Following several scandals (Dentexia, Proxidentaire) and to limit deviant practices, dental and ophthalmological health centers will now be better supervised, according to a bill passed in the Senate on February 14, 2023.
Health centers dental and ophthalmological services have multiplied in France these last years. Of the excesses and frauds have been observed in certain establishments, in particular “low cost”. We remember the Dentexia scandals Or Proxidentarytwo networks of dental centers placed in compulsory liquidation after receiving complaints from patients for “lack of medical ethics, mistreatment, overtreatment, unwarranted care, mutilation and financial abuse“and who had done thousands of victims. To counter these fraudulent practices, the Senate passed a bill aimed at improving the supervision of health centers, on February 14, 2023. This proposal, already adopted at first reading by the National Assembly in November 2022, tightens their opening conditions and strengthens controls and penalties. The text must now be adopted at second reading in the National Assembly.
What is a health center?
A health center is a nearby healthcare facility which groups several health professionals (general practitioners, dentists, nurses, physiotherapists, etc.). They do not belong to a hospital and are not private practices. All patients who so wish are cared for (open to all). There would be approximately 1,750 health centers in Franceaccording to the Directorate General for Healthcare in 2017.
What does the 2023 law provide for health centers?
► The text of the law reintroduces the obligation of an approval issued by the Regional Health Agency (ARS) before the opening of a dental and ophthalmological health center. This approval was abolished in 2009 by the Bachelot Law in order to improve access to care, but which led to “to practices contrary to the regulations“, can we read on the text of the law. To obtain this approval, the centers will have to submit “a health project” as well as “Disclosure of Relationships and Conflicts of Interest” of their governing body. This approval would initially be provisional (one year) and would only be made permanent after a compliance visit.
► Health centers must provide the ARS and the Regional Order with doctors or dental surgeons the contracts and diplomas of all caregivers hired.
► Centers that have been in existence for 6 months will have 2 years (instead of 30 months) to apply for accreditation, otherwise they will not be able to offer dental or ophthalmological care.
► The number of medical assistants and the number of doctors must be equivalent in the health centers.
► A medical committee will be set up in each center to ensure the quality and safety of care. This committee must submit regular reports to the ARS.
► An amendment to the text of the law provides for the prohibition of advertising in favor of the services delivered by these structures.
► If the structures do not comply with the law, the values of the maximum administrative fine and the maximum daily fine of the ARS will be increased respectively to 500,000 euros (instead of 300,000), and to 5,000 euros (instead of 2,000).
What changes for patients?
The text provides better transparency for patients about the professionals who practice in these health centers. In effect, as soon as the appointment is made, the patient will have access to information on the identification of the practitioner performing the care. Centers will no longer be able to request full payment for treatment before it is carried out. In concrete terms, patients will thus have “more confidence in health centers“, specifies Agnès Firmin Le Bodo, Minister Delegate to the Minister of Health and Prevention, in charge of Territorial Organization and Health Professions.
Sources:
Bill aimed at improving the supervision of health centres, National Assembly, 30 November 2022
Senate Bill No. 162
Fact sheet Agnès Firmin Le Bodo, Gouvernement.fr
Official website lescentresdesante.com