Health Insurance Fraud: Healthcare Professionals Responsible for 70% of Amounts
An IGF-Igas report reveals that healthcare professionals account for €433 million out of €628 million in fraud detected in 2024. Policyholders, often singled out, represent only 17.3%.
Social Security Fraud: Igas Holds Healthcare Professionals Accountable, Not Policyholders
According to Google News FR — Crime (fr), a joint report by the General Inspectorate of Finance (IGF) and the General Inspectorate of Social Affairs (Igas), published in late July 2026 after being finalised in October 2025, overturns the image usually associated with social fraud. Of the €628 million in fraud detected and stopped in 2024, 70% is attributable to healthcare professionals or persons usurping their identity. Social policyholders, generally identified as the primary vector of fraud, represent only 17.3% of fraudulent amounts, although they account for 52% of cases processed.
Epoch Times estimated that fraud in prescriptions and billing would amount to between €1.4 and €1.9 billion per year, a volume significantly higher than the sums actually detected. This finding comes in a context of severe budgetary pressure: expenditure of the general health insurance scheme reached €244 billion in 2024, whilst the deficit stands at €13.8 billion for 2026.
A Report Withheld for Several Months
Le Canard enchaîné reported that the document would have been held back for several months within the administration's files. According to this source, the government sought to avoid its publication during parliamentary debates on the law relating to combating fraud, promulgated in late June. The delayed distribution of the report casts new light on the real priorities of oversight policy.
Fictitious Services and Multiple Billing
The report's figures are precise. In 2024, healthcare professionals account for €433 million in fraud detected and stopped — 68.9% of the total — although they represent only 27% of cases. The most frequent failings concern fictitious services and multiple billing of the same act: these practices alone represent nearly €250 million in harm, or 41% of all fraud detected by Health Insurance in 2024.
Over the period 2016-2024, nurses lead among health professions with €330 million in cumulative fraud detected and stopped. Pharmacists total €312 million, medical transporters €180 million. Specialist doctors represent €108 million, general practitioners €67 million, and cosmetic surgeons €88 million additional, counted separately in the report.
Hearing Aids: Marked Increase in 2024
The year 2024 was also marked by a sharp rise in fraud in hearing aids, which reached €115 million within the framework of the "100% Health" scheme. The Igas report describes cases of misappropriation of social security numbers of policyholders in order to bill fictitious equipment, illustrating the growing sophistication of fraudulent schemes.
Redirect Audits Towards Professionals
The IGF and Igas explicitly recommend to "prioritise more the audit cases of healthcare professionals, which carry significant financial stakes, over auditing policyholders". Files involving amounts below €1,000 — primarily linked to policyholders — currently represent 30% of cases processed, but less than 1% of total harm. At the other end, healthcare professionals are involved in more than 80% of cases involving significant harm, those exceeding €500,000.
According to a simulation presented in the report, transferring half of the approximately 18,000 audits currently devoted to policyholders towards professionals would make it possible to detect between €270 and €360 million additionally. The inspections stress, however, that no guarantee exists regarding the full recovery of these amounts: only half of the sums concerned are actually recovered.
Source: Google News FR — Crime (fr)