Nevertheless,
Health insurance wants go further new: Therefore. Similarly,
Health insurance wants go further:
In a report intended to shed light on the public authorities. Similarly, parliamentarians for the next security budget for 2026, health insurance pleads for better cooperation with complementary organizations to combat fraud.
More cooperation with complementary health insurance. Additionally, Similarly. Moreover, this is one of the shock proposals of the National Health Insurance Fund (CNAM) to strengthen the fight against fraud in the health system. Nevertheless, Far from being new, the idea appears in its report “charges and products” presented Tuesday, June 24. Nevertheless, Intended to shed light on the public authorities. Consequently. In addition, parliamentarians for the next security budget for 2026, this 247 -page long document stands out of the boxes a measure which had however been censored from the Social Security financing law (LFSS) for 2025.
It is a question of developing the exchange of health insurance wants go further new information between the primary funds of health insurance (CPAM). the complementary organizations health insurance wants go further “in order to make the fight against fraud even more efficient”. maintains the CNAM. “If they will be useful vis-à-vis the insured. these exchanges have an obvious interest in health professionals. in order to be able to quickly stop unjustified reimbursements,” she institutes.
Problem. this measure was judged as a social horseman by the Constitutional Council. considering that it had no place in a budgetary text.
“However. this article was to generate savings. therefore with a financial objective,” said MP Modem Cyrille Isaac-Sibille in the columns of the newspaper L’Opinion this Friday, June 27.
A bill under study – Health insurance wants go further – Health insurance wants go further new
The elected representative of the Rhône also tabled a. bill on May 13 at the National Assembly. aimed at facilitating (finally) the exchanges between CPAMs and complementary health. In health insurance wants go further new its current state. the text. which could be examined this fall, first provides “that the health insurance funds communicate, in the event of health insurance wants go further a fraud complaint, the name and contact details of the complementary organizations assigned by this fraud to the public prosecutor”.
For the sake of respect for medical confidentiality. it is also specified that “only the information strictly necessary for the identification of the author of the facts. of fraud suspected may be communicated by health insurance with complementary health”.
If the initiative of the parliamentarian is well received by complementary organizations. the three federations of the sector – La Mutualité Française. France Insureurs and the Technical Center for Provident Institutions (CTIP) – are still waiting for an “essential legislative provision which makes it possible to consolidate the processing of health data by complementary health insurance organizations within the framework of their mission to fight health insurance wants go further new fraud”, indicates to BFM Business Laure -Marie Issanchou, Health Director of the French Mutuality Federation (FNMF).
628 million euros in fraud detected. stopped in 2024
According to health health insurance wants go further insurance figures. no less than 628 million euros in fraud were detected and stopped in 2024. “A record result in financial damage” according to the CNAM, since it is up more than a third compared to 2023 (+34%).
“More than half of the fraud detected is committed by insured, for only 18% of the amounts, details the CNAM. Frauds committed by health professionals represent almost 26% of fraud in number, but for much higher amounts, or 62% of damage”.
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