18th March 2022
An investigation by French consumer protection officials has found many hospitals are imposing illegal charges on patients.
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The report by the French consumer protection body 'DGCCRF' (Direction générale de la concurrence, de la consommation et de la répression des fraudes), revealed a non-compliance rate of 47% over charges to patients, mainly in the allocation of individual rooms and a lack of pre-contractual information to patients.
The level of non-compliance was 15 percentage points higher than the last study carried out in 2018.
The investigation was undertaken in 17, mainly private, hospitals, which are contracted to the State to provide medical services to patients in the same manner as public hospitals.
Hospitals in France can charge patients for certain services not covered by the social security system, but only subject to an express request by the patient.
The list of such discretionary charges is strictly limited and may include, for example, installation in a single room, but only if it is not the result of a specific medical necessity and it has been the subject of an express request from the patient.
In addition, hospitals must display on their website, and in main receptions areas, the price and the essential characteristics of the services offered.
The DGCCRF's investigation revealed patients were being charged for an unrequested single room when they were in any event required to be in a private room for medical reasons or having their "consent" obtained after they had been installed in the room.
Officials were also critical of the bedside practices of some hospitals, where in many cases the billing of private rooms was triggered by a check box on admission forms when a patient was alone in their room and without them having been able to explicitly express their will.
Thus, during the investigation it was found that the admission form of one hospital included a checkbox with the statement: "I certify that I have been informed of the invoicing of an amount of €9.00 relating to the costs of facilities (payment facilities, reservation of taxis for your relatives or yourself ...) that I undertake to pay directly to the clinic". The report states that acknowledging 'having been informed of' does not mean 'expressly requesting to benefit from' a wide range of services.
A hospital can in no case charge for a single room if this placement results from health considerations, and the billing of a single room, imposed on the patient on the grounds that double rooms are not available, is strictly prohibited.
Hospitals think they can get away with doing so, as the cost of a private room is often covered by the complementary 'top-up' health policy held by a patient and the investigation found that some hospitals even varied the level of the charge by the degree of coverage in the policy.
In most hospitals private rooms in hospitals are generally the norm rather than the exception, so paying a substantial premium on your complementary 'top-up' health policy to be covered for one is questionable.
In many of the hospitals inspected the DGCCRF noted the multiplication of various "outpatient packages " for example including food or comfort services (magazines, improved snacks, etc.), sometimes invoiced systematically. The composition and price of these packages was not always clear or brought to the attention of the patient prior to their subscription.
Some hospitals now offer a wide range of additional services: access card to the car park, fabric bag, maternity items, "wellness kit", bath cape for baby, "wellness massage", photo album to create online, etc.
While such offers are legal, consumer information on the nature of these services was far from fair in the hospitals controlled by the DGCCRF. Thus, the price list of one hospital only included special meals with an additional cost without the content of these food services being detailed or the difference with a standard meal specified.
The use of a premium-rate telephone number to allow patients to contact the hospital was noted during the inspection. This practice is formally prohibited in law and the hospitals concerned were instructed by officials to return to compliance quickly, under penalty of fine.
You can read more about hospital services in France in our guide below.
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