With the theme “Fighting health insurance fraud: tools, roles and responsibilities of stakeholders (policyholders, delegated organizations and healthcare providers) “, the union committee of the Caisse Nationale d’Assurance Maladie (Canam) organized Canam Day . The general aim of the 4th edition of this meeting was to define the strategies being implemented to combat compulsory health insurance fraud effectively..
An overview of the situation shows that This fraud exists in various forms, notably : the cost of services not in line with the conventional tariff, unauthorized services, various forms of identity theft, billing fictitious insured persons, the use of CMSS insured persons’ numbers (State civil servant) for the benefit of INPS voluntary insured persons.
To put Canam on a solid footing we have embarked on the road to ISO9001 version 2015 certification. With this certificate, we could easily take the Ramu path, which is the perfect illustration of universal will. Coverage will be based on three main mechanisms : compulsory health insurance, medical assistance (Ramed) and mutual health insurance.
M DIAWARA, representative of the Minister of Health.
