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Par une lettre du 21 mai 2021, le ministre des Solidarités et d e la Santé a confié à l’Inspection générale des affaires sociales (IGAS) u ne mission pour explorer les différentes pistes de réflexion qui avaient été soulevées. Ce rapport, publié en novembre 2021, présente le contexte d’émergence des nouveaux partages de compétences en soulignant les facteurs systémiques qui les rendent à la fois nécessaire et particulièrement difficile en France. Pour autant, il est aujourd’hui nécessaire d’avancer sur un repositionnement des professionnels, que ce soit pour un enjeu d’attractivité et de fidélisation des soignants, ou pour l’enjeu primordial d e l ’ a c c è s a u x s o i n s. L’offre de soins médicaux étant insuffisante par rapport aux besoins de la population, il est indispensable de trouver des solutions à très court terme. À cet égard, les protocoles de coopération et le développement de la pratique avancée semblent être les réponses les plus appropriées. L’objet de cette proposition de loi, dans la suite de la loi n° 2021-502 du 26 avril 2021, est donc d’accélérer le décloisonnement de notre système, en faisant confiance aux professionnels et en leur offrant de nouvelles possibilités. L’article 1 er permet d’ouvrir l’a","articles":[{"num":"1er","extrait":"I. – Le titre préliminaire du livre III de la quatrième partie du code de la santé publique est ainsi modifié : 1° Au c du 1° du I de l’article L. 4301-1, après le mot : « obligatoire, », sont insérés les mots : « des prescriptions de produits de santé et de prestations soumis à prescription médicale dont la liste est fixée par décret, » 2° Il est ajouté un article L. 4301-2 ainsi rédigé : « Art. L. 4301-2. – I. – Les infirmiers relevant du titre I er d u p ré s e n t livre peuvent exercer en pratique avancée, conformément à l’art icle L. 4301-1, en tant qu’infirmiers spécialisés ou en tant qu’infi rmiers praticiens. « Un décret détermine, après avis du comité des professions de santé, les compétences des infirmiers de pratique avancée, spécialisés e t praticiens, ainsi que les modalités d’accès à ces professions, qui comprennent notamment la possibilité pour les infirmiers d’obte nir une validation des acquis de l’expérience. « II. – Dans le cadre des structures d’exercice coordonné mentionnée s aux articles L. 1411-11-1, L. 1434-12, L. 6323-1 et L. 6323-3, les infirmiers exerçant en pratique avancée peuvent pratiquer leur art sans prescription médicale. Un compte rendu des soins réalisés est a dressé au médecin traitant et reporté dans le dossier médical partagé. » II. – Après le mot : « conventionné », la fin du troisième alinéa de l’article L. 162-12-2 du code de la sécurité sociale est ainsi rédigée : «, les actes effectués par les infirmiers conventionnés dans les établissements et structures d’hébergement de toute nature et les actes effectués, le cas échéant sans prescription médicale, par les infirmiers en pratique avancée ; » III. – L’article 76 de la loi n° 2021-1754 du 23 décembre 2021 de financement de la sécurité sociale pour 2022 est abrogé."},{"num":"2","extrait":"I. – Après le neuvième alinéa de l’article L. 4321-1 du code de la santé publique, il est inséré un alinéa ainsi rédigé : « Par dérogation au neuvième alinéa, dans le cadre des structures d’exercice coordonné mentionnées aux articles L. 1411-11-1, L. 1434-12, L. 6323-1 et L. 6323-3, le masseur-kinésithérapeute pratique son art sans prescription médicale. Un bilan initial et un compte rendu des soins réalisés par le masseur-kinésithérapeute sont adressés au médecin traitant et reportés dans le dossier médical partagé. » II. – Après le mot : « conventionné », la fin du 1° de l’articl e L. 162-12-9 du code de la sécurité sociale est ainsi rédigée : «, les actes effectués par les masseurs-kinésithérapeutes conventionnés dans l e s établissements et structures d’hébergement de toute nature et l es actes effectués par un masseur-kinésithérapeute sans prescription médicale ; » III. – L’article 73 de la loi n° 2021-1754 du 23 décembre 2021 de financement de la sécurité sociale pour 2022 est abrogé."},{"num":"3","extrait":"I. – Après le cinquième alinéa de l’article L. 4341-1 du code d e la santé publique, il est inséré un alinéa ainsi rédigé : « Par dérogation au cinquième alinéa, dans le cadre des structures d’exercice coordonné mentionnées aux articles L. 1411-11-1, L. 1434-12, L. 6323-1 et L. 6323-3, l’orthophoni ste pratique son art sans prescription médicale. Un bilan initial et un compte rendu des soins réalisé s par l’orthophoniste sont adressés au médecin traitant et reportés d ans le dossier médical partagé. » II. – L’article 74 de la loi n° 2021-1754 du 23 décembre 2021 d e financement de la sécurité sociale pour 2022 est abrogé."},{"num":"4","extrait":"Le titre préliminaire du livre III de la quatrième partie du code de la santé publique est complété par un article L. 4301-3 ainsi rédigé : « Art. L. 4301-3. – I. – Les assistants dentaires relevant du chapitre III bis du titre IX du présent livre peuvent exercer en pratique avancée, conformément à l’article L. 4301-1, en tant qu’assista nts en médecine bucco-dentaire. « Un décret en Conseil d’État pris après avis de l’Académie nationale de médecine et de l’Académie nationale de chirurgie dentaire dé termine les compétences des assistants en médecine bucco-dentaire ainsi que l e s modalités d’accès à cette profession. »"},{"num":"5","extrait":"I. – La charge pour les organismes de sécurité sociale est compensée à due concurrence par la majoration de l’accise sur les tabacs prévue au chapitre IV du titre I er du livre III du code des impositions sur les biens et services. II. – La charge pour l’État est compensée à due concurrence par l a création d’une taxe additionnelle à l’accise sur les tabacs pré vue au chapitre IV du titre I er du livre III du code des impositions sur les biens et services.","resume":"Compense la charge pour la sécurité sociale par une majoration de l'accise sur les tabacs et celle pour l'État par une taxe additionnelle à cette accise."}],"pdfUrl":"https://www.assemblee-nationale.fr/dyn/16/textes/l16b0362_proposition-loi.pdf","pdfPages":null},"dispositionsVersion":6},"stade":{"cle":"intermediaire","etiquette":"Lecture intermédiaire","phrase":"Ce dossier est devenu la loi, promulguée le 19 mai 2023, mais ce texte n'en est qu'une étape : la loi peut en différer.","garde":"Ce résumé décrit cette étape du texte. La loi promulguée peut en différer.","final":"PIONANR5L16BTA0112"},"linkedScrutins":[{"id":"VTANR5L16V863","titre":"l'amendement de suppression n° 251 de M. 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