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In September 2022, the national health insurance fund set itself the objective of doubling the fight against fraud. It has multiplied the checks of caregivers, the crossing of files and the investigations of certain suspicious establishments.
Dental and ophthalmological centers disconcertedthis is the maximum sanction taken by theHealth Insurance in case of fraud. How are they spotted, and what risk do those responsible have? Investigators first spot the warning signs, such as an unexplained explosion of Covid-19 tests in a pharmacy.
Help from doctors
One million electronic care sheets arrive each week at the Paris cash register that must be analysed. Double billing is a common fraud. Other acts are performed, but not justified. The investigators then ask for the expertise of doctors. Investigations then often continue with field checks. In some cases, it is the patients who sound the alarm.
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