The fraud would be enormous. Since January 2021, with the 100% health reform, Social Security funds have suffered from a hearing aid scam. With this reform, people who need it obtain full reimbursement for some of these devices. Only, according to information from Parisiandated October 5, 2023, many prostheses would have been billed to Social Security to patients who would never have had them. Another scam: a more expensive type of prosthesis would be billed while the patient receives a different model. For example, just in Seine-Saint-Denis, as explained West France the same day, the Primary Health Insurance Fund (CPAM) estimated the total damage from these frauds at 8.3 million euros. In total, this fraud could cost the Social Security funds several tens of millions of euros per year since 2021 and the implementation of the reform. “In terms of access to care, it is a major success and it has also made it possible to reduce prices by 12%. But when there are more expenses, mechanically, we see the emergence of fraud phenomena which are not negligible”, recalled Thomas Fatôme, the general director of Health Insurance, during a press conference this Thursday in Paris, including The Parisian echoes.
130 centers would be in the sights of the CPAM
Alerted by the abuses in certain hearing aid centers, the CPAM decided to launch numerous checks. “We carried out checks directly with policyholders, by telephone, with simple questions. For example, are you equipped with a hearing aid?”explained to our colleagues Aurélie Combas-Richard, the boss of Health Insurance in 93. Throughout the territory, there are suspicions in 130 centers. In the coming weeks they should be checked. The objective of the CPAM is to avoid reimbursing files that are fraudulent. In 2023, these investigations would have already made it possible to avoid paying 3.7 million euros to dishonest centers. Same observation on the invoices sent in 2022 by hearing aid professionals to Social Security: 2.3 million euros were not paid due to inconsistencies and attempted fraud. Since the implementation of the reform, numerous centers have emerged. There are currently 5,600 in France. “They’re not hearing aid professionals, they’re business people!”annoyed Luis Godinho, vice-president of the Union of Hearing Aid Professionals, who deplores the fact that everyone can open a center as long as they hire a hearing aid professional.