Question 19112 — social security

Summary

Mrs. Agnès Firmin Le Bodo draws the attention of the Minister of Solidarity and Health to the practice of differentiated reimbursements which aims to grant different reimbursements for an insured person depending on whether they use a practitioner affiliated with a network or not. A third of OCAMs practice it according to a recent IGAS report. The aim of this practice was to contribute to better reimbursement of certain services (optics, equipment hearing, dental mainly). It only applies in areas not concerned by 100% health. If we understand the objective of this measure, we can doubt its real effectiveness. Indeed, in certain regions it leads in particular to a problem of access to care when practitioners are rare; patients are then hesitant to travel many kilometers or wait a long time even if it means being less well reimbursed. By elsewhere, the patient's freedom of choice is questioned by this practice which makes the clientele more or less captive. By seeking to restrict patient pathways, OCAM encroaches on their legitimate freedom of choice. She also questions him about the possibility of changing this practice, in particular by removing the tax advantages granted to OCAMs practicing these differentiated reimbursements as proposed by the Senate during the PLFSS 2019 exam.

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