Shortage obliges, children followed in a medico-psychological center often see a private speech therapist in parallel. The whole being reimbursed. But since December 2024, several primary health insurance funds (CPAM) have recalled that a patient followed in the Medico-Psychological Center (CMP) could no longer benefit in parallel from speech therapy reimbursed in liberal. The displayed objective is simple: to avoid that health insurance will not finance the same care twice.
An administrative rule that upsets the follow -ups
On paper, this rule seems logical. The CMPs, hospital structures, have multidisciplinary teams supposed to “integrate” speech therapy. But in fact, very little CMP have speech therapists in their workforce, for lack of means and attractiveness. To compensate, tolerance so far allowed families to access liberal speech therapists, supported by Social Security.
This system collapses: From now on, care must be the subject of an agreement between the CMP and the liberal speech therapist. However, number of CMPs have neither the resources nor the desire to sign such agreements.
When families find themselves in the deadlock
The consequence is immediate: some speech therapists now prefer to suspend their follow -ups, fearing to have to reimburse several months of care. In Beaugency (Loiret) for example Isabelle Dumeny had to stop the sessions of six children also followed at the CMP. “It is a big financial risk: as we are mainly in third -party payment, if Social Security takes over the money, we will no longer be paid. It can quantify enormously”she confides in World.
On the family side, the amazement also dominates. As in the case of Louis, 3 and a half, diagnosed with an autistic spectrum disorder. After 146 requests, his parents had finally found a liberal speech therapist. But since its entry to the CMP, its sessions have not been reimbursed. However, follow -up costs around 300 to 400 euros per month, an amount impossible to assume for many households, including that of Louis. “”This amounts to asking us to choose: Do you want your child to speak, or to learn to socialize? “testifies his mother.
According to the child psychiatrist Christophe Libert, president of the association of infant-juvenile psychiatrists, “more than 100,000 children” could thus like Louis, finding himself in breach of care.
The anger of speech therapists
It’s not just the parents who are worried. Faced with this situation, the profession is indignant. On its site, the National Federation of Speech therapists (FNO) denounces an administrative complexity which “Massively penalizes professionals, patients and their families”. She emphasizes that CMPs are often reluctant to sign conventions and that this requirement makes the follow -up almost impossible. The Federation of Orthophonists of France for its part alerted the Ministry of Health in early September. The unions fear that the most vulnerable children are the first sacrificed.
Maladie insurance tries to reassure: a period of tolerance runs until October 31 and no retroactive control is planned. But in the field, confidence is no longer there. Many practitioners fear working for free or being asked for thousands of euros in industry.
Access to weakened care
Behind this administrative battle, the issue is crucial: allowing children with language, learning or autistic spectrum to continue an essential support.
As the child psychiatrist Christophe Libert recalls, “To stop speech therapy or the CMP is as if a pharmacist only gave half of the drugs. If we reduce the supply of care, in terms of quantitative or qualitative, we make disability “.
While waiting for a regulatory, families and speech therapists cling to hopes for a rapid solution, so that the reimbursement rule does not come to break care paths already strewn with pitfalls.