Call for providers of medical and paramedical services (hospitals, clinics, laboratories, medical centres and natural persons exercising an activity in the medical or paramedical sector) and pharmacies to offer their services to the JSIS at prices applica

All officials and agents of the European Union institutions and agencies and their dependants (beneficiaries) are insured against sickness. Specifically, the Joint Sickness Insurance Scheme (JSIS) common to the institutions of the European Communities, established by mutual agreement between the institutions, guarantees beneficiaries the reimbursement of costs incurred as a result of sickness, accident or maternity subject to the limits and conditions laid down in the relevant legislation and in the general implementing provisions (DGE). Members of the scheme are also entitled to receive health screening examinations for the purposes of preventive medicine.

The JSIS Central Office (BC), part of the European Commission's Office for the Administration and Payment of Individual Entitlements (PMO), Sickness and Accident Insurance Unit (PMO/3), administers the JSIS.

The fundamental principle of the JSIS is freedom of choice of doctors and healthcare establishments for members and beneficiaries.

The BC intends to draw up lists of providers of medical and paramedical services (hospitals, clinics, laboratories, medical centres and pharmacies) offering their services at prices applicable to the members and beneficiaries of the JSIS. Medical service providers may also draw up proposals for the preventive screening programmes attached (for all services within each programme).

The aim is to make these lists of service providers charging prices applicable to members and beneficiaries available in the eight countries listed in point 4 below.
The lists will be widely publicised amongst the JSIS members and beneficiaries.
An information campaign will alert members and beneficiaries to what is at stake for the JSIS and to the advantages of using listed centres or operators (high-quality service, applicable prices, ease of reimbursement). Those operators offering the best rates may thus reasonably be assured of increased demand for their services and early and speedy payment, particularly where the costs of hospitalisation and hospital examinations (one-day clinics) are billed directly.

Receipt of documentation from operators and the compilation of the list by the Commission will not bind the Commission or JSIS members/beneficiaries. The Commission will not sign any contract or agreement.

Operators expressing an interest in this call, by submitting their lists of prices applicable to members and beneficiaries and/or the proposed percentage discounts granted on their published prices, shall undertake to apply those prices to members and beneficiaries and, if the costs are billed directly to the Commission, to send the payment request or invoice directly to the Joint Sickness Insurance Scheme of the European Community institutions (the JSIS).

Operators wishing to take part in this call will be required to submit a list of the services offered, the proposed prices and the percentage discount to be granted to JSIS members and beneficiaries.

Members and beneficiaries using a listed service provider may:
- pay for the services directly and subsequently apply to the JSIS for reimbursement where provided for by the JSIS rules, or
- in the event of hospitalisation or hospital examination, ask for the invoice to be sent directly to the Commission.

By reimbursing all or part of the fees, the JSIS shall acquire by subrogation the rights of the member, including those of action against third parties, particularly where the fee charged by an establishment or clinic on the list does not match the rates or prices notified (this includes any discount applicable).

In such cases the JSIS shall reserve the right to refuse to pay the difference or to demand reimbursement from the establishment or clinic concerned, where the fee has already been paid.

All operators responding to this call will be told whether or not they have been placed on the list. Any interested party not placed on the list may apply again within four years (less six months) of the date of publication of the call.

This notice constitutes a call for offers of services at prices applicable to JSIS members and beneficiaries.

The services and the applicable prices proposed will be entered on one or more lists that will be valid for four years beginning on the date of receipt by the Commission.

Those invited to express an interest are hospitals, clinics, laboratories, medical centres, pharmacies (in Belgium only) and authorised natural persons exercising their activities in the health sector in the following Member States: Italy, Belgium, France, Germany, Luxembourg, Netherlands, Spain, United Kingdom.

This call will be valid for four years.

Reference: 2011/C 221/06

(Added 2011-07-27)