As the Social Security Financing Bill is about to be debated in the National Assembly, a deputy tabled an amendment to put an end to the surgical procedures practiced “illegally”, that is to say without authorization. Olivier Véran, LREM deputy proposes in his amendment to penalize the services or hospitals which have recourse to these practices, by obliging them to reimburse to the Health insurance the sums unduly received.
To better understand, it should be known that surgical teams can only obtain authorization to perform surgical ablation, when they display a minimum of surgical activities: for example, within the framework of breast cancer, digestive, urological and thoracic, it is necessary to perform at least 30 procedures per year. And and at least 20 annual interventions for gynecological cancers, otolaryngological and maxillofacial, as we learn in Le Parisien. Thresholds set in order to guarantee a minimum quality of care.
But operations without authorization are still common. They are then billed to Health Insurance, which reimburses them. Case law obliges the CNAM to reimburse any medical act that has been performed. Gold, “when you practice little, you lose expertise”, underlines Professor Guy Vallancien, one of the first doctors to be interested in the link between quality of care and volume of activity. The amendment by Olivier Véran, a hospital doctor by trade, therefore wishes to put an end to this situation.
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