses dispositions ne sont pas applicables :
\n
1°) aux laboratoires dont, dans des conditions déterminées par la convention, les directeurs ont fait connaître à la caisse primaire d'assurance maladie qu'ils n'acceptent pas d'être régis par ses dispositions ;
\n
2°) aux laboratoires dont la caisse primaire d'assurance maladie a constaté qu'ils se sont placés hors de la convention par violation des engagements qu'elle prévoit ; cette décision doit être prononcée dans les conditions prévues par la convention.
\n
A défaut de convention nationale, les tarifs des analyses et frais accessoires dus aux laboratoires privés d'analyses médicales sont fixés par arrêté interministériel, après consultation de la profession.
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Les rapports entre les caisses primaires d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales membres du comité professionnel national de la biologie mentionné à l'article L. 162-14-1 et la Caisse nationale de l'assurance maladie des travailleurs salariés.
\n
Cette convention détermine notamment :
\n
1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales :
\n
2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;
\n
3° Les conditions dans lesquelles est organisée la formation continue des directeurs de laboratoires ;
\n
4° Le financement des instances et des actions nécessaires à la mise en oeuvre de l'accord mentionné à l'article L. 162-14-1 de la convention et de l'annexe mentionnée à l'article L. 162-14-2.
\n
La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.
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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales membres du comité professionnel national de la biologie mentionné à l'article L. 162-14-1 et la Caisse nationale de l'assurance maladie des travailleurs salariés et au moins une autre caisse nationale d'assurance maladie.
\n
Cette convention détermine notamment :
\n
1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales :
\n
2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;
\n
3° Les conditions dans lesquelles est organisée la formation continue des directeurs de laboratoires ;
\n
4° Le financement des instances et des actions nécessaires à la mise en oeuvre de l'accord mentionné à l'article L. 162-14-1 de la convention et de l'annexe mentionnée à l'article L. 162-14-2.
\n
La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.
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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire d'analyses de biologie médicale et la Caisse nationale de l'assurance maladie des travailleurs salariés et au moins une autre caisse nationale d'assurance maladie.
\n
Cette convention détermine notamment :
\n
1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales :
\n
2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;
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3° Les conditions dans lesquelles est organisée la formation continue des directeurs de laboratoires ;
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4° Le financement des instances et des actions nécessaires à la mise en oeuvre de l'accord mentionné à l'article L. 162-14-1 de la convention et de l'annexe mentionnée à l'article L. 162-14-2 ;
\n
5° Le cas échéant :
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a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;
\n
b) Les conditions particulières d'exercice permettant la prise en charge globale de patients dans le cadre de réseaux de soins et les modes de rémunération des directeurs de laboratoire d'analyses de biologie médicale participant à ces réseaux ;
\n
c) Les droits et obligations respectifs des directeurs de laboratoire d'analyses de biologie médicale, des patients et des caisses, ainsi que les modalités d'évaluation associées aux formes d'exercice et modes de rémunération mentionnés aux a et b ci-dessus ;
\n
6° Le cas échéant, les modes de rémunération, autres que le paiement à l'acte, des analyses de biologie médicale ainsi que les modes de rémunération des activités non curatives des directeurs de laboratoire d'analyses de biologie médicale.
\n
Pour la mise en oeuvre des 5° et 6°, il peut être fait application des dérogations mentionnées au II de l'article L. 162-31-1.
\n
La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.
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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire d'analyses de biologie médicale et la Caisse nationale de l'assurance maladie des travailleurs salariés et au moins une autre caisse nationale d'assurance maladie.
\n
Cette convention détermine notamment :
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1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales :
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2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;
\n
3° Les conditions dans lesquelles est organisée la formation continue des directeurs de laboratoires ;
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4° (Abrogé)
\n
5° Le cas échéant :
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a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;
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b) Les conditions particulières d'exercice permettant la prise en charge globale de patients dans le cadre de réseaux de soins et les modes de rémunération des directeurs de laboratoire d'analyses de biologie médicale participant à ces réseaux ;
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c) Les droits et obligations respectifs des directeurs de laboratoire d'analyses de biologie médicale, des patients et des caisses, ainsi que les modalités d'évaluation associées aux formes d'exercice et modes de rémunération mentionnés aux a et b ci-dessus ;
\n
6° Le cas échéant, les modes de rémunération, autres que le paiement à l'acte, des analyses de biologie médicale ainsi que les modes de rémunération des activités non curatives des directeurs de laboratoire d'analyses de biologie médicale.
\n
Pour la mise en oeuvre des 5° et 6°, il peut être fait application des dérogations mentionnées au II de l'article L. 162-31-1.
\n
La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.
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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire d'analyses de biologie médicale et l'Union nationale des caisses d'assurance maladie.
\n
Cette convention détermine notamment :
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1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;
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2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;
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3° Les conditions dans lesquelles est organisée la formation continue des directeurs de laboratoires ;
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4° (Abrogé)
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5° Le cas échéant :
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a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;
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b) Les conditions particulières d'exercice permettant la prise en charge globale de patients dans le cadre de réseaux de soins et les modes de rémunération des directeurs de laboratoire d'analyses de biologie médicale participant à ces réseaux ;
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c) Les droits et obligations respectifs des directeurs de laboratoire d'analyses de biologie médicale, des patients et des caisses, ainsi que les modalités d'évaluation associées aux formes d'exercice et modes de rémunération mentionnés aux a et b ci-dessus ;
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6° Le cas échéant, les modes de rémunération, autres que le paiement à l'acte, des analyses de biologie médicale ainsi que les modes de rémunération des activités non curatives des directeurs de laboratoire d'analyses de biologie médicale.
\n
Pour la mise en oeuvre des 5° et 6°, il peut être fait application des dérogations mentionnées au II de l'article L. 162-31-1.
\n
La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.
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Le remboursement des frais exposés par les assurés à l'occasion de l'achat de médicaments est effectué sur la base des prix réellement facturés. Ceux-ci ne peuvent pas dépasser les prix limites résultant de l'application de l'article L. 593 du code de la santé publique.
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Les pharmaciens peuvent s'engager collectivement par une convention nationale, révisable annuellement , conclue entre l'une ou plusieurs de leurs organisations syndicales nationales les plus représentatives et la caisse nationale de l'assurance maladie des travailleurs salariés, à faire bénéficier celle-ci d'une remise déterminée en tenant compte du chiffre des ventes de médicaments remboursables au titre des assurances maladie, maternité et accidents du travail.
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Sous réserve de conventions passées avec des mutuelles et des dispositions concernant la fourniture de médicaments aux établissements de soins, la convention nationale peut prévoir que les pharmaciens ne pourront pratiquer sur le prix limite des médicaments aucun rabais, remise ou ristourne de quelque nature que ce soit ni aucun abattement revêtant le caractère de prestation sociale attribuée par un organisme de prévoyance.
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Cette convention, qui doit être conforme aux clauses d'une convention type fixée par décret, prévoit notamment le taux de la remise mentionnée au deuxième alinéa et les conditions auxquelles se trouve subordonné son versement, qui présente un caractère exceptionnel et temporaire. Elle n'est applicable qu'après approbation par arrêté interministériel. Ses dispositions peuvent être, dans la même forme, rendues obligatoires pour l'ensemble de cette profession.
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Pendant la durée d'application de la convention nationale des pharmaciens d'officines, mentionnée à l'alinéa précédent, approuvée et rendue obligatoire, une remise est versée à la caisse nationale de l'assurance maladie des travailleurs salariés par les pharmacies gérées par les organismes à but non lucratif. Cette remise est d'un niveau équivalent à celui résultant de la convention nationale des pharmaciens d'officines. Le taux et les modalités de cette remise sont fixés par convention conclue entre la caisse nationale de l'assurance maladie des travailleurs salariés et la fédération nationale de la mutualité française, approuvée par arrêté interministériel. Si cette convention ne peut être conclue, le taux et les modalités de la remise sont fixés par décret.
\n
" } }, "LEGIARTI000006740835": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L162-16", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "1999-07-28", "DATE_DEBUT": "1998-12-27" } }, "META_COMMUN": { "ID": "LEGIARTI000006740835", "URL": "article/LEGI/ARTI/00/00/06/74/08/LEGIARTI000006740835.xml", "NATURE": "Article", "ORIGINE": "LEGI", "ANCIEN_ID": "SSAXXXXXXXX1X162L16AXXAB" } }, "LIENS": { "LIEN": [ { "@id": "JORFTEXT000000866621", "#text": "Décret 85-1353 1985-12-17", "@sens": "source", "@cidtexte": "JORFTEXT000000866621", "@numtexte": "85-1353", "@typelien": "CODIFICATION", "@naturetexte": "DECRET", "@datesignatexte": "1985-12-17" }, { "@id": "LEGIARTI000025022332", "@num": "20-5", "#text": "Ordonnance n° 96-1122 du 20 décembre 1996 - art. 20-5 (VD)", "@sens": "cible", "@cidtexte": "JORFTEXT000000368749", "@nortexte": "DOMX9600135R", "@numtexte": "96-1122", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1996-12-20" }, { "@id": "LEGIARTI000006758070", "@num": "29", "#text": "Loi n°98-1194 du 23 décembre 1998 - art. 29 () JORF 27 décembre 1998", "@sens": "source", "@cidtexte": "JORFTEXT000000392993", "@nortexte": "MESX9800131L", "@numtexte": "98-1194", "@typelien": "MODIFICATION", "@naturetexte": "LOI", "@datesignatexte": "1998-12-23" }, { "@id": "LEGITEXT000005628049", "#text": "Arrêté du 11 juin 1999", "@sens": "cible", "@cidtexte": "JORFTEXT000000210725", "@nortexte": "MESP9921747A", "@typelien": "TXT_SOURCE", "@naturetexte": "ARRETE", "@datesignatexte": "1999-06-11" }, { "@id": "LEGIARTI000006791636", "@num": "1", "#text": "Arrêté du 11 juin 1999 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000210725", "@nortexte": "MESP9921747A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "1999-06-11" }, { "@id": "LEGIARTI000006791636", "@num": "1", "#text": "Arrêté du 11 juin 1999 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000210725", "@nortexte": "MESP9921747A", "@typelien": "TXT_SOURCE", "@naturetexte": "ARRETE", "@datesignatexte": "1999-06-11" }, { "@id": "LEGIARTI000006791637", "@num": "2", "#text": "Arrêté du 11 juin 1999 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000210725", "@nortexte": "MESP9921747A", "@typelien": "TXT_SOURCE", "@naturetexte": "ARRETE", "@datesignatexte": "1999-06-11" }, { "@id": "LEGIARTI000006791637", "@num": "2", "#text": "Arrêté du 11 juin 1999 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000210725", "@nortexte": "MESP9921747A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "1999-06-11" }, { "@id": "LEGIARTI000006758509", "@num": "44", "#text": "Loi n°2002-1487 du 20 décembre 2002 - art. 44 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000235196", "@nortexte": "SANX0200141L", "@numtexte": "2002-1487", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2002-12-20" }, { "@id": "LEGIARTI000006758846", "@num": "12", "#text": "Loi n°2003-1199 du 18 décembre 2003 - art. 12 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000249276", "@nortexte": "SANX0300139L", "@numtexte": "2003-1199", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2003-12-18" }, { "@id": "LEGIARTI000023096278", "@num": "2", "#text": "Arrêté du 29 octobre 2010 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000023023102", "@nortexte": "SASS1027822A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2010-10-29" }, { "@id": "LEGIARTI000024881828", "@num": "2", "#text": "Arrêté du 14 novembre 2011 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000024881161", "@nortexte": "ETSS1130920A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "2011-11-14" }, { "@id": "LEGIARTI000045564926", "@num": "Préambule de la convention", "#text": "Arrêté du 31 mars 2022 - art. 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Le remboursement des frais exposés par les assurés à l'occasion de l'achat de médicaments est effectué sur la base des prix réellement facturés. Ceux-ci ne peuvent pas dépasser les prix limites résultant de l'application de l'article L. 593 du code de la santé publique.
\n
Lorsque le pharmacien d'officine délivre, en application du deuxième alinéa de l'article L. 512-3 du code de la santé publique, une spécialité figurant sur la liste prévue à l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à un montant ou à un pourcentage déterminé par arrêté des ministres chargés de la sécurité sociale, de la santé et du budget.
\n
En cas d'inobservation de cette condition, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites, et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée à l'alinéa précédent, qui ne peut toutefois être inférieure à un montant forfaitaire défini par arrêté des ministres chargés de la sécurité sociale, de la santé et du budget.
\n
Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.
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Le remboursement des frais exposés par les assurés à l'occasion de l'achat de médicaments est effectué sur la base des prix réellement facturés. Ceux-ci ne peuvent pas dépasser les prix limites résultant de l'application de l'article L. 593 du code de la santé publique.
\n
Lorsque le pharmacien d'officine délivre, en application du deuxième alinéa de l'article L. 512-3 du code de la santé publique, une spécialité figurant sur la liste prévue à l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à un montant ou à un pourcentage déterminé par la convention prévue à l'article L. 162-16-1. A défaut, ce montant ou ce pourcentage est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.
\n
En cas d'inobservation de cette condition, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites, et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée à l'alinéa précédent, qui ne peut toutefois être inférieure à un montant forfaitaire défini par la convention prévue à l'article L. 162-16-1. A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.
\n
Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.
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Le remboursement des frais exposés par les assurés à l'occasion de l'achat de médicaments est effectué sur la base des prix réellement facturés. Ceux-ci ne peuvent pas dépasser les prix limites résultant de l'application de l'article L. 5123-1 du code de la santé publique.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, l'écart de prix entre la spécialité délivrée et la spécialité la moins chère du même groupe générique ne peut être supérieur à un montant déterminé par la convention prévue à l'article L. 162-16-1 du présent code ou, à défaut, par un arrêté des ministres chargés de la sécurité sociale, de la santé et du budget.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à un montant ou à un pourcentage déterminé par la convention prévue à l'article L. 162-16-1. A défaut, ce montant ou ce pourcentage est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.

En cas d'inobservation des dispositions des deuxième et troisième alinéas du présent article, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites, et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée au troisième alinéa du présent article ou à l'écart de prix mentionné au deuxième alinéa du présent article, qui ne peut toutefois être inférieure à un montant forfaitaire défini par la convention prévue à l'article L. 162-16-1. A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité arrêté par les ministres de la santé et de la sécurité sociale après avis du Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code.

Lorsque le tarif forfaitaire s'applique, le plafond mentionné à l'article L. 138-9 est fixé à 2,5 % du prix des médicaments.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

En cas d'inobservation des dispositions des cinquième et sixième alinéas, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée aux cinquième et sixième alinéas, qui ne peut toutefois être inférieure à un montant forfaitaire déterminé par la convention prévue à l'article L. 162-16-1. A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Lorsque le tarif forfaitaire s'applique, le plafond mentionné à l'article L. 138-9 est fixé à 2,5 % du prix des médicaments.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Lorsque le tarif forfaitaire s'applique, le plafond mentionné à l'article L. 138-9 est fixé à 2,5 % du prix des médicaments.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

Les médicaments dispensés par un pharmacien en application de l'article L. 5125-23-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie dans la limite d'une seule boîte par ligne d'ordonnance au-delà de la durée de traitement initialement prescrite.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

En cas d'inobservation des dispositions des cinquième et sixième alinéas, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée aux cinquième et sixième alinéas, qui ne peut toutefois être inférieure à un montant forfaitaire déterminé par la convention prévue à l'article L. 162-16-1.A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

Les médicaments renouvelés par une infirmière ou un infirmier en application du quatrième alinéa de l'article L. 4311-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie, sous réserve que ces médicaments soient inscrits sur la liste des spécialités remboursables prévue au premier alinéa de l'article L. 162-17 du présent code.

Les médicaments dispensés par un pharmacien en application du deuxième alinéa de l'article L. 5125-23-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie, sous réserve que ces médicaments soient inscrits sur la liste des spécialités remboursables prévue au premier alinéa de l'article L. 162-17 du présent code.

" } }, "LEGIARTI000020897498": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L162-14", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2010-01-16", "DATE_DEBUT": "2009-07-23" } }, "META_COMMUN": { "ID": "LEGIARTI000020897498", "URL": "article/LEGI/ARTI/00/00/20/89/74/LEGIARTI000020897498.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "NOTA": { "CONTENU": "

Loi n° 2009-879 du 21 juillet 2009 article 59 XXIV : Le présent article entre en vigueur à la date d'effet de la convention prévue au XXI (Date d'entrée en vigueur indéterminée).

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R762-37 (M)", "@sens": "cible", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CITATION", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" } ] }, "CONTEXTE": { "TEXTE": { "TM": { "TM": { "TM": { "TM": { "TM": { "TITRE_TM": [ { "@id": "LEGISCTA000006172515", "@fin": "2999-01-01", "#text": "Section 3 : Directeurs de laboratoires", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006156028", "@fin": "2018-03-10", "#text": "Chapitre 2 : Dispositions générales relatives aux soins", "@debut": "1985-12-21" }, { "@id": "LEGISCTA000036687767", "@fin": "2999-01-01", "#text": "Chapitre 2 : Dispositions générales relatives aux soins et à la prévention", "@debut": "2018-03-10" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006141605", "@fin": "2999-01-01", "#text": "Titre VI : Dispositions relatives aux prestations et aux soins - Contrôle médical - Tutelle aux prestations sociales", "@debut": "1985-12-21" } ] }, "TITRE_TM": [ { "@id": "LEGISCTA000006126885", "@fin": "2999-01-01", "#text": "Livre I : Généralités - Dispositions communes à tout ou partie des régimes de base", "@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": "LEGIARTI000006740596", "@fin": "1991-08-01", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "1985-12-21", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006740597", "@fin": "1996-04-25", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "1991-08-01", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006740598", "@fin": "1999-12-30", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "1996-04-25", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006740599", "@fin": "2002-03-07", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "1999-12-30", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006740600", "@fin": "2004-08-17", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "2002-03-07", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000006740601", "@fin": "2009-07-23", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "2004-08-17", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000020897498", "@fin": "2010-01-16", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "2009-07-23", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000021709085", "@fin": "2010-02-26", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "2010-01-16", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000021941487", "@fin": "2011-08-12", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "2010-02-26", "@origine": "LEGI" } }, { "@etat": "MODIFIE", "LIEN_ART": { "@id": "LEGIARTI000024469281", "@fin": "2016-01-28", "@num": "L162-14", "@etat": "MODIFIE", "@debut": "2011-08-12", "@origine": "LEGI" } }, { "@etat": "VIGUEUR", "LIEN_ART": { "@id": "LEGIARTI000031929840", "@fin": "2999-01-01", "@num": "L162-14", "@etat": "VIGUEUR", "@debut": "2016-01-28", "@origine": "LEGI" } } ] }, "BLOC_TEXTUEL": { "CONTENU": "

Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire d'analyses de biologie médicale et l'Union nationale des caisses d'assurance maladie.

\n
\n

Cette convention détermine notamment :

\n
\n

1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;

\n
\n

2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;

\n
\n

3° Le montant de la contribution annuelle des caisses nationales d'assurance maladie au développement professionnel continu ;

4° (Abrogé)

\n
\n

5° Le cas échéant :

\n
\n

a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;

\n
\n

b) Les conditions particulières d'exercice permettant la prise en charge globale de patients dans le cadre de réseaux de soins et les modes de rémunération des directeurs de laboratoire d'analyses de biologie médicale participant à ces réseaux ;

\n
\n

c) Les droits et obligations respectifs des directeurs de laboratoire d'analyses de biologie médicale, des patients et des caisses, ainsi que les modalités d'évaluation associées aux formes d'exercice et modes de rémunération mentionnés aux a et b ci-dessus ;

\n
\n

6° Le cas échéant, les modes de rémunération, autres que le paiement à l'acte, des analyses de biologie médicale ainsi que les modes de rémunération des activités non curatives des directeurs de laboratoire d'analyses de biologie médicale.

\n
\n

Pour la mise en oeuvre des 5° et 6°, il peut être fait application des dérogations mentionnées au II de l'article L. 162-31-1.

\n
\n

La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.

\n
" } }, "LEGIARTI000021684178": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "4", "TYPE": "ENTIEREMENT_MODIF", "DATE_FIN": "2999-01-01", "DATE_DEBUT": "2999-01-01" } }, "META_COMMUN": { "ID": "LEGIARTI000021684178", "URL": "article/LEGI/ARTI/00/00/21/68/41/LEGIARTI000021684178.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "LIENS": { "LIEN": [ { "@id": "LEGISCTA000021709115", "#text": "Code de la sécurité sociale. - Sous-section 3 : Autres dispositions (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CREE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709113", "@num": "L145-5-6", "#text": "Code de la sécurité sociale. - art. L145-5-6 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CREE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709102", "@num": "L161-37", "#text": "Code de la sécurité sociale. - art. L161-37 (VT)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709099", "@num": "L162-13", "#text": "Code de la sécurité sociale. - art. L162-13 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709096", "@num": "L162-13-1", "#text": "Code de la sécurité sociale. - art. L162-13-1 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709094", "@num": "L162-13-2", "#text": "Code de la sécurité sociale. - art. L162-13-2 (M)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709091", "@num": "L162-13-3", "#text": "Code de la sécurité sociale. - art. L162-13-3 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709089", "@num": "L162-13-4", "#text": "Code de la sécurité sociale. - art. L162-13-4 (M)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "CREE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709085", "@num": "L162-14", "#text": "Code de la sécurité sociale. - art. L162-14 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" }, { "@id": "LEGIARTI000021709079", "@num": "L162-37", "#text": "Code de la sécurité sociale. - art. L162-37 (V)", "@sens": "source", "@cidtexte": "LEGITEXT000006073189", "@typelien": "MODIFIE", "@naturetexte": "CODE", "@datesignatexte": "2999-01-01" } ] }, "CONTEXTE": { "TEXTE": { "TM": { "TITRE_TM": [ { "@id": "LEGISCTA000021684170", "@fin": "2999-01-01", "#text": "CHAPITRE II : DISPOSITIONS MODIFIANT LES CODES DE LA SECURITE SOCIALE ET DE L'EDUCATION, ET DE COORDINATION", "@debut": "2010-01-16" } ] }, "@cid": "JORFTEXT000021683301", "@nor": "SASX0927179R", "@num": "2010-49", "@nature": "ORDONNANCE", "TITRE_TXT": [ { "@fin": "2999-01-01", "#text": "Ordonnance n° 2010-49 du 13 janvier 2010 relative à la biologie médicale", "@debut": "2999-01-01", "@id_txt": "JORFTEXT000021683301", "@c_titre_court": "Ordonnance n° 2010-49 du 13 janvier 2010" }, { "@fin": "2999-01-01", "#text": "Ordonnance n° 2010-49 du 13 janvier 2010 relative à la biologie médicale", "@debut": "2010-01-16", "@id_txt": "LEGITEXT000021684158", "@c_titre_court": "Ordonnance n° 2010-49 du 13 janvier 2010" } ], "@ministere": "Ministère de la santé et des sports", "@date_publi": "2010-01-15", "@date_signature": "2010-01-13", "@num_parution_jo": "0012" } }, "VERSIONS": { "VERSION": [ { "LIEN_ART": { "@id": "LEGIARTI000021684178", "@fin": "2999-01-01", "@num": "4", "@debut": "2999-01-01", "@origine": "LEGI" } }, { "LIEN_ART": { "@id": "JORFARTI000021683369", "@fin": "2999-01-01", "@num": "4", "@debut": "2999-01-01", "@origine": "JORF" } } ] }, "BLOC_TEXTUEL": { "CONTENU": "
\n
\n
A modifié les dispositions suivantes :

- Code de la sécurité sociale.
Sct. Sous-section 3 : Autres dispositions, Art. L145-5-6, Art. L161-37, Art. L162-13, Art. L162-13-1, Art. L162-13-2, Art. L162-13-3, Art. L162-13-4, Art. L162-14, Art. L162-37\n
\n

\n
" } }, "LEGIARTI000021709085": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L162-14", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2010-02-26", "DATE_DEBUT": "2010-01-16" } }, "META_COMMUN": { "ID": "LEGIARTI000021709085", "URL": "article/LEGI/ARTI/00/00/21/70/90/LEGIARTI000021709085.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "LIENS": { "LIEN": [ { "@id": "LEGIARTI000006885046", "@num": "1", "#text": "Arrêté du 3 novembre 1987 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000683407", "@nortexte": "ECOC8700123A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "1987-11-03" }, { "@id": "LEGIARTI000006717102", "@num": "1", "#text": "Arrêté du 16 février 1988 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000296521", "@nortexte": "ASES8800279A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "1988-02-16" }, { "@id": "LEGIARTI000006717104", "@num": "2", "#text": "Arrêté du 16 février 1988 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000296521", "@nortexte": "ASES8800279A", "@typelien": "CITATION", "@naturetexte": "ARRETE", "@datesignatexte": "1988-02-16" }, { "@id": "LEGIARTI000006775804", "@num": "Annexe, art. 13", "#text": "Décret n°91-655 du 15 juillet 1991 - art. Annexe, art. 13 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000504362", "@nortexte": "SANS9101463D", "@numtexte": "91-655", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "1991-07-15" }, { "@id": "LEGIARTI000006698094", "@num": "20-3", "#text": "Ordonnance n°96-1122 du 20 décembre 1996 - art. 20-3 (M)", "@sens": "cible", "@cidtexte": "JORFTEXT000000368749", "@nortexte": "DOMX9600135R", "@numtexte": "96-1122", "@typelien": "CITATION", "@naturetexte": "ORDONNANCE", "@datesignatexte": "1996-12-20" }, { "@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": "LEGIARTI000006771852", "@num": "1", "#text": "Décret n°97-379 du 21 avril 1997 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000382928", "@nortexte": "TASS9721343D", "@numtexte": "97-379", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "1997-04-21" }, { "@id": "LEGIARTI000006771854", "@num": "2", "#text": "Décret n°97-379 du 21 avril 1997 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000382928", "@nortexte": "TASS9721343D", "@numtexte": "97-379", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "1997-04-21" }, { "@id": "LEGIARTI000006771859", "@num": "5", "#text": "Décret n°97-379 du 21 avril 1997 - art. 5 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000382928", "@nortexte": "TASS9721343D", "@numtexte": "97-379", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "1997-04-21" }, { "@id": "LEGIARTI000046813870", "@num": "1", "#text": "Décret n°2007-597 du 24 avril 2007 - art. 1 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000649843", "@nortexte": "SANS0721482D", "@numtexte": "2007-597", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2007-04-24" }, { "@id": "LEGIARTI000046813858", "@num": "2", "#text": "Décret n°2007-597 du 24 avril 2007 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000000649843", "@nortexte": "SANS0721482D", "@numtexte": "2007-597", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2007-04-24" }, { "@id": "LEGIARTI000046813849", "@num": "3", "#text": "Décret n°2007-597 du 24 avril 2007 - 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art. 12 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000024457033", "@nortexte": "ETSX1107215L", "@numtexte": "2011-940", "@typelien": "CITATION", "@naturetexte": "LOI", "@datesignatexte": "2011-08-10" }, { "@id": "LEGIARTI000033090911", "@num": "2", "#text": "Décret n°2011-1644\n du 25 novembre 2011 - art. 2 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000024851756", "@nortexte": "ETSS1130305D", "@numtexte": "2011-1644", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2011-11-25" }, { "@id": "LEGITEXT000025677915", "#text": "Décret n°2012-466\n du 10 avril 2012 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000025677145", "@nortexte": "ETSS1205632D", "@numtexte": "2012-466", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2012-04-10" }, { "@id": "LEGITEXT000026880355", "#text": "Décret n°2012-1485 du 27 décembre 2012 (V)", "@sens": "cible", "@cidtexte": "JORFTEXT000026855559", "@nortexte": "AFSS1221366D", "@numtexte": "2012-1485", "@typelien": "CITATION", "@naturetexte": "DECRET", "@datesignatexte": "2012-12-27" }, { "@id": "LEGIARTI000033715404", "@num": "36", "#text": "LOI n°2013-1203\n du 23 décembre 2013 - 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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire de biologie médicale et l'Union nationale des caisses d'assurance maladie.

Cette convention détermine notamment :

1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;

2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;

3° Le montant de la contribution annuelle des caisses nationales d'assurance maladie au développement professionnel continu ;

4° (Abrogé)

5° Le cas échéant :

a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;

c) Les droits et obligations respectifs des directeurs de laboratoire de biologie médicale, des patients et des caisses, ainsi que les modalités d'évaluation associées aux formes d'exercice et modes de rémunération mentionnés aux a et b ci-dessus ;

6° Le cas échéant, les modes de rémunération, autres que le paiement à l'acte, des examens de biologie médicale ainsi que les modes de rémunération des activités non curatives des directeurs de laboratoire de biologie médicale.

Pour la mise en œuvre des 5° et 6°, il peut être fait applications des dérogations mentionnées à l'article L. 162-45.\n

La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.

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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire de biologie médicale et l'Union nationale des caisses d'assurance maladie.

Cette convention détermine notamment :

1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;

2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;

3° Le montant de la contribution annuelle des caisses nationales d'assurance maladie au développement professionnel continu ;

4° (Abrogé)

5° Le cas échéant :

a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;

La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.

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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire de biologie médicale et l'Union nationale des caisses d'assurance maladie.

Cette convention détermine notamment :

1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;

2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;

3° (Abrogé) ;

4° (Abrogé)

5° Le cas échéant :

a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;

La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23 ou de l'article L. 5125-23-3 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique ou du médicament biologique similaire le plus cher du même groupe.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Les dispositions du cinquième alinéa du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

Lorsque le pharmacien d'officine délivre une spécialité sur présentation d'une prescription libellée en dénomination commune, en application du deuxième alinéa de l'article L. 5125-23 du code de la santé publique, la délivrance de cette spécialité ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique la plus chère du même groupe.

Lorsque le pharmacien d'officine délivre, en application du troisième alinéa de l'article L. 5125-23, de l'article L. 5125-23-3 ou de l'article L. 5125-23-4 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance de la spécialité générique ou du médicament biologique similaire le plus cher du même groupe.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Les rapports entre les organismes d'assurance maladie et les directeurs de laboratoires privés d'analyses médicales sont définis par une convention nationale conclue pour une durée au plus égale à cinq ans entre une ou plusieurs organisations syndicales les plus représentatives des directeurs de laboratoire de biologie médicale et l'Union nationale des caisses d'assurance maladie.

Cette convention détermine notamment :

1° Les obligations respectives des caisses primaires d'assurance maladie et des directeurs de laboratoires privés d'analyses médicales ;

2° Les modalités du contrôle de l'exécution par les laboratoires des obligations qui découlent pour eux de l'application de la convention ;

2° bis Les orientations pluriannuelles prioritaires en matière de développement professionnel continu, relevant de l'article L. 4021-2 du code de la santé publique ;

3° (Abrogé) ;

4° (Abrogé) ;

5° Le cas échéant :

a) Les conditions particulières d'exercice propres à favoriser la coordination des soins ;

La convention définit les exigences particulières sans motif médical des patients donnant lieu à dépassement des tarifs.

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Lorsque le pharmacien d'officine délivre, en application du deuxième alinéa de l'article L. 512-3 du code de la santé publique, une spécialité figurant sur la liste prévue à l'article L. 162-17 autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à un montant ou à un pourcentage déterminé par la convention prévue à l'article L. 162-16-1. A défaut, ce montant ou ce pourcentage est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.

En cas d'inobservation de cette condition, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites, et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée à l'alinéa précédent, qui ne peut toutefois être inférieure à un montant forfaitaire défini par la convention prévue à l'article L. 162-16-1. A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale, de la santé, de l'économie et du budget.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

" } }, "LEGIARTI000037950933": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L162-16", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2020-12-15", "DATE_DEBUT": "2020-01-01" } }, "META_COMMUN": { "ID": "LEGIARTI000037950933", "URL": "article/LEGI/ARTI/00/00/37/95/09/LEGIARTI000037950933.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "NOTA": { "CONTENU": "

Conformément à l'article 66, V de la loi n° 2018-1203 du 22 décembre 2018, ces dispositions entrent en vigueur le 1er janvier 2020.\n

Conformément à l'article 1er de l'arrêté du 10 décembre 2020 ( NOR : SSAS2032695A ), la date d'entrée en vigueur mentionnée au B du III de l'article 42 de la loi n° 2019-1446 du 24 décembre 2019 est fixée au 15 décembre 2020.

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I.-Le remboursement des frais exposés par les assurés à l'occasion de l'achat de médicaments est effectué sur la base des prix réellement facturés. Ceux-ci ne peuvent pas dépasser les prix limites résultant de l'application de l'article L. 5123-1 du code de la santé publique.

II.-Pour les médicaments figurant dans un groupe générique prévu au 5° de l'article L. 5121-1 du code de la santé publique, la base de remboursement des frais exposés par les assurés peut être limitée à un tarif forfaitaire de responsabilité décidé par le Comité économique des produits de santé institué par l'article L. 162-17-3 du présent code, sauf opposition conjointe des ministres concernés, qui arrêtent dans ce cas le tarif forfaitaire de responsabilité dans un délai de quinze jours après la décision du comité.

Les dispositions du III du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

III.-La base de remboursement des frais exposés par l'assuré au titre de la spécialité délivrée par le pharmacien d'officine, ou d'une pharmacie à usage intérieur en application du 1° de l'article L. 5126-6 du code de la santé publique, est limitée à la base de remboursement la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné, lorsque le pharmacien délivre une spécialité :
\n
\n1° Sur présentation d'une prescription libellée en dénomination commune qui peut être respectée par la délivrance d'une spécialité figurant au sein d'un groupe générique ou hybride mentionné au 5° de l'article L. 5121-1 du même code ;
\n
\n2° Ou pour laquelle la spécialité prescrite ou délivrée appartient à un groupe générique ou hybride.
\n
\nLe pharmacien délivre pour la spécialité concernée le conditionnement le moins coûteux pour l'assurance maladie.
\n
\nLe pharmacien propose au patient, le cas échéant par substitution, une spécialité dont la base de remboursement n'excède pas la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné.
\n
\nPour l'application du présent III, seules les spécialités inscrites sur l'une des listes mentionnées aux premier et deuxième alinéas de l'article L. 162-17 sont prises en compte.
\n
\nIV.-Le III, à l'exception de l'avant-dernier alinéa, n'est pas applicable lorsque le prescripteur a exclu sur justification médicale la possibilité de substitution conformément au deuxième alinéa du II de l'article L. 5125-23 du code de la santé publique, ou lorsque la délivrance par substitution d'une spécialité hybride n'est pas admise en application du dernier alinéa du II du présent article.

V.-(Abrogé).

VI.-En cas d'inobservation des dispositions des III et V du présent article, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée aux mêmes III et V, qui ne peut toutefois être inférieure à un montant forfaitaire déterminé par la convention prévue à l'article L. 162-16-1. A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale et de la santé.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

VII.-Les médicaments dispensés par un pharmacien en application de l'article L. 5125-23-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie dans la limite d'une seule boîte par ligne d'ordonnance au-delà de la durée de traitement initialement prescrite.

" } }, "LEGIARTI000041397373": { "META": { "META_SPEC": { "META_ARTICLE": { "NUM": "L162-16", "ETAT": "MODIFIE", "TYPE": "AUTONOME", "DATE_FIN": "2021-12-25", "DATE_DEBUT": "2020-12-15" } }, "META_COMMUN": { "ID": "LEGIARTI000041397373", "URL": "article/LEGI/ARTI/00/00/41/39/73/LEGIARTI000041397373.xml", "NATURE": "Article", "ORIGINE": "LEGI" } }, "NOTA": { "CONTENU": "

Conformément au III, B de l’article 42 de la loi n° 2019-1446 du 24 décembre 2019, ces dispositions entrent en vigueur à une date fixée par arrêté du ministre chargé de la sécurité sociale, et au plus tard le 1er janvier 2022. Les dispositions du même 5° ne s'appliquent pas aux groupes génériques pour lesquels le prix d'une spécialité générique a été publié au Journal officiel ou, le cas échéant, au Bulletin officiel des produits de santé antérieurement à cette date d'entrée en vigueur.\n

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Les dispositions du III du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

III.-La base de remboursement des frais exposés par l'assuré au titre de la spécialité délivrée par le pharmacien d'officine, ou d'une pharmacie à usage intérieur en application du 1° de l'article L. 5126-6 du code de la santé publique, est limitée à la base de remboursement la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné, lorsque le pharmacien délivre une spécialité :
\n
\n1° Sur présentation d'une prescription libellée en dénomination commune qui peut être respectée par la délivrance d'une spécialité figurant au sein d'un groupe générique ou hybride mentionné au 5° de l'article L. 5121-1 du même code ;
\n
\n2° Ou pour laquelle la spécialité prescrite ou délivrée appartient à un groupe générique ou hybride.
\nLe pharmacien délivre pour la spécialité concernée le conditionnement le moins coûteux pour l'assurance maladie.
\n
\nLe pharmacien propose au patient, le cas échéant par substitution, une spécialité dont la base de remboursement n'excède pas la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné.
\n
\nPour l'application du présent III, seules les spécialités inscrites sur l'une des listes mentionnées aux premier et deuxième alinéas de l'article L. 162-17 sont prises en compte.

Pour les groupes génériques, la limitation de la base de remboursement mentionnée au présent III s'applique à compter de deux ans suivant la publication au Journal officiel ou, le cas échéant, au Bulletin officiel des produits de santé du prix de la première spécialité générique du groupe.
\n
\nIV.-Le III, à l'exception de l'avant-dernier alinéa, n'est pas applicable lorsque le prescripteur a exclu sur justification médicale la possibilité de substitution conformément au deuxième alinéa du II de l'article L. 5125-23 du code de la santé publique, ou lorsque la délivrance par substitution d'une spécialité hybride n'est pas admise en application du dernier alinéa du II du présent article.

V.-(Abrogé).

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Les dispositions du III du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

III.-La base de remboursement des frais exposés par l'assuré au titre de la spécialité délivrée par le pharmacien d'officine, ou d'une pharmacie à usage intérieur en application du 1° de l'article L. 5126-6 du code de la santé publique, est limitée à la base de remboursement la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné, lorsque le pharmacien délivre une spécialité :
\n
\n1° Sur présentation d'une prescription libellée en dénomination commune qui peut être respectée par la délivrance d'une spécialité figurant au sein d'un groupe générique ou hybride mentionné au 5° de l'article L. 5121-1 du même code ;
\n
\n2° Ou pour laquelle la spécialité prescrite ou délivrée appartient à un groupe générique ou hybride.
\nLe pharmacien délivre pour la spécialité concernée le conditionnement le moins coûteux pour l'assurance maladie.
\n
\nLe pharmacien propose au patient, le cas échéant par substitution, une spécialité dont la base de remboursement n'excède pas la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné.
\n
\nPour l'application du présent III, seules les spécialités inscrites sur l'une des listes mentionnées aux premier et deuxième alinéas de l'article L. 162-17 sont prises en compte.

V.-Lorsque le pharmacien d'officine délivre, en application de l'article L. 5125-23-2 du code de la santé publique, une spécialité figurant sur la liste mentionnée au premier alinéa de l'article L. 162-17 du présent code autre que celle qui a été prescrite, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance du médicament biologique similaire le plus onéreux du même groupe.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

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Les dispositions du III du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

III.-La base de remboursement des frais exposés par l'assuré au titre de la spécialité délivrée par le pharmacien d'officine, ou d'une pharmacie à usage intérieur en application du 1° de l'article L. 5126-6 du code de la santé publique, est limitée à la base de remboursement la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné, lorsque le pharmacien délivre une spécialité :
\n
1° Sur présentation d'une prescription libellée en dénomination commune qui peut être respectée par la délivrance d'une spécialité figurant au sein d'un groupe générique ou hybride mentionné au 5° de l'article L. 5121-1 du même code ;
\n
2° Ou pour laquelle la spécialité prescrite ou délivrée appartient à un groupe générique ou hybride.
Le pharmacien délivre pour la spécialité concernée le conditionnement le moins coûteux pour l'assurance maladie.
\n
Le pharmacien propose au patient, le cas échéant par substitution, une spécialité dont la base de remboursement n'excède pas la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné.
\n
Pour l'application du présent III, seules les spécialités inscrites sur l'une des listes mentionnées aux premier et deuxième alinéas de l'article L. 162-17 sont prises en compte.

Pour les groupes génériques, la limitation de la base de remboursement mentionnée au présent III s'applique à compter de deux ans suivant la publication au Journal officiel ou, le cas échéant, au Bulletin officiel des produits de santé du prix de la première spécialité générique du groupe.
\n
IV.-Le III, à l'exception de l'avant-dernier alinéa, n'est pas applicable lorsque le prescripteur a exclu sur justification médicale la possibilité de substitution conformément au deuxième alinéa du II de l'article L. 5125-23 du code de la santé publique, ou lorsque la délivrance par substitution d'une spécialité hybride n'est pas admise en application du dernier alinéa du II du présent article.

V bis.-Les produits dispensés par un pharmacien d'officine en application de l'article L. 5125-23-3 du code de la santé publique sont pris en charge par les organismes d'assurance maladie, sous réserve que ces produits soient inscrits sur la liste des produits et prestations remboursables mentionnée à l'article L. 165-1 du présent code.

Lorsque le pharmacien d'officine délivre, en application de l'article L. 5125-23-3 du code de la santé publique, un produit figurant sur la liste mentionnée à l'article L. 165-1 du présent code autre que celui qui a été prescrit, cette substitution ne doit pas entraîner une dépense supplémentaire pour l'assurance maladie supérieure à la dépense qu'aurait entraînée la délivrance du produit prescrit.

VI.-En cas d'inobservation des dispositions des III, V et V bis du présent article, le pharmacien verse à l'organisme de prise en charge, après qu'il a été mis en mesure de présenter ses observations écrites et si, après réception de celles-ci, l'organisme maintient la demande, une somme correspondant à la dépense supplémentaire mentionnée aux mêmes III, V et V bis, qui ne peut toutefois être inférieure à un montant forfaitaire déterminé par la convention prévue à l'article L. 162-16-1. A défaut, ce montant est arrêté par les ministres chargés de la sécurité sociale et de la santé.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

VII.-Les médicaments et dispositifs médicaux dispensés par un pharmacien en application du premier alinéa de l'article L. 5125-23-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie dans la limite d'un mois au-delà de la durée de traitement initialement prescrite.

Les médicaments renouvelés par une infirmière ou un infirmier en application du sixième alinéa de l'article L. 4311-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie, sous réserve que ces médicaments soient inscrits sur la liste des spécialités remboursables prévue au premier alinéa de l'article L. 162-17 du présent code.

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\n

Les dispositions du III du présent article ne s'appliquent pas aux médicaments remboursés sur la base d'un tarif forfaitaire.

III.-La base de remboursement des frais exposés par l'assuré au titre de la spécialité délivrée par le pharmacien d'officine, ou d'une pharmacie à usage intérieur en application du 1° de l'article L. 5126-6 du code de la santé publique, est limitée à la base de remboursement la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné, lorsque le pharmacien délivre une spécialité :
\n
\n1° Sur présentation d'une prescription libellée en dénomination commune qui peut être respectée par la délivrance d'une spécialité figurant au sein d'un groupe générique ou hybride mentionné au 5° de l'article L. 5121-1 du même code ;
\n
\n2° Ou pour laquelle la spécialité prescrite ou délivrée appartient à un groupe générique ou hybride.
\nLe pharmacien délivre pour la spécialité concernée le conditionnement le moins coûteux pour l'assurance maladie.
\n
\nLe pharmacien propose au patient, le cas échéant par substitution, une spécialité dont la base de remboursement n'excède pas la plus chère en vigueur pour les spécialités génériques ou hybrides appartenant au groupe générique ou hybride concerné.
\n
\nPour l'application du présent III, seules les spécialités inscrites sur l'une des listes mentionnées aux premier et deuxième alinéas de l'article L. 162-17 sont prises en compte.

Pour son recouvrement, ce versement est assimilé à une cotisation de sécurité sociale.

VII.-Les médicaments et dispositifs médicaux dispensés par un pharmacien en application du premier alinéa de l'article L. 5125-23-1 du code de la santé publique sont pris en charge par les organismes d'assurance maladie dans la limite de trois mois au-delà de la durée de traitement initialement prescrite.

\n
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Article L162-37 AUTONOME MODIFIE, en vigueur du 16/01/2010 au 19/12/2012 (Code de la sécurité sociale)