La pratique concertée des dépassements d’honoraires n’est pas anticoncurrentielle

Sources : Flickr-creative-commons-euros-by-william-spaetzelVoici une décision qui sonne comme une revanche pour les appelants. On pensait, à la lecture d’une décision fleuve du Conseil de la concurrence, que la messe était dite. La Cour d’appel de Paris en a décidé autrement.

Plusieurs syndicats de médecins avaient en effet été condamnés pour avoir, pendant plusieurs années consécutives, et de manière concertée, lancé le mot d’ordre suivant lequel les médecins spécialistes du secteur I devaient s’affranchir de l’encadrement tarifaire correspondant à leur situation conventionnelle en pratiquant des dépassements d’honoraires de manière systématique. Des sanctions pécuniaires leur avaient été infligées allant de 34.000 à 220.000 euros.

Le débat qui s’est alors posé devant les juges du second degré a été celui de savoir si cette pratique concertée était de nature anticoncurrentielle, contrevenant en cela aux dispositions de l’article L. 420-1 du code de commerce, lequel prohibe les actions concertées, conventions, ententes expresses ou tacites ou coalitions, lorsqu’elles ont pour objet ou pour effet d’empêcher, de restreindre ou de fausser le jeu de la concurrence sur un marché, notamment lorsqu’elles tendent à :

1° Limiter l’accès au marché ou le libre exercice de la concurrence par d’autres entreprises ;
2° Faire obstacle à la fixation des prix par le libre jeu du marché en favorisant artificiellement leur hausse ou leur baisse ;
3° Limiter ou contrôler la production, les débouchés, les investissements ou le progrès technique ;
4° Répartir les marchés ou les sources d’approvisionnement.

Comme toute règle de droit, cette incrimination obéit à des conditions qui, réunies, emportent des effets. Les conditions tiennent à :

  • la pratique en elle-même (1),
  • la qualité des parties à l’entente (2),
  • la preuve de l’entente (3),
  • une restriction de concurrence sur le marché (4).

Une condition au moins fait défaut en l’occurrence en ce que (4) le secteur I n’est pas un secteur concurrentiel, dès lors que par définition il fait l’objet d’une convention signée entre les syndicats représentatifs de la profession et l’Assurance maladie, la concurrence par les prix ne pouvant s’y exercer.

La concurrence peut certes s’exercer par d’autres critères tels que la qualité du service rendu, la disponibilité, la réputation, la qualité relationnelle ou encore l’accessibilité ou l’aménagement des locaux, voire les équipements. Mais la concurrence par les prix est exclue du fait de l’encadrement de la cotation DE (dépassement exceptionnel) par l’article 12 du règlement conventionnel minimal (RCM) en vigueur à l’époque des faits, soit l’arrêté ministériel portant RCM du 13 novembre 1998.

C’est cet argument décisif qui a indiscutablement emporté la conviction des juges d’appel, à travers l’arrêt de la Cour d’appel de Paris du 18 mars dernier, et qui les a dispensé d’examiner les autres arguments avancés par les parties appelantes.

Au demeurant, la Cour a pris soin de relever que le Conseil avait lui-même reconnu, dans sa décision, que la concurrence n’était même pas rétablie par les dépassements exceptionnels (DE), compte tenu des conditions restrictives dans lesquelles ils s’exercent.

Omar YAHIA

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