Faced with the explosion of false sick leave, health insurance sets up a brand new paper form. It comes into force tomorrow, Tuesday July 1. Objective: to fight against fraud, which multiply.
Fraud estimated at more than 30 million euros
Indeed, in the era of teleconsultation and fraud sites, nothing easier to afford, for a few tens of euros, a false work stoppage. So much so that these false documents have led to fraud estimated at more than 30 million euros. To fight against this phenomenon, health insurance squeezes the screw and sets up a new secure paper form.
While almost 80 % of stops are now transmitted online, some cases still require the paper format. From now on, these versions must imperatively use the new model, with seven authentication devices, under penalty of being rejected.
What changes with the new paper form
Since September 2024, this form was only recommended. From now on, it becomes compulsory for stops in paper format. The objective? Make falsification impossible.
For this, the document incorporates specific security elements:
- An infalcyable special paper;
- A holographic label;
- Magnetic ink;
- A single identification code of the prescriber;
- And four other control points not revealed.
In addition, this form is prohibited for reproduction: any scan or photocopy will automatically be rejected by health insurance funds. Even leaves for documents generated from software, then printed without going through official remote transmission.
Teletransmission or paper: what the insured must know
For the vast majority of situations, healthcare professionals already use Amelipro, the secure health insurance platform. Thanks to it, 8 out of 10 work stoppages are sent directly from the doctor’s computer to state services.
This system is privileged for its speed and reliability.
But there are still cases where paper is necessary: home consultation, computer failure, or white areas. In these cases, the patient receives the Cerfa form in three components, to be distributed between the CPAM and the employer (or France work).
What are the risks in the event of work stoppage fraud?
In addition to these new forms, health insurance also strengthens sanctions, towards cheaters. In case of fraud, there will be:
- The full reimbursement of the allowed allowances;
- A fine of up to the amount of the damage three times;
- And up to 5 years in prison and € 375,000 fine for false and use of false, in the event of recurrence.
This should dissuade more than one.
Health insurance finally recalls that no work stoppage can be obtained without consultation or teleconsultation with a health professional. And that in the event of teleconsultation, the work stoppage or the renewal of work stoppage cannot exceed a period of three days if the prescriber is neither the attending physician nor the referent midwife.