Call for providers of medical and paramedical services (hospitals, clinics, laboratories, medical centres and authorised natural persons exercising an activity in the medical or paramedical sector) and pharmacies to offer their services to members and beneficiaries of the Joint Sickness Insurance Scheme at more economical prices
Date: 2014-10-15
Institutions: European Commission
Subjects: health service, invitation to tender, nursing staff, paramedical profession, pharmacy, price reduction, social security








C_2014364EN.01000401.xml










15.10.2014   


EN


Official Journal of the European Union


C 364/4





Call for providers of medical and paramedical services (hospitals, clinics, laboratories, medical centres and authorised natural persons exercising an activity in the medical or paramedical sector) and pharmacies to offer their services to members and beneficiaries of the Joint Sickness Insurance Scheme at more economical prices
(2014/C 364/04)
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 PMO.3, 1049 Brussels, Belgium, Tel. +32 22952799, Fax +32 22975728.
2.   Subject of the call

All serving and retired officials and other staff members of the European Union institutions, bodies and agencies (members) and their dependants (beneficiaries) are insured against sickness by the Joint Sickness Insurance Scheme (the Scheme or JSIS). The Scheme guarantees members and beneficiaries the reimbursement of costs incurred as a result of sickness, accident or maternity, subject to the limits and conditions laid down in the Joint Rules and in the general implementing provisions (GIP) of the Joint Rules. The Scheme also finances a preventive medicine programme (health screening) that is available to all members and beneficiaries (see Annex 1 for the relevant programmes).
The JSIS is administered by the European Commission’s Office for the Administration and Payment of Individual Entitlements (PMO). The administrative structure of the JSIS comprises the Central Office (BC), a Finance Section and three Settlements Offices, located in Brussels, Luxembourg and Ispra.
Freedom of choice of doctors, hospitals, clinics and other healthcare providers for members and beneficiaries is one of the fundamental principles of the JSIS.
The Central Office wishes to draw up lists of medical and paramedical service providers (hospitals, clinics, laboratories, medical centres, pharmacies and authorised natural persons exercising an activity in the medical or paramedical sector, referred to as ‘operators’ below) that will offer their services to JSIS members and beneficiaries on more advantageous terms. Establishments wishing to offer services in the preventive medicine field (health check-ups and screening) are also invited to put forward proposals in this connection.
The aim of the JSIS Central Office is to draw up lists of operators that members can use when looking for the best possible financial terms for health care in the 16 Member States listed in point 4 below. The lists will therefore be widely publicised amongst the JSIS members and beneficiaries. 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 expect to see increased demand for their services, and at the same time be assured of early and speedy payment when the costs of hospitalisation and hospital examinations and treatment (one-day clinics) are billed directly.
Receipt of the documentation submitted by operators and the distribution by the JSIS of the lists resulting from this call will not bind JSIS members/beneficiaries or the abovementioned service providers. The service providers concerned will not enter into contracts, but may sign price agreements.
By submitting their lists of prices applicable to members and beneficiaries and/or the proposed percentage discounts granted on their published prices, operators expressing an interest in this call shall undertake to apply those prices to members and beneficiaries and, if the costs are billed directly to the Commission, to send the invoice directly to the JSIS.
Operators wishing to take part in this call will be required to submit a list of the services offered and the proposed prices, and to indicate 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 Sickness Insurance Fund 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 under the direct billing system.




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, if 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 service provider concerned where the fee has already been paid.
The JSIS hereby informs service providers of the provisions of Article 31 of the Joint Rules, according to 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 the Rules, vest in the EU institutions in accordance with Article 85a of the Staff Regulations of Officials of the European Union.
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 on more advantageous financial terms to JSIS members and beneficiaries. It replaces the previous call (ref. 2001/C 221/06 of 27.7.2011), which now ceases to apply.
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 department concerned.
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-year period following the date of publication of the call has elapsed.
All operators are invited to make themselves known in accordance with this notice, naming a person responsible for contacts with the JSIS and giving that person’s contact details. The PMO will draw up a list of candidates meeting the criteria set out in point 7 below.
Operators included on the lists drawn up following the previous call (ref. 2011/C 221/06) shall remain listed until their proposal reaches the end of its validity. They may submit a new proposal under the terms of this latest call in order to ensure the continued provision of their services.
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 EU institutions, bodies and agencies 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:






—


Belgium (1)











—


Luxembourg (2)











—


Germany










—


Italy










—


France










—


Spain










—


United Kingdom










—


Netherlands










—


Greece










—


Portugal










—


Finland










—


Austria










—


Ireland










—


Poland










—


Denmark










—


Sweden




5.   List categories

Lists should be broken down into the following categories:






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hospitals — any specialisations should be indicated within this category,










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private clinics,










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laboratories performing analyses and specialist visits,










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medical specialists (gynaecologists, paediatricians, dentists, etc.),










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general medical practitioners,










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paramedical services,










—


pharmacies (Belgium only),










—


screening programmes.




The prices given for hospital or clinic beds should be the daily price for both single rooms and double rooms, and any additional fees charged for specialists and various other service providers where the patient chooses a private room.
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









1.


Operators will be excluded if:






a)


they are bankrupt or being wound up, are having their affairs administered by the courts, have entered into an arrangement with creditors, have suspended business activities, are the subject of proceedings concerning those matters, or are in any analogous situation arising from a similar procedure provided for in national legislation or regulations;










b)


they have been convicted of an offence concerning their professional conduct by a judgment which has the force of res judicata;










c)


they have been guilty of grave professional misconduct proven by any means which the contracting authority can justify;










d)


they have failed to fulfil obligations relating to the payment of social-security contributions or taxes in accordance with the legal provisions of the country in which they are established or of the country of the contracting authority or of the country where the service is to be rendered;










e)


they have been the subject of a judgment which has the force of res judicata for fraud, corruption, involvement in a criminal organisation or any other illegal activity detrimental to the European Union’s financial interests.
















2.


Operators must certify (by a declaration on their honour, a model of which can be found in Annex 2) that they are not in one of the situations listed in paragraph 1.




7.2.   Selection criteria

Technical and professional capacity:






—


compliance with obligations and authorisation to engage in an activity under the law of the country in which they are established or exercise their activity.




7.2.1.   Operators must provide documentation certifying compliance with the above legislation.

8.   Documentation to be provided by operators

8.1.   Operators must provide a third-party liability insurance certificate.
8.2.   Operators must also submit:






1)


a list of the healthcare services performed/provided within their structure;










2)


a list of prices of all their services/examinations applicable to JSIS members or beneficiaries and/or the percentage discount on their published prices that will be granted to JSIS members or beneficiaries. If offering discounts, operators must also submit their list of published prices;










3)


the comparability table included in the annex, which contains lists of standard services and must be completed with the proposed prices and discounts offered;










4)


a list of pharmaceutical products with the percentage price discount (for Belgium only);










5)


pricing documentation, to be provided in digital format also.




8.3.   The PMO reserves the right to:






—


reject incomplete applications from operators, i.e. those not providing all the necessary information, formalities and documentation,










—


require operators to resubmit some or all of the information, formalities and documentation where, for example, supporting documents are no longer valid.




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 provided.
9.2.   Operators must inform the PMO immediately of any change preventing them from meeting the criteria in point 7.
9.3.   The prices and/or percentage discount proposed may be revised once per year.
If prices are changed, operators must submit the revised price list by 31 December each 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 PMO of this by registered letter addressed to the contact person indicated in point 1.
9.5.   The 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:





PMO.3 — RCAM




Rue de la Science/Wetenschapstraat 27 (SC 27 3/54)




1049 Bruxelles/Brussel




BELGIQUE/BELGIË




For the attention of Mr SCOGNAMIGLIO




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:






1)


non-application of the price proposed by the operator;










2)


failure to comply with the specific rules laid down by the Member State in which the activity is exercised.




Annexes: (http://ec.europa.eu/pmo/tender.htm)






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Annex 1: JSIS health screening programmes










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Annex 2: Declaration on the exclusion criteria










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Annexes 3 a) and b) Comparability tables of the prices for services






(1)  In Belgium, the price proposed may not be higher than the nationally agreed price for equivalent services and procedures, (cf. Act of 19 March 2013 laying down miscellaneous provisions on health, published on 29 March 2013 and entering into force on 8 April 2013:
Art. 4. In Article 42 of the same Act, as amended by the Acts of 20 December 1995, 22 February 1998 and 19 December 2008, a paragraph worded as follows is inserted between the first and second paragraphs:

‘The agreements referred to in the previous paragraph shall also apply, as regards the provisions on pricing, to beneficiaries of health care under a Regulation of the European Union, the Treaty on the Functioning of the European Union or a social security agreement.’

Art. 5. A paragraph worded as follows shall be added to Article 50(1) of the same Act:

‘The abovementioned agreements shall also apply, as regards the provisions on pricing, to beneficiaries of health care under a Regulation of the European Union, the Treaty on the Functioning of the European Union or a social security agreement.’

This call consequently applies to the additional fees charged in the case of hospital stays in private rooms.

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


ANNEX 1
JSIS health screening programmes












ANNEX 2





ANNEX 3 a)




ANNEX 3 b)