Over the primary six months of the yr, fraud detected by Well being Insurance coverage reached practically 150 million euros, or 30% greater than within the first half of 2022. A particular case, listening to support fraud. Since 2019, some have been absolutely supported and the variety of folks geared up has doubled.
Well being Insurance coverage will monitor 130 listening to support firms in France to confirm their practices, whereas the booming sector is marked by important fraud, it introduced Thursday throughout a press convention devoted to its efforts. to struggle in opposition to fraud. “We’re initiating an motion plan regarding 130 listening to support firms, which we are going to go to on web site, to take a look at their recordsdata, and provoke administrative and legal sanctions if crucial,” declared Thomas Fatôme, the director Common of the Well being Insurance coverage Fund.
150 million euros of fraud
The listening to support market was boosted by the introduction of 100% well being (supply permitting full protection of prescription glasses, dental prostheses or listening to aids), which enabled many individuals to equip themselves whereas They couldn’t earlier than. In three years, from 2019 to 2022, the variety of folks geared up has doubled, from 400,000 to 800,000, and Well being Insurance coverage reimbursements reached 420 million euros in 2022, recalled Thomas Fatôme.
However this market takeoff was accompanied by the arrival of unscrupulous gamers and scammers, who invoice the Well being Insurance coverage for prostheses which have by no means been fitted, set up easy tools whereas charging for the costliest , or equip individuals who don’t want them… In view of the primary anti-fraud controls and procedures launched by Well being Insurance coverage, fraud linked to listening to aids “might signify a number of tens of hundreds of thousands of euros”, in response to the estimates of Thomas Fatôme.
Well being Insurance coverage introduced a “mid-year assessment” of the struggle in opposition to fraud on Thursday. It estimates that it managed to detect and cease 150 million euros of fraud within the first half of the yr and considers itself on observe to achieve the target of 380 million in whole in 2023, in comparison with 315.9 million in 2022. Two thirds of those frauds stopped within the first half of the yr relate to group care, primarily within the type of fictitious acts and overbilling by well being professionals. Figures to be in comparison with the full expenditure of Well being Insurance coverage, of the order of 200 billion euros per yr.