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Amendement 1044 — art. 5 #1386

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Théo Bernhardt
f27c6f16a4 Amendement 1044 — art. 5 
Dispositif :

    I. – À l'alinéa 15, supprimer les mots :
    « , à l'exclusion des finalités mentionnées au 2° de l'article L. 135‑2 du présent code ».
    II. – En conséquence, à l'alinéa 39, supprimer les mots :
    « , à l'exclusion des finalités mentionnées au 2° de l'article L. 211‑17 du présent code ».
    III. – En conséquence, à l'alinéa 70, supprimer les mots :
    « , à l'exclusion des finalités mentionnées au 2° de l'article L. 931‑3‑10 du présent code ».

Exposé sommaire :

    Cet amendement supprime la restriction introduite en commission des affaires sociales, qui exclut explicitement les finalités de contrôle et de lutte antifraude des échanges de données autorisés dans le cadre du tiers payant.
    Le projet de loi vise prioritairement à renforcer les moyens de détection et de sanction des fraudes sociales, y compris celles affectant les organismes complémentaires d'assurance maladie. Le tiers payant représente une part très majoritaire des actes et prestations remboursés ce qui en fait un vecteur essentiel des remboursements mais aussi un point vulnérable aux fraudes organisées.
    Exclure les finalités de contrôle antifraude des données transmises pour le tiers payant créerait un cloisonnement artificiel, rendant plus difficile la vérification a posteriori des actes remboursés directement. Cela irait à l'encontre de l'objectif de recouvrer efficacement les sommes indues et de préserver l'intégrité du système de protection sociale, au bénéfice des assurés honnêtes et des finances publiques.
    Cet amendement rétablit ainsi la cohérence de la version initiale du texte, sans créer de nouveaux droits ni élargir les accès : les transmissions restent limitées aux données strictement nécessaires, sur demande ciblée et proportionnée, et réservées aux personnels habilités soumis au secret professionnel renforcé. Les documents de santé font déjà l'objet de garanties spécifiques.
    Par ailleurs, ce dispositif s'aligne pleinement sur les délibérations de la CNIL ont jugé le cadre proportionné et sécurisé pour les flux existants en tiers payant et pour la lutte antifraude, sans accès massif à des données sensibles et avec un encadrement strict.

Sort : Tombé | Déposé le 20/02/2026
Source : https://www.assemblee-nationale.fr/dyn/opendata/AMANR5L17PO838901BTC2250P0D1N001044.xml

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Angit-Diff: auto
 2026-02-20 12:00:00 +02:00