Table 2.

Benefit-defining laws/decrees, catalogues and implicit regulation

	GBR	CCAM, NGAP	LSAC ATU	Med. dev.	NABM	Sp. reg.
Legal status: law, decree	Law	UNCAM decision	Ministerial order	Ministerial order	UNCAM decision	Administrative document
Decision maker	Parliament	UNCAM, on the advice of HAS and UNOC	Ministers of health and social security, on the advice of the Transparency Commission	Ministers of health and social security on the advice of the ad hoc Commission	UNCAM, on the advice of HAS and UNOC
Original purpose: entitlements, reimbursement, target setting	Reimbursement	Positive list	Positive list	Positive list	Positive list	Positive list
	Tariffs	Fee schedule	Prices or reference prices	Reference prices	Fee schedule
Positive-negative definition of benefits	Positive	Positive	Positive	Positive	Positive	Positive
Degree of explicitnessa	3 (except inpatient care: 1)	3	3	3	3	2 or 3
If itemized: goods/procedures only; linked to indications	Mainly goods and procedures; linked to indications	Procedures, sometimes linked to indications	Pharmaceutical products, linked to indications	Goods linked to indications	Procedures linked to indications	Mainly indications
Updating	–	Regularly	Regularly	Regularly	Regularly	–

GBR General Benefit Regulation, CCAM list of physicians’ and dentists’ technical procedures, NGAP list of physicians’ consultations and other health professionals’ activity, LSAC ATU positive lists of drugs, Med. dev. positive lists of medical devices, NABM positive lists NABM biology procedure, Sp. reg. specific regulation

^a 1, “all necessary”; 2, “areas of care”; 3 “items”