Question 4621 — maternity health insurance

Summary

Ms. Julie Laernoes alerts the Minister of Labor, Health, Solidarity and Families to the serious malfunctions of the ARPEGE software which is used to ensure the processing of sick leave and work accidents of insured persons but also the calculation and payment of daily allowances, tested since October 2024 in the CPAMs (primary health insurance funds) in Loire-Atlantique and Vendée. This new software is being tested to replace PROGRES, the old tool described by services as obsolete. However, the deployment of this new tool has caused a number of malfunctions, in particular delays or absences of payments as well as particularly long file processing times. These different anomalies cause alarming situations among policyholders, here are some examples. A supervisor, having had to undergo surgery on a shoulder with a prosthesis break: the surgeon plans between 3 and 6 months of leave but having no more income, he had to, despite pain, return to work with the risk of serious complications due to the compulsory non-rest after this type of intervention. A care assistant for the elderly via the CESU (unified service employment check), was on long-term leave following capsulitis (shoulder) not operable with a current occupational disease file filed. She had to return to work due to lack of income because the CESU only pays the employer's share on presentation of IJSS certificates, which currently do not exist. A worker with a disability, on long-term work stoppage, having also suffered dismissal and is soon awaiting a labor tribunal. This person is in the incapacity to work and the file no longer advances to obtain a disability pension. She no longer has any income or any help because she lives alone. These extremely problematic situations obviously go back to the CPAM services of Loire-Atlantique and Vendée, which suffer the consequences of a poorly calibrated tool. Given the complex situation of policyholders with loss of income or even absence of income, aggression increases towards staff already overworked because they have to correct software errors by hand. The various updates made since October do not resolve the dysfunctions, anger is growing and so is the discomfort of the CPAM teams. Double payments and recipient errors have already led to a cessation of payments, leading to an overwhelm of physical and telephone reception. Of Furthermore, the payments made are advance payments but they do not correspond to the daily allowances due. These installments result in changes in income for policyholders, which may also cause complications when calculating taxes. The situation is all the more regrettable since various trade union organizations (CFDT and CGT) had warned the CPAM management when awarding the contract to ARPEGE, because already ARPEGE TI (self-employed workers), launched in 2020, is still not working correctly several years after its launch. She asks him for information regarding the number of policyholders who have been affected. When will measures be taken to truly stabilize the ARPEGE software in the departments of Loire-Atlantique and Vendée? She also asks her if she intends to suspend the distribution of this tool. defective throughout the national territory.

Machine translation from French. The official text remains authoritative.

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