Surcharge applied for not using card
The largest doctors’ union wants to pass on to patients a 50 centime fine for using traditional reimbursement forms
DOCTORS are planning to start charging an extra 50 centimes on a consultation if people do not bring a carte vitale.
These health cards, which have existed since 1998, allow doctors and pharmacies to send information electronically to local state health insurance bodies (Cpams) when a patient receives a medical consultation or treatment, or medicines attracting a reimbursement.
Money is then paid directly into the patient’s bank account, with no need for filling out paper feuille de soins forms to send to the Cpam (in the case of medicines, an immediate discount is applied and the pharmacist is reimbursed by the state).
Since January, doctors are being fined 50 centimes per feuille de soins, to discourage use of them. The Cour des Comptes recently said processing them represented in 2009 an avoidable cost to the state of €200 million. Nearly a third of doctors are said to have not bothered to get the equipment needed for swiping the cards.
However doctors’ union CSMF has said that, in many cases, feuilles de soins have to be used because, for whatever reason, patients have not brought a card. Anyone who is in the French health system is entitled to a carte vitale, though expats sometimes report significant delays in obtaining one from their Cpam.
The union is telling its members to put up signs saying there will be an extra fee if patients do not bring a card, because of the fine that the state will apply. CSMF president Michel Chassang says this is “perfectly legal” under billing rules that limit the tariffs charged by doctors, especially those in “sector one”, who apply state-fixed prices.
“It can be considered an exceptional surcharge,” he said. He said the measure is designed to raise patients’ awareness that their doctor can be penalised if they do not bring their card, which he said was “absurd”. The surcharge would not be applied to patients where paper forms are used because the doctor is not equipped.
However the Cpams have advised patients to refuse to pay unless a surcharge is justified by the demands they have made.
Another union, MG France, is collecting details of patients who do not bring cards and their reasons, and sends them to the Cpams. They say doing this gives a useful snapshot of what is going on. “It tends to be the Cpams that are to blame in most cases,” a spokesman said.
