From this Monday, thirteen health centers of the Alliance Vision group will be deregistered from Health Insurance for Social Security fraud, note our colleagues from the Parisian. Concretely what does this mean? As of Monday, Social Security will only reimburse the care provided in these ophthalmological and dental establishments on a very low basis called the “authority rate”, i.e. for example for an ophthalmology consultation at 30 euros a reimbursement of 1, 22 euro, details the Health Insurance.
This announcement is unprecedented in the fight against fraud. “After the deconvention of five health centers at the beginning of 2023, Health Insurance is for the first time initiating a large-scale deconvention procedure, against 13 health centers in the same network, located in nine regions”, welcomed the National Health Insurance Fund (Cnam) in a press release.
Alliance Vision “vigorously” contests this heavy sanction
The damage could exceed 21 million euros since the start of the controls, in 2020, according to the Parisian. The Cnam accuses the ophthalmological and dental centers of the Alliance Vision group of “invoicing of fictitious acts and the repeated non-compliance with the rules of quotation and invoicing of acts”.
Alliance Vision contests “vigorously” the reproaches and the sanction of which it is the object and seizes “from now on the competent administrative courts in order to obtain the suspension of the execution of the decisions” of the Health Insurance, according to a press release from his lawyer Patrick Atlan, transmitted to AFP.
The 15 Alliance Vision health centers – 13 of which, therefore, are in the sights of the Secu – are managed by associations, said the lawyer, adding that the company acted as a supplier of service delivery contracts. According to the article of Parisianthe centers of Argenteuil, Franconville, Amiens, Nancy, Antibes, Saint-Étienne, Orléans, Rennes, Le Mans and Le Havre are affected by this deconvention.