I. – Where the budget includes a provisional main profit and loss account in deficit, the Director General of the Regional Health Agency shall forward it within thirty days of receipt to the Ministers responsible for Health, Social Security and the Budget, together with his or her proposals for approval.
In the absence of a response within forty-five days of receipt of the budget by the Director General of the Agency, the statement is deemed to have been tacitly approved.
II. – The Ministers of Health, Social Security and the Budget have fifteen days following receipt of the draft statement of estimates of revenue and expenditure to send their opinion to the Director General of the Agency.
If the ministers’ opinion is favourable, the budget is tacitly or expressly approved.
If the ministers responsible for health, social security and the budget make known their opposition to the draft statement of estimates of revenue and expenditure, the Director General of the Agency rejects the budget by means of a reasoned decision, taking into account the reasons for the ministers’ opposition. In this case, the Chief Executive Officer of Assistance publique-hôpitaux de Paris submits a new statement taking into account the observations of the Chief Executive Officer of the Agency, within a period set by the latter which may not exceed thirty days.
III. – If the new statement of forecast revenue and expenditure includes a balanced main profit and loss account, the Director General of the Agency is responsible for deciding whether to approve it.
If the new statement of forecast revenue and expenditure includes a main forecast income statement in deficit, the Director General of the Agency will again refer the matter to the Ministers of Health, Social Security and the Budget, who will have fifteen days to give their opinion. If the opinion of the ministers is unfavourable, the Director General of the Agency shall apply the provisions of the first paragraph of Article L. 6145-2.