The "Health Benefit Basket" in France.
The French "Health Benefit Basket" is defined principally by positive lists of reimbursed goods and services; however, global budget-financed hospital-delivered services are more implicitly defined. The range of reimbursable curative care services is defined by two coexisting positive lists/fee schedules: the Classification Commune des Actes Médicaux (CCAM) and the Nomenclature Générale des Actes Professionnels (NGAP). The National Union of Health Insurance Funds has been updating these positive lists since August 2004, with the main criterion for inclusion being the proposed procedure's effectiveness. This is assessed by the newly created High Health authority (replacing the former ANAES). In addition, complementary health insurers are consulted in the inclusion process due to their important role in French health care financing.
Bellanger
Martine M
MM
Institut de Recherche et de documentation en Economie de la Santé, France. martine.bellanger@ensp.fr
Cherilova
Veneta
V
Paris
Valérie
V
D005602:France; D006291:Health Policy; D006292:Health Priorities / Q000458:organization & administration; D006296:Health Services / Q000191:economics / Q000331:legislation & jurisprudence*; D006298:Health Services Administration; D006801:Humans; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D005791:Patient Care