“Senate Examines Bill to Improve Supervision of Health Centers Following Scandal in France”

The Senate is preparing to examine at second reading a bill aimed at improving the supervision of health centers. This text was written in reaction to the scandal linked to two dental centers located in the East of France accused of “mutilation and voluntary decay” of patients.

These dental centers are among those pointed out by the CNAM for serious breaches[1]. Created under the status of “association” – in reality masking a lucrative and fraudulent activity – these centers practice in an almost systematic way the invoicing of fictitious acts, over-invoicing or even the performance of acts contrary to the interests of patients.

Patients are the first victims of these practices. Health insurance and mutuals, for their part, suffer the financial consequences.

These centers must of course be distinguished from “historic” health centres, municipal, associative and mutualist, which are a tool for access to quality care at agreed rates throughout the territory.

In this context, the Mutualité Française understands the wish of parliamentarians to regulate the activity of these centers provided that the measures proposed are in line with the objectives pursued and do not create constraints that penalize virtuous centers without having any impact on the deviant centers. This applies to the reintroduction of prior authorization for the opening of health centres, which, it should be remembered, had been abolished because the Regional Health Agencies lacked the resources to carry out this mission.

A better use of the existing means of control could no doubt have made this new law superfluous, as shown by the recent cancellation of two health centers by health insurance.

At the same time, and while they meet the expectations and health needs of policyholders (90% of patients treated in mutual health centers are satisfied with their care [2]), Mutualité Française regrets that the bill does not seek to improve their economic health. Many of them experience financial difficulties, even those frequented by a large clientele. This winter, a Parisian health center attended by 75,000 patients/year was placed in compulsory liquidation.

Today, the methods of financing health centers do not take into account their specificities, particularly related to the reception of disadvantaged patients requiring support in access to care and the coordination of professionals. Moreover, the proposed law reinforces persistent treatment inequities between health centers and private structures, in particular coordinated exercise structures. For example, health centers and the professionals who work there are often overlooked in the aid systems benefiting other health professionals or health establishments in general.

Rather than hampering the activity of all the health centers, running counter to the initial objective, it would have been preferable to strengthen the conditions of exercise of the virtuous health centers, by supporting the development of their missions of interest public and ensuring the sustainability of their economic model.

If nothing is done by the public authorities to perpetuate the economic model of health centers, tomorrow, few French people will be able to access consultations without excess fees and practicing third-party payment. Rather than making their operation more complex, it is therefore much more urgent to recognize and sustainably consolidate the added value of health centers by providing them with the tools and means necessary for their activity.

[1] In the CNAM report “Expenses and income” for the year 2021

[2] Annual barometer 2022 carried out by Majors Consultants with 230 mutualist dental centers, with more than 11,000 patient responses collected throughout the national territory

Panel signatories:

1. Eric Chenut, president of the Mutualité Française
2. Elvire de Almeida Loubière, president of the Mutualité Française Haute-Garonne
3. Jean-Paul Benoît, President of the Federation of Mutuals of France
4. Christophe Bertin, President of the Mutualité Française Aisne-Nord-Pas de Calais SSAM
5. André Boubée, president of the Mutualité Française Gers
6. Patrick Brothier, President of Aésio
7. Gilles Deschamps, President of the Mutualité Française Saône-et-Loire SSAM
8. Patrick Giraud, President of the Mutualité Française Center Atlantique
9. Nicolas Gomart, President of Matmut Mutualité LIII
10. Patrice Guichaoua, president of the MGC group
11. Pascal Haury, president of Aésio Santé
12. Stéphane Junique, Chairman of the VYV group and of VYV3
13. Jean-Philippe Laval, president of the Mutualité Française Dordogne
14. Lionel Le Guen, President of the PACA SSAM French Mutual Fund
15. Denis Leyder, president of the Mutualité Française Haute-Saône
16. Claude Mouly, President of the UDSMA-Mutualité Française Aveyron
17. Olivier Pouyaud, president of the mutualist group RATP
18. Jean-Marie Schmidt, President of the Mutualité Française Alsace
19. Jacques Seguin, president of the Mutualité Française Jura
20. Michel Viciana, President of the Mutualité Française Grand Sud
21. Dominique Savary, President of the Mutualité Française des Landes