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Social fraud: why you will receive an SMS when leaving the doctor

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Gabriel Attal, Minister of Public Accounts, unveiled his plan to fight social fraud this Monday, May 29, 2023. Presenting the various measures of this plan to Parisians, the Minister said: “The Court of Auditors has assessed, overall, between 6 and 8 billion euros per year for all social fraud. We must act, because social fraud is a form of hidden tax on French people who work.”

To fight against social fraud, “we are going to create a thousand additional jobs in the five-year term and invest 1 billion euros in information systems, in particular to better cross-check data.” Objective: to overcome fraud.

Health benefits fraud is the second largest fraud in terms of amounts. “Last year, Health Insurance detected 300 million euros in fraud. I have set the objective of reaching 500 million euros next year,” says Gabriel Attal. To fight against these illegal misappropriations, it is necessary to fight against over-invoicing or the invoicing of fictitious acts. Because, “in 70% of cases, the fraud is on the initiative of a health professional”, explains the Minister of Public Accounts.

According to Health Insurance, in 2021, “nearly 2/3 of the fraud detected is concentrated among health professionals. The main grievances concern non-compliance with regulations or nomenclature, fictitious acts or even fraud in the prescription”. In order to fight against these practices, the government plans to involve citizens. Soon, you will receive an SMS when leaving your doctor. What will it be? What will you need to do?

To counter the abuses of health professionals, the government wants to set up a control system that will directly involve the French. “To better detect fraud, we will make an innovation: from 2025, French people treated in a dental or ophthalmological center will receive by SMS the list of treatments billed to Health Insurance. If they identify inconsistencies, they will be able to report them” , explains Gabriel Attal to the Parisian.

Will the patient become the guarantor of the doctor’s good practice? Will his responsibility be engaged in the sanction of a health professional for social fraud?

With the implementation of a control of health professionals via SMS, will the patient be directly responsible for the sanction of this or that practitioner? According to Gabriel Attal, “it will always be the Social Security which will control. But these reports will allow it to target the professionals or the health centers which pose a problem”, reports Le Parisien.

With this report, the government intends to improve its repressive policy. “As of this year, we will strengthen the sanctions. We will be able to deconvention, that is to say prohibit the reimbursement by Health Insurance of all care providers who defraud – health centers, community pharmacists or health carriers We are also going to increase the penalties to 300% of the amount of the fraud and to 400% in the event of an organized gang”, concludes the minister.

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