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 applicable to JSIS members and beneficiaries

2011/C 221/06

1.   Contact point at the European Commission

European Commission, PMO/3 Bureau Central du RCAM (JSIS Central Office), for the attention of Mr Scognamiglio, Head of Unit PMO3 RCAM, 1049 Bruxelles/Brussel, Belgique/België. Tel. +32 22952799. Fax +32 22956639.

2.   Subject of the call

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 (see Annex I for the relevant programmes).

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 (1)) 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.

The members and beneficiaries will retain their freedom of choice of service provider, whether or not a provider is on the proposed lists.

An information campaign will, however, 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:

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.

The JSIS hereby informs service providers of the provisions of Article 31 of the JSIS Rules, under which, where an accident or illness is caused by a third party, the rights of action of the person concerned or of those entitled under him or her against the third party shall, within the limits of their obligations under these Rules, vest in the Communities in accordance with Article 85a of the Staff Regulations applicable to officials of the European Communities.

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.

3.   Type

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 (indicated in point 5) that will be valid for four years beginning on the date of receipt by the Commission.

A special list will be drawn up for screening programmes.

The closing date for submission of documents expressing an interest will be six months before the four years following the date of publication of the call have elapsed.

All operators are invited to make themselves known in accordance with this notice, naming a person responsible for contacts with the JSIS. The PMO will draw up a list of candidates meeting the criteria set out in point 7 below.

Personal data will be processed pursuant to Regulation (EC) No 45/2001 on the protection of individuals with regard to the processing of personal data by the Community institutions and bodies and on the free movement of such data. These and the responses given may be used only for the purposes of evaluation of the documents received by the PMO.

Details of the processing of personal data are available at:

http://ec.europa.eu/dataprotectionofficer/privacystatement_publicprocurement_en.pdf

4.   Member States

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:

5.   List categories

The list should be broken down into the following categories:

The prices for hospital or clinic beds should be given for both single rooms (used by the majority of our beneficiaries) and double rooms.

6.   Expiry date of the list drawn up following the call for expressions of interest

All operators may submit documentation within four years less six months of the publication date of this notice.

7.   Criteria for placement on the list of operators

7.1.   Exclusion criteria

7.2.   Selection criteria

Technical and professional capacity:

8.   Documentation to be provided by operators

8.1.   Operators must provide documentary evidence of third-party liability insurance.

8.2.   Operators must also submit:

8.3.   The PMO reserves the right to:

9.   Further information for operators

9.1.   The supporting documents and invoices issued by operators to JSIS members must comply with the legislation of the country in which the services are rendered.

9.2.   Operators must inform the PMO immediately of any change preventing them from meeting the criteria described in point 7.

9.3.   The prices proposed may be revised once per year.

If prices are changed, operators must submit the revised price list by 31 December of the current year. The revision will take effect from 1 February of the year following receipt of the revised prices.

9.4.   Operators wishing to be removed from the list must inform the Commission of this by registered letter addressed to the contact person indicated in point 1.

9.5.   This call for expressions of interest will be valid for four years beginning on the date on which this notice is sent to the Publications Office of the European Union.

10.   Submission procedure

Operators are invited to send their applications together with the required documentation by registered mail with acknowledgment of receipt to the following address:

11.   Other information

All operators taking part in this procedure will be informed of the success or otherwise of their application (i.e. whether or not they will be placed on the list) within 30 calendar days of submission of the application.

The PMO reserves the right to revoke inclusion on the list for the following reasons, in which case it will inform the party concerned within 15 calendar days:

Annexes:

(1)  For Belgium only.

(2)  In Belgium, the price proposed may not be higher than the nationally agreed price for equivalent services and procedures (cf. the accord national médico-mutualiste 2011 (national agreement between doctors and sickness insurance funds — INAMI agreement) signed on 13 December 2010 and published in the Moniteur Belge on 17 January 2011 — point 9.1, second paragraph: ‘The Commission nationale médico-mutualiste (National Doctors and Sickness Insurance Funds Commission) points out that, pursuant to the European Treaty and to Regulation (EC) No 883/2004, rates demonstrably higher than those applicable to residents subject to the national social-security scheme may not be applied to European citizens, including staff employed by the European Union institutions’ — http://www.ejustice.just.fgov.be/cgi/article_body.pl?language=fr&caller=summary&pub_date=2011-01-17&numac=2010022524#end#end).

(3)  In Luxembourg, the percentage of discount should be based on the nationally agreed prices.