Overview

• Assurance Maladie has deconventioned seven health centers across Bourgogne-Franche-Comté, Grand-Est, Bretagne, Ile-de-France, and Normandie for fraudulent practices.
• Fraudulent activities included billing for unperformed procedures, unnecessary treatments, and systematic billing unrelated to patients' medical conditions.
• The financial loss from these practices exceeded 6.6 million euros, with investigations conducted in collaboration with law enforcement and regulatory bodies.
• Two of the health centers have closed—one voluntarily and another after losing its operating authorization.
• The case underscores vulnerabilities in the healthcare payment system under the 100% health reform, which introduced generalized third-party payment, enabling large-scale fraud.