The 2024 Social Security Funding Law (SFLA) was enacted on December 26, 2023. It was published in the Official Journal of 27 December 2023. The law includes measures to improve access to health care; prevention; loss of autonomy and disability; and combating social fraud.

Medicinal products delivered on a unit basis in the event of supply disruption

The law provides for the general unit dispensing by pharmacists of medicinal products affected by a supply disruption. One order from the Minister of Health will make it mandatory for drugs to be dispensed to the unit in the event of supply disruptions, and another order will terminate the measure when it is no longer necessary.

Limitation of the duration of work stoppages prescribed in teleconsultation

The FSSA 2024 provides that it is no longer possible to benefit by teleconsultation from a work stoppage of more than 3 days or from the renewal of a work stoppage. There are two exceptions:

• prescriptions made by the attending physician;
• and if the patient proves that it is impossible to obtain an in-person consultation for the renewal of his work stoppage.

Prior knowledge of the patient, their history, health and environment has been found to enable treating physicians, even without physical examination, to assess the situation through teleconsultation.

Pharmacists' Care of Cystitis and Tonsillitis

The law provides that pharmacists are authorized to dispense antibiotics for simple tonsils and cystitis without a prescription, after a test has been carried out to confirm the bacterial origin of the disease.

This will allow patients with sore throat or burning on urination to go to the pharmacy, do a test and be directly dispensed with an antibiotic.

Evolution of the preventive appointment system at key life ages

Preventive appointments at different key life ages were created by the Social Security Funding Act for 2023. The Social Security Financing Act 2024 extends this scheme. Every insured person must be offered three free medical examinations by the Health Insurance between the ages of 18 and 25, 45 and 50, 60 and 65 and 70 and 75 in order to take stock of their physical and mental health and to provide appropriate care where appropriate. The aim is to strengthen adult health and prevent the development of chronic diseases, in particular through awareness-raising and the adoption of healthy lifestyles.

The LFSS 2024 specifies that these assessments can be carried out by different health professionals (doctors, nurses, midwives, pharmacists) trained for this purpose. The measure in the draft law states that health professionals may not charge extra fees on these preventive appointments.

The fight against menstrual precariousness among women under 26 and most precarious

Menstrual insecurity (the difficulty women face in purchasing sanitary pads because of their low income) now affects nearly 31% of menstruating women aged 18-50 and 44% of 18-24 year olds in France, according to an Opinionway survey published in March 2023.

The law provides for the reimbursement of reusable menstrual protection (panties and menstrual cups) for insured persons under the age of 26, as well as for beneficiaries of the supplementary health insurance scheme (C2S) without any age limit.

Insured persons under the age of 26 will receive 60% of the cost from the Health Insurance and their contribution may be compensated by supplementary bodies. Recipients of C2S will receive 100% coverage for these sanitary pads.

A referencing procedure, based on a specification, will be implemented to ensure product quality. The products will initially be made available in pharmacies.

Free condoms, without prescription, for all under 26

The LFSS 2024 enshrines in law the 100% responsibility of the health insurance for the dispensing of female and male condoms to young people under 26 years of age in pharmacies, without a medical prescription; this measure has already been implemented by the health insurance funds since 1^er January 2023.

Only condoms included in the list of products and benefits reimbursable by the Health Insurance (LPP) will be issued. At present, two condom brands are registered on the PLL; applications for registration are pending.

Facilitating access to complementary health care in solidarity

The supplementary health insurance scheme (C2S) offers insured persons with modest incomes extended protection, guaranteeing that they receive an extended basket of care, without any advance payment and without any overpayment of fees. Depending on the resources of the household, this supplementary benefit is available free of charge or in return for a financial contribution. Many beneficiaries of de minima social benefits, most of whom are eligible for C2S, do not use this scheme.

The 2024 PLFSS proposes to introduce a presumption of entitlement to the supplementary health benefit with financial participation for most beneficiaries (subject to certain criteria):

• Disabled Adult Allowance (DAA);
• supplementary invalidity allowance (SIA);
• the specific solidarity allowance (SSA);
• and the Youth Employment Contract (YCEA) allocation.

When the social minimum to which they are entitled is awarded, the health insurance funds will send them a letter offering to benefit from the C2S fee, without them having to declare their resources.

Additional ways for older people to function independently

Home nursing services (SSIAD) provide care for the elderly and people with disabilities; they also ensure coordination with other medical and paramedical workers (home support services, physiotherapists, doctors...). SADIs are authorized to work with a limited number of people and in a specific geographical area.

The FNHA 2024 provides additional funding for the creation of new nursing home care spaces, as well as for the funding of an increase in the number of professionals practicing in HPAD.

An early support service for disability situations

Late diagnosis of developmental disorders can cause over-disability and loss of opportunity. This translates into a loss of autonomy, ultimately involving more care and important support throughout the life of the person with a disability.

The FSSA 2024 proposes that a service be set up for all children under 6 years of age, regardless of their disabilities or suspected disabilities, by creating a pathway for assessment, diagnosis and intervention.

This service will be responsible for supporting families with children affected in particular by:

• neurodevelopmental disorders;
• cerebral palsy;
• multiple disabilities;
• or sensory impairment.

This mechanism should make it possible to bring the existing structures in this field closer together to make coherent a care and support offer that is currently fragmented.