French health insurance inspectors urge focus on professional fraud

A report from the General Inspectorates of Finance (Igf) and Social Affairs (Igas) recommends that the French health insurance system (Assurance Maladie) shift its anti-fraud focus toward healthcare professionals rather than individual policyholders to increase efficiency.

Data indicates that while individual fraud accounts for many cases, a small number of high-value files involving professionals represent the majority of financial losses. Specifically, approximately 3% of fraud cases, which often involve healthcare practitioners, account for 60% of the total financial prejudice. In 2025, fraud from liberal healthcare professionals and those posing as such represented 73.5% of the €723 million in fraud detected and stopped by the health insurance fund.

The report suggests that current anti-fraud efforts are disproportionately spent on small files—30% of cases involve losses under €1,000, mostly from individuals. To improve returns, inspectors propose tightening third-party payment procedures and strengthening requirements for the use of the Vitale card to prevent misuse and preserve the sustainability of the social security system.