Question 16731 ​​— people with disabilities

Summary

Mr. Édouard Bénard questions the Minister Delegate to the Minister of Health, Families, Autonomy and Disabled People, responsible for autonomy and disabled people, on the persistent constraints to achieving full wheelchair coverage for people with disabilities. Since December 1, 2025, vehicles for people with disabilities, such as Wheelchairs of all types (manual, electric, specific or modular), included on the list of reimbursable products and services, as well as their options recognized as disability compensation, are theoretically covered by health insurance (CPAM or MSA). This measure aims to give effect to an effective right to mobility, by removing certain financial burdens for the people concerned and by simplifying the administrative procedures thanks to the establishment of a one-stop shop with health insurance, responsible for processing access requests. However, seven months after the implementation of this reform, feedback from the field still shows persistent dysfunctions. Indeed, many individuals, associations and professionals in the sector are alerting to the difficulties they have faced since the creation of the device. Thus, 25% of requests for prior agreements are rejected by CPAMs even before the order is placed and 36% are rejected at the stage of invoicing to service providers. These rejections could be explained in particular by errors in filling out forms, refusals of options or additions exceeding the authorized sales limit price, or even by the invoicing of additional costs for options qualified as "comfort", then that they should normally be covered by health insurance. Another major point of tension, raised during the reform monitoring committee organized on June 18, 2026, concerns the congestion of appointments, with waiting lists of up to several months for the prescription of equipment. If the prescription for a “simple” chair can be established relatively quickly by a doctor or occupational therapist, it becomes much more complex for technical chairs, with manual or electric propulsion, or even for vertical models. These require validation by a multidisciplinary team, made up of a doctor specializing in physical medicine and rehabilitation (MPR) or a holder of a university diploma in orthopedic equipment, as well as an occupational therapist or physiotherapist. These professionals having to meet to establish the prescription and their rarity results in delays in first appointments with a multidisciplinary team of at least six months. Territorial and financial disparities are also noted. People with access to a physical medicine and rehabilitation center close to their home, equipped with the necessary human resources, can obtain a chair more quickly and without additional costs for the prescription. Conversely, others, to obtain their chair within a reasonable time, are forced to request a private prescription, from an occupational therapist in tandem with a specialist in physical medicine and rehabilitation, for an unreimbursed consultation of around 200 euros. Another sticking point concerns wheelchair rental. Although part of the cost must be borne by the complementary health insurance, refusals have been noted: some complementary health insurance companies consider that there are excesses and reject reimbursement requests. In addition, prior approval from health insurance medical advisors is required for long-term rentals as well as for certain configurable chairs. The French Mutualité also indicated last March that 76% of the invoices transmitted had been paid, citing difficulties linked to a very tight implementation deadline and practical arrangements communicated late. Other causes of delay are to be deplored, such as delays in carrying out tests with pharmacists or medical equipment suppliers. The latter, who generally order two chairs to carry out the tests, do not always have all the demonstration models. They often have to borrow or rent chairs from manufacturers. With the increase in requests following the implementation of the new device, the wait can reach two additional months, according to the National Union of Medical Device Providers (UNPDM). In addition, these tests must take place at home, in the presence of the multidisciplinary team, to validate the choice of chair. This can become problematic when these professionals practice far from the patient's home. Also, he asks how the Government intends to streamline the processing of requests for support by Social Security, adapt the process of prescribing wheelchairs, which is not adapted to the realities of the entire territory, due to a lack of sufficient authorized professionals and require complementary health insurance to respect their financial obligations in matter of remaining charges for the aforementioned medical equipment.

Machine translation from French. The official text remains authoritative.

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