For having charged 350% more for their medical consultations, three practitioners were deprived of their freedom of tariffs and are obliged for 2 months to invoice their care in the amount of Social Security.
A new agreement in place since 2013
Since 2013, a new agreementsigned between the National Health Insurance Fund (Cnam) and the doctors’ unions stipulated that the excess fees could not exceed 70 euros for doctors who have chosen to sign this contract for access to care. A doctor therefore no longer has the right to exceed a ceiling rate, set at 150% of Social Security rates, i.e. 70 euros for a specialist consultation at 28 euros. For the Ministry of Health, “this agreement made it possible to put in place concrete measures to regulate excess fees and improve the care of insured persons. Patients with modest incomes are now guaranteed to benefit from consultations at the rate reimbursed by social security. Doctors who have entered into an “access to care contract” to moderate their overruns allow their patients better care. “
The average overshoot rate continues to decline
Moreover, according to a press release from the Ministry of Health, “the latest health insurance figures show that in 2013, the average rate of excess continues to fall, confirming the trend reversal initiated in 2012. This decrease is more particularly marked for certain specialties, such as gynecologists and obstetricians, psychiatrists or ophthalmologists.
However, according to the sources of figaro.fr, “last August, the Health Insurance called to order by mail 554 doctorsfor excessive pricing practices. “
In the event of abusive practices, doctors must moderate their prices under penalty of going before a regional joint committee. to be sanctioned.
An outlaw doctor can also be “deconvented”. He will be forced to leave Social Security. A measure which generally scare away patients who will no longer be reimbursed.
