Health Insurance Fraud: Healthcare Professionals Behind 70% of €628M Detected
An IGF-Igas report reveals that 70% of fraud detected in 2024 is attributable to healthcare professionals, not policyholders. Inspections recommend reorienting control measures.
Health Insurance Fraud: Healthcare Workers as Principal Culprits According to Igas
Of the €628 million in fraud detected and stopped in 2024, 70% is attributable to healthcare professionals or individuals fraudulently using their identities. This is the central finding of a joint report by the General Inspectorate of Finance (IGF) and the General Inspectorate of Social Affairs (Igas), published at the end of July 2026 after being finalised in October 2025, which Google News FR — Crime (fr) brought to light. Social security policyholders, often designated as the principal vector of fraud, actually represent only 17.3% of fraudulent amounts, although they account for 52% of the cases handled.
Real Amounts Far Exceed Detected Fraud
Fraud involving prescriptions and billing would actually be between €1.4 and €1.9 billion per year, according to Epoch Times — far exceeding the sums actually identified. This figure must be compared with the €244 billion in general health insurance scheme expenditure in 2024 and a deficit estimated at €13.8 billion for 2026, which gives combating fraud considerable budgetary significance.
The report was allegedly withheld for several months in the administration's files, according to Le Canard enchaîné. The government reportedly wished to avoid its release during debates on the law relating to combating fraud, enacted at the end of June. Its delayed publication casts new light on the stated priorities regarding control measures.
Fictitious Services and Multiple Billings at the Forefront
The report's data are unambiguous: in 2024, healthcare professionals account for €433 million in detected and stopped fraud, or 68.9% of the total, whilst representing only 27% of cases. The principal breaches identified are fictitious services and multiple billings for the same procedure, which alone total nearly €250 million in damage, or 41% of all identified fraud.
Over the 2016–2024 period, nurses lead among the professions involved with €330 million in cumulative fraud detected and stopped. Pharmacists follow with €312 million, ahead of medical transport providers (€180 million), specialist doctors (€108 million), cosmetic surgeons accounted for separately (€88 million), and general practitioners (€67 million).
Hearing Aids, New Ground for Embezzlement
2024 was also marked by a sharp increase in hearing aid fraud, which reached €115 million in the context of the rollout of the "100% healthcare" scheme. Igas notably describes cases of the misappropriation of social security numbers of policyholders to bill for fictitious equipment, a practice which illustrates the growing sophistication of the schemes being employed.
Reorient Controls Towards Healthcare Professionals
Faced with these findings, the IGF and Igas explicitly recommend "prioritising more the control files of healthcare professionals, carrying heavy financial stakes, compared to the control of policyholders". Files under €1,000 — predominantly linked to policyholders — currently represent 30% of cases handled, but less than 1% of total damage. By contrast, healthcare professionals are involved in more than 80% of high-damage cases, those exceeding €500,000.
According to a simulation integrated into the report, transferring half of the approximately 18,000 controls currently devoted to policyholders towards healthcare professionals would allow detection of between €270 and €360 million in additional fraud. The inspectors nevertheless temper this optimism: no guarantee exists that these sums can be entirely recovered. To date, only half of the identified overpayments are actually recovered.
Source: Google News FR — Crime (fr)