Hundreds of thousands of euros and more than a thousand patients… The court does not know where to start because the scale of the fraud appears immense. “Doctors perform on average 62 medical procedures per year and you, that’s 8,906… The amount of procedures was more than four times higher than the regional average in 2014“, says the president of the court to the defendant.
Alerted by the explosion in the number of consultations carried out by this doctor, the Primary Health Insurance Fund (CPAM) of the Bouches-du-Rhône department decided to file a complaint. It is then joined by the National Military Social Security Fund. According to the survey, 1,539 patients had billing anomalies.
His responsible illness?
The doctor charged in particular for tests for the evaluation of adult or child intellectual efficiency, at €70, in addition to the cost of the traditional consultation. In addition to the abusive invoicing, which the defendant acknowledges, the CPAM pointed the finger at “night surcharges“and”night travel increases“fictitious.”Some patients interviewed explained to investigators that you had never given them a night consultation“, specifies the judge. The defendant disputes these facts.
The doctor comes to the stand limping. For him, these abusive billings are due to his encephalitis (an inflammation of the brain) caused by HIV, which he has suffered from since 2013.The context is complicated, I have a kind of fog at home, I can’t find any explanations. This is where I am today…“
#French
