Further regulating health centers is the objective of a bill adopted in committee last week which must be examined in the coming days in the Assembly.
Dental and ophthalmological centers have been particularly targeted since the scandals in the Dentexia and Proxidentaire centers, some of whose patients have been poorly treated, even mutilated.
The objective is also to fight against abusive invoicing.
In a report, the National Health Insurance Fund (Cnam) estimates that Medicare fraud would have reached at least 22 million euros in 2020. Ophthalmology centers
are particularly implicated there. , in particular for
abusive invoicing.
"
This proposal aims to regulate these health centers insofar as there are serious abuses in some of them
”, highlights MP Fadila Khattabi (Renaissance) who presents the proposal.
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A file presenting their “health project”
Concretely, if the bill is passed, the centers will then have to obtain approval from their reference Regional Health Agency (ARS).
To obtain it, they will have to compile a file presenting their "
health project
", but also "
the declarations of the links and conflicts of interest of all the members of the governing body
" or even "
the contracts binding the managing body to third-party companies
”.
The diplomas and employment contracts of the practitioners must also be sent to the ARS and to the order of the health professions concerned.
But this approval is issued on a provisional basis and becomes final only one year after the opening of the center and subject to the results of a compliance visit organized by the ARS.
Existing health centers will also have to apply for approval.
They will no longer be authorized to provide dental or ophthalmological care if they have not obtained it within two years of the entry into force of the law.
This requirement for approval existed before but was removed in 2009 to facilitate and expand the care offer.
“
The abolition was commendable in particular to facilitate the installation of health centers in places which were under-equipped.
But this was not the case since the centers developed mainly in the big cities where the need was not crying out.
Today, the goal is not to slow down development but for the new centers to settle where there are needs
”, claims MP Fadila Khattabi.
It will therefore be up to the Regional Health Agency to judge the relevance of the health project.
Read alsoHealth insurance fraud: pinned health centers
In addition, the bill also contains measures that facilitate the monitoring of their activity, such as an annual transmission to the ARS of the manager's accounts but also the increase in the level of penalties applicable in the event of breach, with a ceiling rising from 150,000 to 300,000 euros.
Since October 2021, the Health Insurance has deployed a national "
task force
" which currently monitors several networks of dental health centers: in total, 45 dental health centers are concerned by this action.
With regard to ophthalmology, a national control program was launched at the beginning of 2021 concerning 8 health centers in two waves of control.
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