The ATS of the Metropolitan City of Milan, the Health Protection Agency, was established by Regional Law No. 23/2015 – Evolution of the Lombardy Social Health System. The Agency comprises 193 municipalities and encompasses the territories of the four former Local Health Authorities (ASL): Milan, Milan 1, Milan 2, and Lodi.

The ATS is responsible for

ensuring the governance of the healthcare and social health network within its territorial scope, promoting the integration of the delivery network with the local social network,

entering into contracts with accredited public and private providers in its area of jurisdiction,

ensuring the achievement of the objectives set out in the Lombardy Integrated Social Health Plan.

The Regional Law assigns the ATS the following functions: negotiating and purchasing healthcare and social health services from accredited facilities; managing and promoting health education, prevention, assistance, treatment, and rehabilitation programs; promoting food, medical, and veterinary safety; veterinary public health; Health prevention and monitoring in living and working environments; implementation of regional guidelines and monitoring of pharmaceutical, dietary, and prosthetic spending; supervision and control of healthcare, social, and social care facilities and units.

With the Lombardy healthcare reform (Regional Law 22/2021), the functions of the Health Protection Agencies (ATS) are detailed in Article 6 of the “Consolidated Law on Regional Health Laws” (Regional Law 33/2009 and subsequent amendments).