Faced with the explosion in the number of work stoppages, the Health Insurance has launched a new campaign to control attending physicians.
For the doctors’ unions, it is neither more nor less than a “witch hunt”: Health Insurance last week launched a wave of checks to “fight against the excesses” of certain doctors, accused of prescribing too many work stoppages.
Several warning letters have indeed been sent to caregivers suspected of being “too big prescribers”, who represent, according to the director of Health Insurance Thomas Fatome, 2% of French doctors. “They prescribe twice, three times, four times more than the average sick leave per patient, he explains to franceinfo. For those, we are launching a campaign”.
These “reframings”, which should concern between 15,000 and 20,000 doctors, will take the form, for the most part, of simple reminder visits to their offices. But, as our colleagues point out, 5,000 of them could be sanctioned in order to review their prescription habits.
Penalties
If, as the Health Insurance website points out, a doctor’s “prescription activity” “appears abnormally high”, two sanctions can be put in place: the pinned professional can be “put under prior agreement” ( MSAP) or be “put under target” (MSO).
The first is the heaviest: if it is put under prior agreement, the doctor’s prescriptions are subject, for a maximum period of 6 months, to the agreement of the medical control service. In this configuration, “possible financial penalties may be imposed on the doctor” and patients who have received these prescriptions are contacted by mail, indicates Health Insurance.
In the case of the MSO, which is less punitive, the doctor undertakes with the CPAM to “achieve an objective of reducing prescriptions within a certain period”. In case of refusal, here again, possible financial penalties may be imposed.