When presenting the results of the fight against tax and social fraud last month, Gabriel Attal slammed his fist on the table. If the Prime Minister welcomed the deregulation of 21 health centers in 2023, he also indicated that Health Insurance would “continue this work in 2024”. We didn’t have to wait long to see the fruits. One month after this speech, ten new dental health centers, all from the same network, were deregulated, Health Insurance announced on Tuesday.
The reasons behind this deregulation are serious: “fictitious, multiple or inconsistent invoicing”, “non-compliance with good practice standards or the conditions of support provided for in the nomenclature of technical acts (CCAM)”, or even “dilapidation of healthy teeth. The financial damage is estimated at “nearly 2.9 million euros, which represents almost 20% of the amounts of dental expenses of these centers covered by Health Insurance”.
Also read: Overbilling, poorly performed procedures… The excesses of certain dental and ophthalmology centers
These health centers all belong to the Nobel Santé network, according to information from France Inter confirmed to Le Figaro. They are located in four regions (Île-de-France, Provence-Alpes-Côte d’Azur, Auvergne-Rhône-Alpes and Nouvelle-Aquitaine), and are exempt from conventions for periods ranging from 1 to 5 years, from 13 may. These ten centers represent almost half of the network, made up of 22 centers in total, Health Insurance told AFP. Concretely, this means that, during this period, Social Security will cover the care provided in these centers on a very low reimbursement basis, known as the “authority” rate.
For Thomas Fatôme, general director of Health Insurance, these deregulations “show once again the effectiveness of this system of controls and sanctions put in place by Health Insurance, in the face of the rise in fraudulent practices of certain health centers. health”. “The fight against “social fraud” begins with the dismantling of these cash machines,” welcomed the number 2 of Health Insurance, Marguerite Cazeneuve, on last year of thirteen health centers of the Alliance Vision group.