In the government’s battle to limit fee overruns, the CNAM draws its first weapon. She called to order 554 doctors accustomed to resorting to fee overruns, namely consultations whose price is 2.5 times higher than the price of Social Security. So far 500 letters have already been sent. GPs are not the only ones affected by these warnings. Among the recipients are 105 doctors “with particular practice” (homeopaths, etc.), 101 surgeons, 77 general practitioners, 69 gynecologists and 49 ophthalmologists. These practitioners practice for the most part in Ile-de-France, the region most affected by fee overruns.
Doctors are entitled to a period of time to moderate their rates, otherwise their file will be sent to a regional joint committee, which will be held between October and December. In the event of non-compliance with the rules, practitioners may be subject to sanctions. In particular, they could no longer be contracted so patients will no longer be able to obtain secure reimbursement.
After these first letters, other doctors should be called to order. Indeed, the Health Insurance estimates at 29,135 the number of health professionals practicing excess fees.
A report published last May by the Citizen Observatory of Out-of-Pocket Health Costs, the Collectif interassociatif sur la santé and the SantéClair network revealed that fee overruns increased by 9%from 2010 to 2012. A figure allows us to measure the extent of the phenomenon: in 2012, excess fees represented 7 billion euros.
