Health Insurance Fraud: €330m Detected Among Independent Nurses, National Federation Contests
An IGF-IGAS report targets independent nurses in the fight against fraud. The National Federation of Nurses denounces collective suspicion without reliable data.
IGF-IGAS Report on Fraud: Independent Nurses in the Spotlight, National Federation Demands Reliable Data
Google News FR — Crime (fr) reports that, according to a report from the general inspectorates of the Ministry of Finance and Social Affairs (IGF and IGAS) made public this week, the fight against health insurance fraud should focus more on healthcare professionals rather than individuals. Independent nurses (IDEL) feature prominently among the targeted professions.
The report highlights €330 million in fraud detected and stopped among independent nurses between 2016 and 2024. However, this figure provides neither the number of independent nurses actually affected, nor the proportion constituting intentional fraud, nor the fraud rate relative to the overall volume of activity within the profession.
The document itself recognises several important limitations: confusion between fraud, abuse, misconduct and coding errors, the complexity of nomenclatures, statistical correlations that establish no causality, and the absence of data demonstrating that degraded flows would be the source of a significant proportion of the fraud detected.
Among the measures under consideration are nonetheless coercive measures: capping of degraded flows, administrative sanctions, strengthened control before payment and increased oversight of billing.
The National Federation of Nurses (FNI) has spoken out against this direction. It supports the fight against proven fraudsters, but refuses for the entire profession to be placed under suspicion. The FNI demands, before any new constraints, solid, comparable and transparent data, as well as genuine consideration of the real conditions of home care.
The FNI has published a position paper on this report as well as an official press release.
Source: Google News FR — Crime (fr)