health insurance points to abuse

From 1 October 2022, teleconsultations that were reimbursed at 100% until 30 September will only be reimbursed at 70%. Except for people being treated for specific pathologies.

These are work stoppages

Once again, practices around teleconsultations could evolve. From now on, the government plans to stop the reimbursement of work stoppages issued by teleconsultation when these are not prescribed by the attending physician from June 2023. Indeed, the health insurance points to abuse, especially with regard to work stoppages issued by teleconsultation.

You should know that the CGSS (general social security fund) cannot separate a judgment given in person or by teleconsultation. On the other hand, it can be ascertained whether this verdict was given by the treating doctor or a doctor outside the region.

There are rules to respect

For the regional trade union of liberal doctors, the initiative that the government wants to put in place to limit subsidies is a good thing.

Anne Criquet Hayot, president of the URML (regional union of liberal doctors) in Martinique:

It is to give all the space back to the treating doctors, because many teleconsultation platforms are flourishing which do not know the patients. And then we find ourselves in the office with patients who have consulted about teleconsultation booths and we are quite surprised. There are many errors in the teleconsultations that are carried out, many diagnostic errors. Many lawsuits are being processed. It is certain that when you are in a teleconsultation and you do not know your patient, the situation changes completely.

There are rules that the doctor must respect during the teleconsultation. The work stoppage must be prescribed by the attending physician. This is why the check will be carried out during 2022 from 2023.

Rose-Evelyne Essart, head of the department for doctors, dentists, pharmacies at CGSS:

There are of course a number of rules that must be observed at a hearing, and a charter has also been drawn up on this subject. The rules for teleconsultation are as follows: The doctor must have seen the patient beforehand, or there has been an alternation between teleconsultation and face-to-face consultation, and he must have been briefed by his attending physician. These rules were suspended at the time of the pandemic. These rules are extended until 31 December 2022.

More than 40,000 Martinicans consulted teleconsultation platforms during the pandemic.

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