Elise Lucet and Donatien Lemaître coordinated a team of journalists to conduct an in -depth investigation among healthcare professionals.
by Catherine Pacary
A dentist who performs 852 plugs in four months for an amount of more than 80,000 euros; residents of a “house for seniors” to which their vital card is subject; Industrial home care, unnecessary panoramic radios … By starting their investigation into social security fraudsters, the “cash investigation” team was amazed by the figures provided by health insurance: they are not the insured who cheat most, but health professionals, responsible in 2021 of 72 % of the amount of fraud detected.
They only had to find out which ones. Physiotherapists? Generalists? Nurses? Others ? Directed in the form of a 100 meters, this “race” serves as a common thread for journalists led by Elise Lucet and Donatien Lemaître. To achieve this, they have been inventive: two of them, “let’s call them François and Gabriel”, do not hesitate to play guinea pigs in a dental center Dentego or with an ophthalmological and dental center Cilaé.
Light interludes, like the one inspired by the La Casa de Papel series, are welcome. Before meeting Claire in Marseille, whose mother spent a year and a half in a senior residence. She reports a hundred pages of medical acts, while her mother requires almost no daily care. The old lady also shows her flexibility in front of the camera. A great lesson in humor. We can also salute the courage of the father of one of the journalists for his participation. 2>
actions of the CPAM
The precautions taken by some “witnesses” indicate their fear. Two ex-Dettego residents thus make their comments repeat on the obligation to make figures by two actors, so as not to be recognized. A dentist who alerted to Cilaé appears hooded and in Chinese shadow to denounce the business of the vital card: “Who will worry about the invoice he pays when he has nothing to pay?”
At the other end of the channel, journalists searched for the actions in progress to fight against these frauds. Starting with those of the CPAM (Primary Health Insurance Fund). “We pay blind. It is the strength of health insurance. We are quite proud,” we hear.
The subject also has a political dimension. If Marisol Touraine, Minister under François Hollande (2012-2017), who brought the law of modernization of the health system, declined the invitation of Elise Lucet, the current Minister of Health, François Braun, A, him , immediately accepted. Pin’s Sidaction on the back of his jacket, he answers questions. Despite everything, in 2021, 2,300 fraud complaints were filed in criminal. And then “everyone is investigating at the end of your show,” said the minister. This reassures.