Three Nurses in Roquebrune-Cap-Martin Accused of Insurance Fraud Totaling Nearly €1 Million
The nurses face charges for false billing practices linked to the Health Insurance system, with a significant rise in fraud cases reported in 2024.
Authorities in France have uncovered an extensive insurance fraud scheme involving three private nurses from Roquebrune-Cap-Martin, who are alleged to have defrauded the Caisse Primaire d’Assurance Maladie (CPAM) of nearly €1 million over a three-year period.
The charges include submitting false claims for medical services and travel expenses, as well as duplicating certain service fees.
The sums involved are substantial, with one nurse implicated in €450,000, another in €300,000, and the third in €215,000.
A thorough investigation, conducted by CPAM agents in collaboration with specialized gendarmerie units, revealed the infringement through the analysis of thousands of documents.
In response to the allegations, the defense has claimed the discrepancies are due to simple input errors; however, the CPAM's attorney has asserted that such significant amounts cannot be attributed to unintentional mistakes.
Prior to their trial set for December, the three nurses have been placed under judicial control, which includes mandatory reporting and a prohibition on practicing their profession.
The prosecution has already secured the seizure of €700,000 worth of assets, including real estate, in anticipation of potential confiscation stemming from the case.
The simultaneous trial of the three individuals raises questions about a possible connection among them, suggesting potential coordination or complicity in the alleged fraud; however, no official details have confirmed organizational links, and legal representatives from both sides have refrained from making statements on the matter.
This case comes in light of increased attention to healthcare fraud.
In 2024, an estimated €628 million in fraudulent activities within the Health Insurance system were detected, representing a 35% increase from the previous year.
Among those accused of fraud, healthcare professionals account for a significant portion, comprising 68% of the identified and intercepted irregularities.
Specifically, audiologists have been cited as the most significant contributors to the discrepancies, responsible for €115 million in fraud, followed by pharmacists at €62 million and nurses at €56 million.
In a related development earlier in 2023, a 31-year-old nurse from Nice was prosecuted for allegedly diverting nearly €300,000 from CPAM using similar fraudulent methods during temporary work placements from 2021 to 2022. Previously involved in forgery and fraud cases, she was sentenced in January 2024 to four years in prison, two of which were suspended, alongside a five-year ban on her professional practice and a requirement to repay the funds to the health insurance agency.
The charges include submitting false claims for medical services and travel expenses, as well as duplicating certain service fees.
The sums involved are substantial, with one nurse implicated in €450,000, another in €300,000, and the third in €215,000.
A thorough investigation, conducted by CPAM agents in collaboration with specialized gendarmerie units, revealed the infringement through the analysis of thousands of documents.
In response to the allegations, the defense has claimed the discrepancies are due to simple input errors; however, the CPAM's attorney has asserted that such significant amounts cannot be attributed to unintentional mistakes.
Prior to their trial set for December, the three nurses have been placed under judicial control, which includes mandatory reporting and a prohibition on practicing their profession.
The prosecution has already secured the seizure of €700,000 worth of assets, including real estate, in anticipation of potential confiscation stemming from the case.
The simultaneous trial of the three individuals raises questions about a possible connection among them, suggesting potential coordination or complicity in the alleged fraud; however, no official details have confirmed organizational links, and legal representatives from both sides have refrained from making statements on the matter.
This case comes in light of increased attention to healthcare fraud.
In 2024, an estimated €628 million in fraudulent activities within the Health Insurance system were detected, representing a 35% increase from the previous year.
Among those accused of fraud, healthcare professionals account for a significant portion, comprising 68% of the identified and intercepted irregularities.
Specifically, audiologists have been cited as the most significant contributors to the discrepancies, responsible for €115 million in fraud, followed by pharmacists at €62 million and nurses at €56 million.
In a related development earlier in 2023, a 31-year-old nurse from Nice was prosecuted for allegedly diverting nearly €300,000 from CPAM using similar fraudulent methods during temporary work placements from 2021 to 2022. Previously involved in forgery and fraud cases, she was sentenced in January 2024 to four years in prison, two of which were suspended, alongside a five-year ban on her professional practice and a requirement to repay the funds to the health insurance agency.
