2023-08-20 13:00:00
This is the first time that an entire network has been subject to such a large-scale sanction. From this Monday, August 21, as we revealed in an article on July 21, the 13 health centers of the Alliance Vision group will all be deconventioned, for a period of five years. This means that the ophthalmological and dental care that will be practiced there will be reimbursed much less, or even very little. Health insurance will only cover them on the basis of the so-called “authority tariff”. For example, 1.22 euros for an ophthalmology consultation at 30 euros.
According to the Social Security Code, these health centers will have “the obligation to inform patients of changes in the conditions of care and exemption from advance fees, as well as on their prices”, specifies the Insurance. Disease. For its part, the latter “will inform appointment booking platforms such as Doctolib, so that they can update the pricing information posted online for patients”.
“There will be others”
The centers concerned are located in Paris, for three of them, as well as in Argenteuil, Franconville (Val-d’Oise), Amiens (Somme), Nancy (Meurthe-et-Moselle), Antibes (Alpes-Maritimes) , Saint-Étienne (Loire), Orléans (Loiret), Rennes (Ille-et-Vilaine), Le Mans (Sarthe) and Le Havre (Seine-Maritime).
This measure, unprecedented, follows the fraudulent practices observed for several years within the Alliance Vision group: invoicing of fictitious acts, non-compliance with the rules of quotation and invoicing of acts. For example, optical imaging examinations, intended to detect glaucoma, were billed to children when this disease develops mainly following 40 years. The damage is still estimated at an astronomical total of 21 million euros since the start of the controls, in 2020.
Cancellations in such cases have been made possible and facilitated by several measures taken last year. At the start of 2023, 5 centers had already paid the price. “And this is not the end of the story, there will be other disappointments in the months to come”, assured us Thomas Fatôme, the director general of Health Insurance, last July.
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