Question 9567 — maternity health insurance

Summary

Mr. Hubert Ott draws the attention of the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, on the provision of medical transport for residents in accommodation establishments for dependent elderly people (EHPAD). According to articles L. 322-5 and R. 322-10 of the social security code, reimbursement of transport costs requires a prescription prior medical treatment and, in certain special cases (long distance, mass transport, plane or boat, etc.), prior agreement from health insurance. If this framework aims to control expenses and prevent abuse, it appears poorly adapted to the reality of EHPADs. The residents of these establishments are dependent elderly people or those losing their autonomy, for whom transport to care is essential. The requirement of a prior prescription, sometimes combined with prior agreement from health insurance, leads to delays, omissions or refusals of reimbursement. These procedures rely on EHPAD staff, who are already in high demand, as well as on patients who are often unable to carry them out, which generates out-of-pocket costs for families, who are not always present with the resident on a daily basis. He asks him if the The Government is considering adapting the regulations so that medical transport for residents in EHPADs can be covered systematically or, at the very least, more simply, for example via a single prescription valid for all recurring trips between EHPADs and hospitals, without the need to renew the act for each transport. Failing this, he asks what measures the Government intends to put in place. to reduce this administrative burden, guarantee effective access to care and simplify reimbursement for this transport.

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