{"d":{"__metadata":{"id":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')","uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')","type":"itsystems.Pd.DataServices.DataModel.Business"},"BusinessResponsibilities":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/BusinessResponsibilities"}},"RelatedBusinesses":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/RelatedBusinesses"}},"BusinessRoles":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/BusinessRoles"}},"Publications":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Publications"}},"LegislativePeriods":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/LegislativePeriods"}},"Sessions":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Sessions"}},"Preconsultations":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Preconsultations"}},"Bills":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Bills"}},"Councils":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Councils"}},"BusinessTypes":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/BusinessTypes"}},"Votes":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Votes"}},"SubjectsBusiness":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/SubjectsBusiness"}},"BusinessStates":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/BusinessStates"}},"Council":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Council"}},"Transcripts":{"__deferred":{"uri":"https://ws.parlament.ch/OData.svc/Business(ID=20105617,Language='FR')/Transcripts"}},"ID":20105617,"Language":"FR","BusinessShortNumber":"10.5617","BusinessType":14,"BusinessTypeName":"Heure des questions. Question","BusinessTypeAbbreviation":"Qst.","Title":"Du tiers payant au tiers garant: Intras respecte-t-elle ses engagements conventionnels?","Description":null,"InitialSituation":null,"Proceedings":null,"DraftText":null,"SubmittedText":"<p>Bien que l'art.\u00a042, al.\u00a01, LAMal consacre le principe du tiersgarant, la majorit\u00e9 des assureurs utilisent le syst\u00e8me dit du tiers payant pr\u00e9vu \u00e0 l'alin\u00e9a 2 de l'article pr\u00e9cit\u00e9. R\u00e9cemment, d'autres caisses dont Intras ont annonc\u00e9 mettre un terme au remboursement des m\u00e9dicaments selon les modalit\u00e9s du tiers payant. Cette d\u00e9cision est manifestement anti-social.</p><p>La d\u00e9cision de passer du syst\u00e8me du tiers payant au tiers garant est-elle bien en conformit\u00e9 avec les engagements conventionnels d'Intras\u00a0?</p>","ReasonText":null,"DocumentationText":null,"MotionText":null,"FederalCouncilResponseText":"<p>L'art.\u00a042, al.\u00a01er, LAMal \u00e9rige en principe que l'assur\u00e9 est le d\u00e9biteur de la r\u00e9mun\u00e9ration du fournisseur de prestations et qu'il a le droit d'\u00eatre rembours\u00e9 par l'assureur\u00a0; c'est le syst\u00e8me du tiers garant. Les assureurs et les fournisseurs de prestations peuvent toutefois d\u00e9cider par convention d'appliquer le syst\u00e8me du tiers payant. Intras avait conclu une convention avec la Soci\u00e9t\u00e9 suisse de pharmacie pour instaurer le syst\u00e8me du tiers payant pour les m\u00e9dicaments. Selon les informations obtenues de l'assureur, celui-ci a valablement d\u00e9nonc\u00e9 cette convention en \u00e9t\u00e9 2010 pour le 31 d\u00e9cembre 2010. En pratiquant le syst\u00e8me du tiers garant pour les m\u00e9dicaments d\u00e8s janvier 2011, Intras ne violera par cons\u00e9quent pas ses obligations conventionnelles. Intras a d\u00fbment inform\u00e9 ses assur\u00e9s de cette situation nouvelle lorsqu'elle leur a communiqu\u00e9 les primes 2011. Les assur\u00e9s ont ainsi eu la possibilit\u00e9 et le temps de d\u00e9cider, en toute connaissance de cause, s'ils restent chez Intras ou s'ils changent d'assureur.</p>","FederalCouncilProposal":null,"FederalCouncilProposalText":null,"FederalCouncilProposalDate":"\/Date(1292198400000)\/","SubmittedBy":"Rielle Jean-Charles","BusinessStatus":229,"BusinessStatusText":"Liquid\u00e9","BusinessStatusDate":"\/Date(1292198400000)\/","ResponsibleDepartment":4,"ResponsibleDepartmentName":"D\u00e9partement de l'int\u00e9rieur","ResponsibleDepartmentAbbreviation":"DFI","IsLeadingDepartment":true,"Tags":"2841","Category":null,"Modified":"\/Date(1690538027853)\/","SubmissionDate":"\/Date(1292198400000)\/","SubmissionCouncil":1,"SubmissionCouncilName":"Conseil national","SubmissionCouncilAbbreviation":"CN","SubmissionSession":4816,"SubmissionLegislativePeriod":48,"FirstCouncil1":null,"FirstCouncil1Name":null,"FirstCouncil1Abbreviation":null,"FirstCouncil2":null,"FirstCouncil2Name":null,"FirstCouncil2Abbreviation":null,"TagNames":"Sant\u00e9"}}