Sign inter-institutional health agreements online
Cooperation agreements between health institutions (territorial hospital groupings GHT, territorial professional health communities CPTS, hospital-clinic partnership agreements), signed electronically with the same legal value as a paper agreement. Compliant with art. L6132-1 and L1434-12 of the Public Health Code (2016 modernization law) and eIDAS regulation — advanced signature recommended, multi-institutional, 10-year archiving included.
- Legal framework
- Art. L6132-1 + L1434-12 CSP
- Signature level
- AES eIDAS recommended
- Legal archiving
- 10 years included
What is an inter-institutional health agreement?
Inter-institutional health agreements formalize cooperation between health system actors. Several categories: (1) territorial hospital groupings (GHT, art. L6132-1 CSP, created by the health system modernization law of January 26, 2016) bring together public health institutions in the same territory around a shared medical project; (2) territorial professional health communities (CPTS, art. L1434-12 CSP) coordinate liberal professionals and institutions across a territory; (3) hospital-clinic agreements (art. L6122-15) organize public/private complementarities. All can be signed electronically with advanced signature + audit trail, which drastically accelerates implementation timelines (often 6-12 months on paper).
Why sign electronically?
Multi-institutional (up to 20+)
A GHT agreement can involve 5 to 20 public health institutions. Our workflow handles sequential signing (support institution first, then associates) or parallel. Each legal representative signs from their phone with individual SMS OTP.
Reduced implementation timelines
No more postal mail back-and-forth between 10+ institutions (which can take 3-6 months). Electronic signature the same day of validation by supervisory boards. Operational rollout accelerated by several months.
10-year archiving + ARS traceability
Art. L6122-7 CSP requires healthcare agreements to be kept for 10 years. Certyneo automatically archives the agreement + audit trail + amendments, accessible for any inspection by the Regional Health Agency (ARS) or the Court of Audit.
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Each agreement comes with a proof PDF: identity of legal representatives, qualified timestamp, SHA-256 hash, SMS OTP. Enforceable against the ARS, the Court of Audit, and before administrative court in case of dispute over validity or implementation.
4-step procedure
From preparation to legal archiving, in less than 5 minutes.
1. Prepare the agreement
Upload your draft or use an ARS template. Mandatory provisions: purpose, participating institutions, shared medical project (GHT), governance arrangements, financial terms, duration, termination provisions, evaluation.
2. Add signatories
Legal representatives of each institution (hospital directors, CME presidents, private clinic directors). For CPTS, add representatives of liberal professionals and partner associations.
3. Choose the eIDAS level
Advanced signature (AES) required given institutional and financial stakes. Identity verification by SMS OTP, single certificate, qualified timestamp.
4. Notify ARS and implement
The finalized agreement + audit trail are archived for 10 years. Notification to the ARS for validation (GHT) or information (CPTS). Immediate operational implementation after ARS validation.
Frequently asked questions
- Can a GHT agreement be signed electronically?
- Yes, without restriction. Art. L6132-1 CSP requires a written document but prescribes no specific form. Certyneo's advanced signature (AES) satisfies evidentiary requirements and is compatible with ARS practices since 2024.
- Which institutions must mandatory adhere to a GHT?
- All public health institutions in the same territory (art. L6132-1 CSP). Membership is mandatory — one GHT per institution (except exceptional ARS exemption). University hospitals, psychiatric hospitals and reference institutions may be designated as support institution.
- Can private institutions participate in a GHT?
- Not directly — GHT is exclusively public. However, private institutions can sign partnership agreements with a GHT (art. L6132-9 CSP) or participate in a CPTS (art. L1434-12 CSP). Certyneo handles these mixed public/private signatures.
- How to meet ARS requirements?
- The ARS must be informed of any significant healthcare agreement. For GHTs, the ARS approves the shared medical project (art. L6132-2 CSP). Certyneo allows you to include the ARS as a validation signatory, with joint audit trail.
- What signature level for a GHT agreement?
- Advanced signature (AES) recommended. It provides the presumption of reliability (art. 1367 Civil Code) and meets institutional requirements. Given the financial stakes (pooling of support functions, group purchasing), SES is insufficient.
- How long must the agreement be kept?
- Minimum 10 years after the agreement expires (art. L6122-7 CSP, art. L1611-4 CGCT for public funding). For agreements involving European funds (FEDER hospitals), 10 years after program closure.
- Can an agreement be amended by an electronically signed amendment?
- Yes — amendments are signed like the initial agreement. Given the number of signatories (10-20 for a GHT), electronic signature is particularly effective for minor modifications (addition of an establishment, governance changes).
- Is the electronically signed agreement enforceable against the ARS?
- Yes — administrative case law recognizes eIDAS-compliant electronic signature. The ARS cannot contest the formal regularity of an agreement signed with advanced signature + Certyneo audit trail. Substantive review (compliance with the regional health plan) remains of course within its remit.
Also read
Sign your next inter-establishment agreement
Permanent free plan (5 envelopes / month), no credit card required. Compliant with Public Health Code and eIDAS. Multi-establishment and 10-year archival included.