L’Assurance Maladie (the Health Insurance Fund)
Mission
Financing / Regulation
Type of actor
Institutional player
Fields of intervention
Health / Social care / Medical Device
Intervention zone
National
What is the Health Insurance Fund?
The French national Health Insurance Fund supports 60 million insured people throughout their lives - both personal and professional - by covering their health care costs, regardless of their resources, situation or state of health. It thus guarantees universal access under the law and enables all insured persons to seek care.
It also acts to head off illnesses and complications before they set in, with an ever-expanding range of preventive measures. In the workplace, it reinforces the protection of the most exposed or most vulnerable employees.
It works hand-in-hand with health professionals and healthcare facilities, companies and all stakeholders to try to reconcile the best quality of care with the best cost.
Missions
The five main objectives of the French National Health Insurance Fund are:
- strengthen access to the healthcare system
- contribute to the transformation and efficiency of our health system
- provide users with service that is maintained at a high level of quality
- support innovation in health
- successfully integrate other insurance plans by ensuring that the branch operates efficiently
These objectives are redefined every 4 years by the National Health Insurance Fund and the Government.
I have a project, how can contacting the Health Insurance Fund be of use to me?
One of the missions of the Health Insurance Fund is to support innovation in health care by enhancing the digital services offered to insured persons and health professionals.
The future Personal Health Data Space will be the Government platform offering a 360° view of the health services available to all citizens. It will have its own listing process to which all eHealth players will have to refer.
Since the creation of the SESAM-Vitale dematerialised invoicing system in 1998, the Health Insurance Fund has built up a wide range of teleservices for healthcare professionals in institutions and private practice. These services have made it possible to facilitate and secure attending physicians’ declarations, sick leave prescriptions, and pregnancy declarations.
These services are accessible to healthcare professionals through the Amelipro portal and within their software. As part of the process, healthcare software publishers register at the GIE SESAM-Vitale website (https://industriels.sesam-vitale.fr), and the GIE will assist them through all the steps until their software is certified. This certification, carried out by the Centre National de Dépôt et d'Agrément (https://cnda.ameli.fr) , verifies the compliance of software developed by publishers with the specifications of Health Insurance Fund services.
At what stage of my project should I contact them?
To use the online Healthcare Professionals services, register early on at the GIE SESAM Vitale website (https://industriels.sesam-vitale.fr), which will guide you until you earn CNDA certification.
What can the Health Insurance Fund do for project leaders?
Project leaders do not interact directly with the Health Insurance Fund because their contact throughout the process remains the GIE SESAM-Vitale for services to health professionals.
Topics involved
The Health Insurance Fund contributes to the creation of online services for health professionals.
These services are designed to ANS standards: Interoperability framework, security (PGSSI-S, CPx card), identification and authentication (RPPS, ProSanté Connect, etc.).
Accessible resources (database, observatory)
The functional documentation is available on the GIE SESAM-Vitale website (https://industriels.sesam-vitale.fr) after registration. The test environments will be made available to project leaders by the CNDA once the software version has been developed.
Does it fund projects?
No.
50 Avenue du Professeur André Lemierre 75020 Paris
