- A "denial bonus"? This is how some internet users qualify, on Facebook, figures relayed on the LCI antenna.
- The photo in question shows the prices - from 2 to 55 euros - which doctors would benefit from for consultation and monitoring of patients with Covid-19 in addition to a "classic" consultation.
- This system is well planned as part of the screening and isolation strategy in which doctors and Health Insurance will participate. The additional cost of the consultation would however be reimbursed to patients.
- The contours of this device are still vague, which gives rise to concerns within the profession as well as among individuals.
If the start of deconfinement is approaching, the work of health professionals to identify patients with Covid-19 in the long term, in order to "break" the chain of contamination, has only just begun. The latter are in fact preparing for a particularly crucial test and follow-up phase to prevent contamination from starting to rise again.
But a specific measure planned in this context feeds speculation and criticism on Facebook, with the help of a shared photo without further details. This shows a graph disseminated on LCI - probably on May 4, before the intervention of Edouard Philippe in the Senate -, on which we can read, below a banner titled "General practitioners mobilized": "55 euros : reporting of a patient with Covid; + 2 euros: surname, first name and date of birth; + 4 euros: contact and security number ”.
"Can someone explain to me?" Please, thank you, "asks the author of the post, eliciting multiple comments with surprising explanations:" Special compensation, is that it? "," The doctors will become scales "," paid denunciation "...
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The measures relayed by this Facebook publication are very real and at the heart of the strategy of tracing infected people planned from May 11 in order to "break" the chains of contamination of Covid-19. As we explained to you at the beginning of the week, in each department, “health brigades” will, once these patients have been identified, “investigate” their entourage to isolate as many people as necessary in order to fight against a restart of the epidemic.
General practitioners will be on the “front line” of this system, according to Edouard Philippe, while health insurance teams will then take over.
“General practitioners will have […] the responsibility, as is already the case, to take care of their patients with Covid-19, to have them carry out a test and to ensure their follow-up throughout their illness. But they will also be invited to strongly engage in the search for their contacts in order to help their identification ”, explained the Assurance maladie from May 2 on its website.
Several increases possible, including one at 30 euros reimbursed by the Social Security
The organization also details the "specific tariff measures" implemented on this occasion, which include the possibility of an increase in the consultation fee of 30 euros (to be added to the usual amount of 25 euros in sector 1) for patients tested positive. An amount which would therefore be paid by the patient but taken into account in the reimbursement of the Health Insurance - once this increase is transmitted by the doctor to the latter.
This price also takes into account "the prescription of tests for close contact cases (people living at the patient's home), the information given to the patient on the barrier measures and the recording in the" Contact Covid "tool [the future Health Insurance file responsible for identifying the patient's “contact cases”] and close contact cases (people sharing the same domicile as the patient). "
Finally, doctors can also obtain additional remuneration if they go back beyond the circle closest to the patient - that is to say beyond people residing in the same home: "2 euros for each contact case with entry of basic elements, 4 euros for each case contact with entry of more complete data. "
Contacted by 20 Minutes , Philippe Vermesch, president of the Syndicate of Liberal Doctors (SML), details the concrete functioning of this system: "If a patient in consultation is potentially Covid +, therefore contaminating, we must ask him for his contact details, those of the family who lives with him, and there would be a check box, through which the patient authorizes the doctor to send this data to Medicare. "
"If the person accepts, we send their contact details to the Health Insurance Fund after having the results of the test, after 24 or 48 hours - during which the person must remain confined to their home - and Health Insurance pays us 30 euros. Then there is an increase of 2 euros per potential contact identified by doctor and 4 euros if the doctor gives all the contact details. But I have no illusions, the doctors will not have time to do this second phase, it will be done by the Health Insurance teams who will call positive people to find out who they have seen in the last days , in order to trace the thread of potential contamination ”, continues Philippe Vermesch.
A device still "vague" which raises several concerns
If the president of the SML considers that the additional remuneration of doctors is not a problem in view of "the extra work that is required of us to ensure this tracking and the already significant investment of doctors, not always paid", he is concerned revenge for the "vagueness" that still prevails around this tracing device.
The health emergency extension bill, adopted at first reading by the Senate, provides, for example, in article 6, that the transmission of patient data in tracing files may be done "without the consent of people interested ”. "But if this follow-up is not compulsory, some patients will tell us" out of the question "when asked if they agree to communicate this data to the Health Insurance. So the big concern is that patients could go back to nature by being positive, ”explains Philippe Vermesch.
In addition, if the increase in this monitoring work is an integral part of the system presented by the Health Insurance, an amendment tabled today during the consultation of the bill in the National Assembly requests to prohibit this remuneration.
"The habit of handling this type of data"
The president of the SNM is far from the only doctor to express concerns about the device. The National Council of the Order of Physicians has indeed requested measures guaranteeing the strict collection and management of this data for patients with Covid-19, and in a limited time, in order to avoid breaches of medical confidentiality.
For its part, Health Insurance reminds 20 Minutes that it "works continuously with health professionals including doctors", especially for work stoppages, and that it "has the habit of handling this type of data, which are subject to extreme vigilance, the protection of medical data [being] at the heart of [its] DNA, in particular respecting instructions issued by the National Commission for Data Protection (Cnil) ” .
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