Nearly 2 million euros of health insurance fraud detected and stopped in 2024 in Dordogne, twice as much as in 2023

In 2024, 95 cases resulted in sanctions in the Dordogne region. These cases mainly involved hearing aid and daily allowance fraud. Prosecutions are systematically initiated.

In September 2024, the Dordogne Primary Health Insurance Fund (CPAM) was already predicting an increase in attempted health insurance fraud. The immediate future has proven it right. In 2024, its services detected and stopped nearly two million euros of fraud, double the figure achieved in 2023. Compared to the 2021 financial year, the increase is more than 230%.

"Fraud is everyone's business," insists Delphine Camblenne, director of CPAM 24. "Never give out your social security number or bank details in response to a text message or email. Also, don't give out your Vitale card for future billing for care," the manager explains. More original, because under the weight of the obvious, "don't buy fake medical certificates or prescriptions."

In 2024, 95 fraud cases resulted in sanctions. The majority of these cases involved healthcare professionals (75%). "Nevertheless, this is the case of a minority of professionals who bring shame on the entire profession," emphasizes Julien Irvoas, accounting and financial director of CPAM 24.

The number one fraud in Dordogne is hearing aid fraud, which has been recurring since the implementation of the 100% Health insurance for hearing aids on January 1, 2021. The total amount of fraud locally? €910,564. "These often involve hearing aid professionals who are not domiciled in France and who use various schemes such as identity theft, fictitious billing, or fraudulent prescriptions," explains Sandrine Costardoy, legal manager of the anti-fraud department. The team still employs five investigators and is expected to expand in 2025.

Second largest fraud: an orthoptist from Charente who employed untrained and unqualified staff and treated patients from several departments (368,000 euros defrauded in Dordogne, one million in Charente).

On the policyholder side, daily allowance fraud is the leading cause, in Dordogne as everywhere else. Often, the doctor doesn't exist, or their identity is stolen. These fake sick notes are sold on social media or online platforms. "We've also uncovered fake medical prescriptions for sale on Amazon, for example. Or we've uncovered codeine trafficking, which isn't expensive because a box costs €2.50. But it's a public health issue, which led to a complaint being filed with the prosecutor," adds the head of the legal department. In this specific case, only four policyholders were involved, practicing pharmaceutical nomadism.

The vast arsenal of actions to stop fraud is based on four axes: assessment, prevention, detection and control (the most mobilizing axis), and finally, punishment. The CPAM "systematically" initiates prosecutions against fraudsters, from financial penalties to criminal actions (prison sentences), and, for professionals, this can go as far as delisting, specifies the Health Insurance.