Quality & safety audits
Assistance during unannounced or scheduled audits (HAS, ARS, IGAS) on the quality of care, safety and compliance with good practice.
→ Health · Sub-expertise
Audits by the ARS (regional health agency) may concern the quality of care, compliance with authorisations, activity-based (T2A) billing, and technical conditions. They may result in injunctions, suspensions of authorisation, or even criminal sanctions. We support establishments during audits and in litigation.
→ What we cover
Assistance during unannounced or scheduled audits (HAS, ARS, IGAS) on the quality of care, safety and compliance with good practice.
Defence during T2A audits by the health insurance fund: analysis of the disputed files, defence of the coding, management of overpayments and penalties.
Defence against an audit on compliance with the conditions of the authorisation (equipment, staff, organisation), risk of withdrawal or suspension.
Defence against the sanctions contemplated: injunction, formal notice, suspension of authorisation, withdrawal, financial penalties.
Appeals to the administrative court and the higher courts against unfavourable ARS decisions, application for suspension.
Coordination in the event of parallel proceedings (ARS sanctions, criminal proceedings, civil liability action, CPAM audit) for a coherent strategy.
→ Our approach
01
Immediate mobilisation upon notification of the audit, securing the files, support during the on-site operations.
02
Analysis of the grievances, drafting of the responses to the observations, negotiation of the outcomes of the audit.
03
Defence against the sanctions contemplated: factual and legal challenge, request for an undertaking rather than a sanction, negotiation.
04
Appeals to the administrative court (interim suspension proceedings, action on the merits), appeal proceedings, support with any enforcement.
→ Who we help
Defence of an establishment facing a T2A audit resulting in a significant overpayment: challenge of the reclassified files, negotiation, appeal before the amicable-appeals commission.
Defence against a decision by the ARS to partially suspend activity following a serious adverse event: interim suspension proceedings before the administrative court, defence on the merits.
Support during an audit of compliance with the technical operating conditions, implementation of corrective actions, securing the renewal of the authorisation.
Defence of an establishment and its executives facing criminal proceedings following a serious accident, aligned with the defence before the ARS and the civil actions of the families.
→ Q&A
Several authorities: the ARS (authorisations, quality), the HAS (certification), the health insurance fund (pricing, T2A), the IGAS (ad hoc missions), the prefectural services. Coordinating the defence strategies is essential in the event of parallel audits.
A prior request for reconsideration to the ARS, then a contentious appeal to the administrative court within 2 months. In the event of urgency (suspension of activity), interim proceedings may be filed to suspend the decision pending the proceedings on the merits.
The identification of irregularities may lead to an overpayment (reimbursement of sums wrongly received) and penalties (in the event of a serious or repeated irregularity). The sums can be very significant, with an impact on cash flow and continuity of activity.
Maintain rigorous documentation at all times (patient records, quality procedures, traceability), train teams on how to conduct themselves, identify in advance the legal contacts who can be mobilised. Continuous preparation is more effective than an emergency response.
→ Go further
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