Came for a banal eye check in one of the Alliance Vision centers in Paris, the young man was imposed unnecessary examinations.
A fraud estimated at 20 million euros. Health insurance will deconvention the 13 establishments of the Alliance Vision group, located in 9 regions (Ile-de-France, PACA, Normandy, Hauts-de-France, Pays-de-Loire, Auvergne-Rhône-Alpes, Center Val de Loire, Grand-Est, Bretagne), distributed throughout France, reveals this Thursday franceinfo. This private chain, which offers both ophthalmic and dental care, is suspected of having set up a vast system of health insurance fraud.
>> INFO FRANCEINFO. Health insurance will deconvention all Alliance Vision health centers for fraud estimated at more than 20 million euros
They billed Social Security for acts that its doctors had either never performed or that were totally unjustified. This is the case, for example, of optical imaging examinations or retinography to detect glaucoma, retinal degeneration, diseases that mainly affect the elderly. However, according to information from franceinfo, these examinations have been carried out or supposedly carried out regularly on children. These children were sometimes 3 years old.
The bill for a consultation with a practitioner he has “never seen”
At 22, without having a sight problem, Léo explains that he “felt the scam during the consultation”. There were a lot of people in the waiting room for consultations that lasted between 5 and 10 minutes“. Like many patients who testify on the Internet, he feels that this center has only one objective: “make money“.
An appointment for an ordinary annual check-up is then fixed with an orthoptist. However, he must then pass several examinations:I didn’t feel like it was helpful. I’m 22 years old, looking on the internet, it didn’t really match…“. But Leo, he winced, when he received the bill for a consultation with an ophthalmologist he did not have “never seen. The only contact I had with him was his prescription stamp.“. The young man then tries to find out a little more: “I see on the invoice that there is some for 96 euros, and I am trying to understand with the secretary”.
“His only answer was ‘you don’t have to pay anything anyway, it’s social security that will take care of everything or your mutual insurance company. You, it’s none of your business what happened.’
“The damage is colossal”
Most of the time, patients do not realize this type of scam, because this care is fully covered by Social Security: they pay nothing and often they do not even check the bills. This is also what explains why the investigation concerning these centers took more than two years.
The 13 health centers concerned are now deregistered for a period of 5 years from August 21, 2023 for the following facts for “invoicing of fictitious acts” And “repeated non-compliance with the rules for listing and invoicing acts“.”The damage is colossal.”details the head of Health Insurance Thomas Fatôme: “We are here to reimburse care that is justified and not for fraudulent practices.“, he indicates.