82 E DENTAL CARE NETWORKS Dental surgeons: fined for boycott Following a referral from Santéclair, and after conducting unannounced inspections in 2015 and an in-depth investigation, the Autorité fined the National Council and five departmental councils of the Order of dental surgeons a total of €4 million, as well as two federations of dentists’ unions (the FSDL and the CDF), for having implemented boycott practices against dental care networks (in particular Santéclair, Kalivia, Itélis) proposed by complementary health insurance organisations. THE FINANCING OF DENTAL of complementary health insurance sche- CARE IN FRANCE AND HEALTH mes to manage the constantly rising costs R CARE NETWORKS of health expenditure in the sectors in which COMPLIANCE: they are the main funders (ophthalmic, den- ADVICE TO The dental care expenditure budget in tures or hearing aids). The existence and UNDERTAKINGS France is considerable (€11.3 billion in characteristics of the care networks avai- Seeking to act as 2017) and the statutory health insurance lable to policyholders are a fundamental a concerted obstacle scheme only bears the cost of a relatively aspect of the competitive positioning of to the entry or small proportion of this expenditure (33.2%complementary health insurance sche- development of in 2017). Complementary health insurance mes, particularly in respect of businesses, another actor in schemes (OCAM) therefore play a signifi- which pay particular attention to the exis- the market exposes cant role in their funding (40.9% of den- tence of networks when they choose a com- you to boycott tal health expenditure in 2017), with a sanctions. plementary health insurance scheme for very substantial excess to be funded by their employees. The legal framework for households (22.2%), which is one of the care networks was established by Law main reasons for foregoing care. 2014-57 of 27 January 2014, known as the Law Le Roux, to enable mutual insurance Care networks are established on the basis companies to adopt differentiated rates of of agreements concluded between comple- reimbursement depending on whether the mentary health insurance schemes and policyholder uses a care network or not. health professionals and reflect the desire A T L T H C A R E • H E A L T H C A R E • H E I A N L T TROPER LAUNNA 0202 – erutuf evitisop erom a gniretsoF H S C A H R E O • H