DISCUSSIONS

Find the answers to many of your expat questions here

View Latest Posts

You're missing out...

As a member you can enjoy exclusive info and offers.

REGISTER NOW

Who do you report ( social security ) fraud to

Posted by citic-213768 - Created: 6 years ago
0 0
Sorry no image available

6 replies (Showing replies: 1 to 6)

Sorry no image available
Posted by ChristopherL-188542 - 6 years ago

If its just idol (sic) curiosity then the nature of this fruad doesn't concern you.If by "curiosity" you mean "nosiness" - no that it is not my interest. Nobody on this forum needs to know who did what to whom. I simply wanted to get a more objective understanding of what you thought was the nature of the so-called fraud so as to determine if it was truly a fraudulent act or perhaps an incompetence of the practitioner or even a misunderstanding on your part. If for example your concern was an overcharging issue for a correct codification then this is something that affects a lot of people and causes huge confusion but it is not actually a fraud. On the other hand you might be concerned about a false codification to increase the practitioner's SS payment whilst leaving you with the balance to pay (practitioner fraud) or you could have experienced a false codification to reduce the nett payable by yourself (complicit fraud) or maybe you have a complaint about non-compliant (or non-qualified) professional treatment albeit under correct codification (also not actual fraud but maybe subject to redressement)

So you see - out of 4 possible scenarios, only 2 would be considered fraud. Then assuming that you have an actual case of fraud to be concerned about, the way that you signal it depends upon the way in which you receive your health payments because it is up to the director of each "caisse locale" to make these determinations.

... Article L114-13 du Code de la sécurité sociale ...

en fonction de la fraude en question, le montant de la pénalité financière est fixé par le directeur de la caisse locale d'assurance maladie ayant versée les prestations selon la gravité des faits reprochés

Sorry no image available
Posted by citic-213768 - 6 years ago

what is vague about asking for contact detail to report fraud ? , why do you assume I dont understand the system ? what I need is an ADDRESS of the fraud department , not to be asked details about the fraud not to be told i understand the system etc
please read what i have posted before comments , thank you

Sorry no image available
Posted by ouch that hurt !-230853 - 6 years ago

ChristopherL is usually ready to offer excellent advise, however your post is vague & it isn't easy to offer advise if you don't understand, perhaps you don't understand the sytem ?
Iif you aren"t a private patient, I imagine your CPAM is the place to complain

Sorry no image available
Posted by Methuselah-217505 - 6 years ago

I would be inclined to use a little initiative and rather than rely on other peoples' inputs, start with the Social Security. You are affiliated to one of the French SS organisations, for example CPAM or RSI. Contact them.

Sorry no image available
Posted by citic-213768 - 6 years ago

If its just idol curiosity then the nature of this fruad doesn't concern you. if you have the appropriate address to complain to then I would be interested

Sorry no image available
Posted by ChristopherL-188542 - 6 years ago

Can you explain a little more about the so-called fraud ?