400,000 euros is the sum that this physiotherapist would have diverted to the primary health insurance fund (CPAM).
Emmanuel R., 58, was indicted at the end of September by an examining magistrate from Fontainebleau (Seine-et-Marne) for "organized gang fraud, forgery and money laundering".
He is suspected of having, with the complicity of three other people, between 2017 and 2021, defrauded the Social Security in Paris, Seine-et-Marne but also in the Bas-Rhin and the Ardennes.
READ ALSO>
A nurse suspected of a security scam of more than 1.3 million euros
This story begins in March 2018 when the Paris CPAM files a complaint with the prosecution denouncing a series of irregularities concerning a physiotherapist.
This re-educator is based in Dormelles but he practices mainly in the homes of his patients in Paris, in the 14th and 15th arrondissements, and in the provinces.
The funds of the four departments concerned note that he invented phantom patients, overcharged his services and produced seventy-five false prescriptions to be compensated.
The police find and hear twenty-seven doctors who, for the most part, explain that they do not know him.
"He even makes remote declarations when he is traveling for the holidays that he justifies by videoconference consultations", notes a source close to the investigation.
Surprising for physiotherapy acts.
Physiotherapist and coach specializing in stress management
Emmanuel R. has been practicing the profession since 1989. He was formerly based near Versailles, in the Yvelines.
But, in 2015, he took a break to set up a coaching company specializing in stress management.
In 2017, he lived with his partner in this village of Seine-et-Marne and developed with some success his activity in patients' homes.
Before his arrest, he cherished the project of embarking on the luxury hotel and well-being.
Investigators scrutinize the bank accounts of the masseur who earns 20,000 euros per month. They note that large sums of money have passed to the account of his partner and two pseudo patients. Mainly that of Nicolas S. This 41-year-old man, who suffers from psychiatric problems so serious that he cannot work, has received more than 250,000 euros. The second, recruited by Nicolas to "participate in a small scheme", provided his vital card to divert the more modest sum of 1,700 euros. The investigations made it possible to identify accounts belonging to Emmanuel, scattered in Europe but which have not yet been examined.
In May 2020, the physiotherapist was summoned and placed in police custody.
His computer equipment is seized.
The fifty-year-old is released, time for the police to carry out their technical investigations.
But the hijackings continue as if nothing had happened.
On September 21, the gendarmes launched an operation and arrested Emmanuel, his wife and a third suspect.
Nicolas is missing because he is on vacation in Tunisia.
It will be picked a few days later when the plane gets off at Orly (Val-de-Marne).
"I did not realize his madness"
During the hearings, the physiotherapist denies any participation in this scam and accuses Nicolas of having cheated on him. “When I resumed my activity, I found myself overwhelmed by administration. Before, it was my ex-wife who handled all of this. But my new companion has no desire to do it, says the physiotherapist. I met Nicolas who offered to recover my overpayments. He was very efficient. I did not realize his madness. I trusted him too much. I am completely a victim of his actions ”.
The practitioner's lawyer believes that the indictment of his client does not hold.
According to his analysis, there would be no proof that he was the author of the forgery.
He would not have carried out any money laundering maneuver because the money transfers to his wife's account were intended to prevent an undue wage garnishment.
She believes that all the fault lies with Nicolas who was responsible for recovering undue payments.
READ ALSO>
Scam at the CPAM: the couple got richer by falsifying prescriptions
For his part, Nicolas confesses but explains that he did not make a mistake. He even gives investigators the address of a box in Chatou (Yvelines) where he hid his computers and blank prescriptions. “Yes, I made some mistakes,” he says. I invested the physiotherapist's money. Nicolas has already been convicted of an insurance fraud. He is schizophrenic, very fragile and has already tried to kill himself. Her advice, Me Léa Dordilly, believes that her client must be treated.
From the point of view of the prosecution, the involvement of Emmanuel R. is not in doubt because it is indeed on his bank account that this money was paid.
"Without him, the scam is impossible to carry out because it is he, the health professional who makes the declarations of care," said a magistrate.
Faced with justice, these two men deliver two opposing versions.
But during all these years, they had made a pact.
"
Health professionals responsible for 48% of CPAM fraud
135.1 million euros.
This is the amount of financial damage to health insurance caused by fraud to be attributed to professionals and health establishments in 2019. Throughout France some 1,650 agents have thus verified 13 million invoices, 23,000 inquiries. were opened following a noted damage and 8,800 litigation actions were opened, against 5,500 in 2014. The fraud of these “care providers” represents only 20% of the cases but 48% of the total financial damage for the CPAM.
