Fraud investigation in French healthcare

A large-scale investigation by the general directorate of fraud repression (DGCCRF) has uncovered illegal and fraudulent practices in the French medical sector. The DGCCRF inspected over 1,100 health facilities, with a focus on collective medical practice structures like dental centers and imaging centers.

Recurring violations found

Investigators discovered recurring and serious violations, including additional fees imposed on patients in the form of administrative packages or unjustified surcharges. Some health centers charged for simply accessing the center without informing users beforehand.

Regulations and prohibited fees

According to the rules, fees charged by practitioners should cover all operations necessary for care. Outside of regulated overcharging and services explicitly requested by the patient, it is strictly prohibited to impose administrative or file fees. This includes cancellation fees, postal sending of results, archiving, subcontracting, or sample collection fees, as well as fees applied in cases of full third-party payment. Some centers even charged for appointments, which is strictly prohibited.

Reminder of the law

In consultation with the Ministry of Health and the DGCCRF, the National Health Insurance Fund has published a reminder of the applicable law on its website, Ameli. This information is for both doctors and patients. One imaging center was fined 150,000 euros after deliberately misleading the public by making it seem that their doctors were contracted in sector 1, while three-quarters practiced overcharging.

Doctors failing to display information

The DGCCRF did not only focus on health centers. It also found that 55% of the doctors checked did not comply, at least partially, with their display obligations. Doctors must indicate in the waiting room and at the payment location their contractual status, prices, and the amount of coverage for services.

Improvements after inspections

Fortunately, most of the practitioners or centers in breach quickly complied with the regulations. Following these inspections, nearly 90% of the violations have been corrected by the professionals, according to the DGCCRF.