Doctors will now have to justify themselves to Health Insurance so that patients are reimbursed

On October 30, Michel Barnier signed a decree for better control of health insurance reimbursements, which requires doctors to justify their prescriptions to the organization.

The reimbursement of certain medicines by Health Insurance will now be subject to the obligation for health professionals to mention the “circumstances” and the “indications for the prescription”. This decision comes from a decree signed on October 30, 2024 by the Prime Minister, published the following day in the Official Journal.

A lot of information required

An article of the law of December 26, 2023 subjects “the coverage by Health Insurance of a health product and its possibly associated services” to the mention “on the prescription or on a form provided for this purpose by the health professional of elements relating to the circumstances and indications of the prescription”.

This obligation will apply “when this product and, where applicable, its associated services present a particular interest for public health, a financial impact on health insurance expenditure or a risk of misuse”, according to information relayed by our colleagues at Thanks for the info.

The doctor who is treating you will then have to write this information either on the prescription or on a specific document that must be attached to the prescription and accessible via online service, indicating “if the prescription complies with the indications giving entitlement to reimbursement” or with “recommendations of the High Authority for Health (HAS)”.

Anger among doctors' unions

This decision by the government has sparked anger anger among some doctors' unions. The application of these rules “will directly aggravate the difficulties of access to care and increase the loss of opportunities for patients due to an overload of administrative work, unjustified and time-consuming”, estimates the French Union for Free Medicine (UFML).

The mechanism is intended to “restrict medical prescriptions”, to the detriment of patients, states the union in a press release, calling on “the profession to disobey”. Which drugs will be affected ? The National Health Insurance Fund (CNAM) wants to target class “AGLP-1” antidiabetics, such as “Ozempic or Trulicityq”, announced the organization's general director Thomas Fatôme, according to BFMTV.