Un d\u00e9cret n\u00b0 2026-649 du 22 juillet 2026, publi\u00e9 au Journal officiel du 23 juillet 2026, renforce l\u2019intervention du pr\u00e9fet dans le versement du fonds d\u2019intervention r\u00e9gional (FIR) par les agences r\u00e9gionales de sant\u00e9 (ARS). Le FIR, con\u00e7u comme un outil flexible au service des ARS pour la pr\u00e9vention, l\u2019organisation des soins et le m\u00e9dico-social, a connu une croissance plus rapide que l\u2019ensemble des cr\u00e9dits de l\u2019Ondam, sans r\u00e9examen structurel, ce qui avait conduit l\u2019Inspection g\u00e9n\u00e9rale des finances (IGF) et l\u2019Inspection g\u00e9n\u00e9rale des affaires sociales (Igas) \u00e0 en souligner les limites et \u00e0 recommander un pilotage national renforc\u00e9.<\/p>\n
Le d\u00e9cret pr\u00e9voit qu\u2019une partie des cr\u00e9dits du FIR fera d\u00e9sormais l\u2019objet, chaque ann\u00e9e, d\u2019une r\u00e9partition en \u00ab dotations d\u00e9partementales limitatives \u00bb par le directeur g\u00e9n\u00e9ral de l\u2019ARS. Il impose \u00e9galement \u00e0 l\u2019ARS d\u2019informer ou de consulter le pr\u00e9fet de r\u00e9gion ou de d\u00e9partement avant toute d\u00e9cision de financement significative d\u2019un acteur local sur le FIR. Le pr\u00e9fet pourra, s\u2019il l\u2019estime n\u00e9cessaire, demander le r\u00e9examen de cette d\u00e9cision. Un arr\u00eat\u00e9 pr\u00e9cisera le p\u00e9rim\u00e8tre des d\u00e9cisions concern\u00e9es, en fonction de leur objet et de la cat\u00e9gorie de b\u00e9n\u00e9ficiaires.<\/p>\n
Selon le compte rendu du Conseil des ministres du 22 juillet 2026, cette r\u00e9forme vise \u00e0 rapprocher les d\u00e9cisions des territoires, \u00e0 mieux articuler l\u2019action des ARS avec les priorit\u00e9s locales et \u00e0 renforcer la coh\u00e9rence de l\u2019action de l\u2019\u00c9tat en mati\u00e8re d\u2019acc\u00e8s aux soins. Les objectifs mis en avant sont d\u2019apporter davantage de visibilit\u00e9 aux acteurs locaux et de soutenir plus rapidement les projets r\u00e9pondant aux enjeux locaux d\u2019acc\u00e8s aux soins, de pr\u00e9vention et d\u2019organisation de l\u2019offre de sant\u00e9.<\/p>\n
La mesure avait initialement \u00e9t\u00e9 envisag\u00e9e dans le projet de loi \u00ab Renforcer l\u2019\u00c9tat local \u00bb, pr\u00e9sent\u00e9 en Conseil des ministres le 20 mai 2026 puis retir\u00e9 de l\u2019ordre du jour du S\u00e9nat. Le Conseil d\u2019\u00c9tat avait toutefois indiqu\u00e9, dans un avis du 7 mai, que cette \u00e9volution s\u2019inscrivait dans la continuit\u00e9 de dispositions d\u00e9j\u00e0 en vigueur pr\u00e9voyant l\u2019intervention du pr\u00e9fet dans certaines d\u00e9cisions des ARS et relevait du domaine r\u00e9glementaire plut\u00f4t que de la loi.\u00a0(contenu r\u00e9sum\u00e9 en fran\u00e7ais par l’IA)Lire la Suite<\/a><\/p>","protected":false},"excerpt":{"rendered":" Un d\u00e9cret n\u00b0 2026-649 du 22 juillet 2026, publi\u00e9 au Journal officiel du 23 juillet 2026, renforce l\u2019intervention du pr\u00e9fet dans le versement du fonds d\u2019intervention r\u00e9gional (FIR) par les 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