Two dental or ophthalmological health centers, located in Yvelines and Seine-Saint-Denis, were deregistered by Social Security for fraudulent practices whose damage amounts to nearly 1.5 million euros, announced Sunday health insurance.
“These centers are notably accused of having established false invoicing and of having invoiced fictitious acts, that is to say not carried out”, specifies the National Health Insurance Fund (Cnam) in a press release.
According to the newspaper The Parisian, the centers are located in Trappes (Yvelines) and Blanc-Mesnil (Seine-Saint-Denis). The first offers dental care only, the second adds ophthalmology procedures.
Disqualified for five years
“In view of the seriousness of the facts and the amount of the financial damage”, which it estimates at “nearly 1.5 million euros for these two centers”, the Health Insurance has decided to deconvention them “for a period five years without reprieve,” its statement read. The measures take effect from Monday for the center of Saint-Saint-Denis, the 1is February in that of Yvelines.
Consequence of these deconventions: Social Security will only cover care there on a very low basis, the so-called “authority” tariff. For an ophthalmology consultation at 30 euros, the reimbursement is 1.22 euros.
Dental and ophthalmological health centres, the development of which has been favored to improve the supply of care, are in the crosshairs of many medical and paramedical professionals. The National Assembly voted at the end of November in favor of a stricter framework for these structures, some of which are presented as “cash machines”.
Health Insurance says it is “strongly mobilized” in the control of centers that display “atypical” billings. “Thus, 88 dental health centers and 44 ophthalmological health centers are currently subject to checks by the health insurance funds,” according to the press release.
