The Health Insurance presented this Friday its plan to duplicate the result of its fight against fraud, thanks to file crossings, caregiver controls, complaints against health centers.
An arsenal to “protect the common good”. Guarantor of the “good management” of more than 230,000 million euros in annual health spending, the director of the National Health Insurance Fund (Cnam), Thomas Fatôme, stressed during a press conference his “duty to intensify the fight against the fraud”.
The trend was quite encouraging before Covid-19, with the number of “damages detected and stopped” rising from 150 million in 2012 to 287 million in 2019, before falling by more than half in 2020 (128 million) and then rebounding. last year (219 million).
If the first half of 2022 “gives hope” of a record vintage, we will have to do even better to reach the target of 500 million in 2024, more than double that of 2021.
“No Excess Vitale Card”
Part will come from the automatic crossing of data with Bercy and Interior, a “huge machinery” that has allowed targeting 1.6 million policyholders in the last twelve months, of which 300,000 have been discharged after the control.
But for a “limited financial impact”, of the order of 70 million euros, said Thomas Fatôme. Wrying his neck at a persistent rumour, he added that “there is no excess Vitale card” at Cnam.
The room for improvement is rather on the side of caregivers, whose professions are subject to scrutiny, although “fraud is the act of a small minority,” he said.
After the spring nurses, the CNAM calculates the “harm” caused by general practitioners at around 200 million annually, and the same for ambulance assistants, taxis and other “health transporters”.
At the same time, Health Insurance increases legal actions against health centers: after the 26 complaints filed against an ophthalmological network, other actions should “derive in the coming weeks” against audiological and especially dental marks, under the blow of a disappointment imminent.
Source: BFM TV
