The creation of UNCAM
The National Union of Health Insurance Funds (Union nationale des caisses d'assurance maladie / UNCAM) is a new body which puts together the three main health insurance schemes - the general one, the agricultural one (MSA) and the social scheme for independent professionals (RSI) - in order to:
- Run the conventional policy.
- Define the scope of services eligible for reimbursement.
- Set up healthcare reimbursement tariffs.
Extended powers for CNAMTS' general director who:
- Is also UNCAM' s general director and exercises UNCAM missions within the framework of adopted guidelines and the given term of office, particularly as far as risk management is concerned.
- Appoints the bodies' managers and accountants.
- Takes necessary measures for the organization and steering of the network.
- Negotiates the Management and Objectives Agreement (Convention d'objectifs et de gestion / COG) with the State, and negotiates resulting Pluriannual Management Contracts (Contrats pluriannuels de gestion / CPG) with the bodies.
- May suspend or cancel the Council's decision or the one of a local or regional body which would not be aware of the commitments concluded in the COG or a CPG.
A reorganised CNAMTS' Council
- Marked by the return of employers' representatives, and in which representatives of mutual insurance companies and other institutions in the health insurance sector can take part.
- Set up to define risk management policy guidelines and to clarify the implementation modalities as far as the healthcare policy and organization of the healthcare system are concerned.
