A network of eye centers suspected of fraudulent acts

Overbilling, fictitious acts, accumulation of exams: an investigation by the Paris prosecutor’s office points to a network of ophthalmological centers since the summer of 2021 on suspicion of fraud estimated at more than 7 million euros, we learned this Monday from concordant sources, confirming information from the JDD. Within the framework of a “national control operation against twelve ophthalmological health centers belonging to the same network”, which began in October 2020, “non-compliant billing practices” were revealed, according to a document from the National Fund forhealth insurance (Cnam) consulted by AFP.

Among these fraudulent acts were discovered, among others, “double billing to Health Insurance for the same act, fictitious acts, that is, billed acts but not carried out” or “billing of medically redundant acts whose accumulation is prohibited in the nomenclature”, details. The economic damage is estimated “in more than seven million euros”, announces in this document the Health Insurance.

Between June 2021 and June 2022, twenty-six complaints were filed against twelve centers located in Île-de-France, Provence-Alpes-Côte d’Azur, Normandy, Hauts-de-France, Pays-de-la-Loire, Auvergne -Rhône-Alpes, Centre-Val-de-Loire and Grand Est. A complaint for fraud was sent on September 15 to the Paris prosecutor’s office, which centralizes all complaints, by the National Union of Ophthalmologists of France, told the AFP its president, Dr. Thierry (…).

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