| Ilena Rose 2006-02-27, 1:00 am |
| Crackdown on breast surgery fraud
http://www.telegraph.co.uk/news/mai...27/ixworld.html
By Henry Samuel in Paris
(Filed: 27/02/2006)
France's heavily-indebted health service is cracking down on doctors
who pass off cosmetic surgery as life-saving reconstructive treatment,
a fraud which it says is costing taxpayers millions of euros.
The investigative arm of the health insurance service, CNAM, said it
would get tough on the "willingness of certain health professionals to
obtain reimbursement for their patients" for operations that were
purely aesthetic.
It said it had detected requests for reimbursement for two breast
implants following breast cancer when the vast majority of patients
have the disease in only one breast.
Acording to CNAM, such "undue reimbursement" cost it the equivalent of
about £7 million a year.
France's annual health budget deficit is scheduled to exceed £4
billion this year. CNAM estimated its anti-fraud crackdown would save
the health service £70 million this year.
After years of being accused of being soft on health care abuse, CNAM
launched its first anti-fraud operation last year, the results of
which were published last week.
The biggest area of abuse was in requests for sick leave. After
investigating 750,000 cases it found that 15 per cent of all doctors'
notes authorising short-term sick leave and 17.5 per cent for
long-term leave were unjustified.
It also targetted almost 4,000 "mega-consumers" of medicine,
prescribed five times the national average.
In one instance a young woman consulted 75 doctors per month on
average, and bought 12 boxes of anti-depression tablets per day from a
network of 67 chemists.
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