“A pediatrician listening,” comments a patient on the Internet. "An exceptional pediatrician," says another. "Excellent pediatrician!" Welcomes a third. Based in Bourges and Vierzon (Cher), this 65-year-old practitioner promised a few years ago in the local press “pediatrics of the future”. For justice, the doctor is especially suspected of swindling at the Primary Health Insurance Fund (CPAM). He was indicted Wednesday for "aggravated scam", we learned from Joël Garrigue, the prosecutor of the Republic of Bourges. The pediatrician is thus suspected of having embezzled nearly 1.2 million euros of public money by abusing the vital cards of his patients. Facts which would have been committed for several years.
A few months ago, Health Insurance noticed that the practitioner performed many more acts than his colleagues. Alone, he is reimbursed for almost half of the department's pediatric consultations. A complaint is filed, and the Orléans judicial police are responsible for investigations at the start of 2020. Their investigations then show that the doctor has a well-established operating method for inflating his fees. "When he performed a deafness test, he not only billed the patient he had examined but passed the vital card of an entire sibling group," explains a judicial source. This allowed him to be reimbursed for several medical procedures instead of just one. "
300,000 euros overdraft on bank accounts
The police noted in particular that the doctor billed some children for an eye test, much more profitable than a simple consultation, almost every week. Some acts billed to Health Insurance were also simply invented. And the patients, often CMU holders and who do not pay for their medical appointment, were not aware of the doctor's scheming. Tuesday morning, the alleged crook was arrested at his home by investigators from the PJ, who could see his comfortable lifestyle. "Financial investigations have revealed an important real estate heritage in Lebanon, its country of origin, as well as in France," notes the prosecutor of Bourges. More than 300,000 euros were also discovered on his bank accounts.
In the searches, the police also made an interesting discovery, which could make the pediatrician's case worse: letters from patients complaining about the doctor. They explain that they had to pay for the consultation, but that they were not reimbursed. The instruction which has just opened will have to determine whether the practitioner was abusing these patients affiliated with the CMU by asking them to pay for consultations, which are normally free. "One wonders if he was not looking to win on both fronts: to be paid by a patient who should not have advanced the money, then by the CPAM which is responsible for paying the consultations of CMU holders" , explains a source close to the file. The doctor has been placed under judicial supervision, but can continue to practice.
