2023-10-05 17:37:38
Barthélémy Philippe with AFP / Photo credit: THIBAUT DURAND / HANS LUCAS / HANS LUCAS VIA AFP
Over the first six months of the year, fraud detected by Health Insurance reached nearly 150 million euros, or 30% more than in the first half of 2022. A specific case, hearing aid fraud. Since 2019, some have been fully supported and the number of people equipped has doubled.
Health Insurance will monitor 130 hearing aid companies in France to verify their practices, while the booming sector is marked by significant fraud, it announced Thursday during a press conference dedicated to its efforts. to fight once morest fraud. “We are initiating an action plan concerning 130 hearing aid companies, which we will visit on site, to look at their files, and initiate administrative and criminal sanctions if necessary,” declared Thomas Fatôme, the director General of the Health Insurance Fund.
150 million euros of fraud
The hearing aid market was boosted by the introduction of 100% health (offer allowing complete coverage of prescription glasses, dental prostheses or hearing aids), which enabled many people to equip themselves while They mightn’t before. In three years, from 2019 to 2022, the number of equipped people has doubled, from 400,000 to 800,000, and Health Insurance reimbursements reached 420 million euros in 2022, recalled Thomas Fatôme.
But this market takeoff was accompanied by the arrival of unscrupulous players and scammers, who bill the Health Insurance for prostheses that have never been fitted, install simple equipment while charging for the most expensive , or equip people who do not need them… In view of the first anti-fraud controls and procedures launched by Health Insurance, fraud linked to hearing aids “might represent several tens of millions of euros”, according to the estimates of Thomas Fatôme.
Health Insurance presented a “mid-year review” of the fight once morest fraud on Thursday. It estimates that it managed to detect and stop 150 million euros of fraud in the first half of the year and considers itself on track to reach the objective of 380 million in total in 2023, compared to 315.9 million in 2022. Two thirds of these frauds stopped in the first half of the year relate to community care, mainly in the form of fictitious acts and overbilling by health professionals. Figures to be compared to the total expenditure of Health Insurance, of the order of 200 billion euros per year.
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