Question 13252 — maternity health insurance

Summary

Ms. Anne-Sophie Ronceret draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the difficulties encountered, in certain territories, in securing coverage by health insurance for hearing aid medical devices when they are prescribed following a teleconsultation with an ENT doctor. Indeed, professionals in the sector report situations observed particularly in Charente where, due to particularly long delays in accessing an ENT appointment, patients with hearing problems have resorted to an ENT teleconsultation in order to avoid a disruption in their journey. In these cases, the teleconsultation would have been covered by health insurance. On the other hand, the coverage of medical devices prescribed on this occasion would sometimes be subject to a posteriori questioning by the National Health Insurance Fund (CNAM), with request for restitution of the sums paid, on the grounds that the prescription would have been established within the framework of a teleconsultation. These situations seem to reveal a need for clarification and harmonization, in order to guarantee a clear and secure application of the rules of care, both for patients and for professionals, in a context where telemedicine contributes to facilitate access to care in areas under tension. Also, the MP would like to know if the Government intends to specify the framework applicable to prescriptions for hearing aid medical devices delivered following an ENT teleconsultation, in order to secure their care, to harmonize the practices of the funds throughout the territory and to define, where applicable, the traceability requirements which must appear on the order.

Machine translation from French. The official text remains authoritative.

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