{"id":656302,"date":"2026-04-23T07:04:54","date_gmt":"2026-04-23T05:04:54","guid":{"rendered":"https:\/\/kohenavocats.com\/tribunal-judiciaire-de-dijon-le-30-janvier-2026-n22-00033\/"},"modified":"2026-04-23T07:04:54","modified_gmt":"2026-04-23T05:04:54","slug":"tribunal-judiciaire-de-dijon-le-30-janvier-2026-n22-00033","status":"publish","type":"post","link":"https:\/\/kohenavocats.com\/en\/tribunal-judiciaire-de-dijon-le-30-janvier-2026-n22-00033\/","title":{"rendered":"Tribunal judiciaire de Dijon, le 30 janvier 2026, n\u00b022\/00033"},"content":{"rendered":"
\n

Le tribunal judiciaire, statuant en mati\u00e8re sociale, a rendu un jugement le 30 janvier 2026. Une infirmi\u00e8re lib\u00e9rale contestait la r\u00e9gularit\u00e9 d\u2019un redressement op\u00e9r\u00e9 par sa caisse primaire d\u2019assurance maladie. La juridiction a rejet\u00e9 la majeure partie de ses pr\u00e9tentions apr\u00e8s un examen d\u00e9taill\u00e9 des prescriptions m\u00e9dicales litigieuses. Elle a ainsi valid\u00e9 un indu de plus de vingt-cinq mille euros pour inobservation des r\u00e8gles de facturation et de tarification.<\/p>\n

Le cadre proc\u00e9dural et la r\u00e9partition de la charge de la preuve<\/p>\n

La proc\u00e9dure de recouvrement de l\u2019indu ob\u00e9it aux seules dispositions de l\u2019article L. 133-4 du code de la s\u00e9curit\u00e9 sociale. Le juge rappelle que l\u2019action en recouvrement s\u2019ouvre par l\u2019envoi d\u2019une notification pr\u00e9cisant la nature et le montant de l\u2019indu. La caisse \u00e9tablit alors l\u2019irr\u00e9gularit\u00e9 de la facturation par des \u00e9l\u00e9ments pr\u00e9cis et circonstanci\u00e9s. Il appartient ensuite au professionnel de sant\u00e9 contr\u00f4l\u00e9 d\u2019apporter des \u00e9l\u00e9ments pour contester l\u2019inobservation des r\u00e8gles retenue. “La caisse \u00e9tablissant la nature et le montant de l’indu par les \u00e9l\u00e9ments pr\u00e9cis\u00e9s dans le tableau joint \u00e0 sa notification d’indu, il appartient au professionnel de sant\u00e9 d’apporter des \u00e9l\u00e9ments pour contester l’inobservation des r\u00e8gles de facturation et de tarification” (Cour d’appel, le 30 janvier 2026, n\u00b024\/00679). Cette r\u00e9partition de la charge de la preuve, conforme au droit commun, place une obligation probatoire active sur le professionnel contr\u00f4l\u00e9. La d\u00e9cision confirme ainsi la logique administrative du contr\u00f4le, o\u00f9 la notification initiale de l\u2019organisme suffit \u00e0 fonder sa cr\u00e9ance. Le professionnel doit ensuite d\u00e9montrer le bien-fond\u00e9 de sa facturation pour \u00e9chapper au recouvrement.<\/p>\n

Le respect strict de la prescription m\u00e9dicale comme condition de prise en charge<\/p>\n

Le fond du litige repose sur le respect imp\u00e9ratif des conditions l\u00e9gales de remboursement des actes infirmiers. Ceux-ci n\u00e9cessitent une prescription m\u00e9dicale \u00e9crite, qualitative et quantitative pr\u00e9alable. Le juge examine scrupuleusement chaque anomalie reproch\u00e9e au regard de ce principe cardinal. Il rappelle que l\u2019infirmier ne peut modifier la prescription initiale, m\u00eame avec l\u2019accord suppos\u00e9 du m\u00e9decin. “Il r\u00e9sulte de ces dispositions que l’infirmier ne peut s’affranchir des termes de la prescription m\u00e9dicale ni se retrancher derri\u00e8re les erreurs ou omissions du m\u00e9decin prescripteur” (Cour d’appel, le 29 avril 2025, n\u00b023\/00780). La d\u00e9cision sanctionne s\u00e9v\u00e8rement toute alt\u00e9ration des ordonnances, y compris par ajout de fr\u00e9quence ou de mention m\u00e9dicale. De telles pratiques, qualifi\u00e9es de montage de prescription, sont consid\u00e9r\u00e9es comme constitutives de faux. Elles rendent les actes correspondants irr\u00e9m\u00e9diablement non remboursables, m\u00eame si les soins ont \u00e9t\u00e9 r\u00e9ellement prodigu\u00e9s. Le juge \u00e9carte \u00e9galement les justifications a posteriori, comme les attestations ou nouvelles ordonnances \u00e9tablies apr\u00e8s le contr\u00f4le.<\/p>\n

La port\u00e9e de cette d\u00e9cision est significative pour l\u2019exercice lib\u00e9ral des professions param\u00e9dicales. Elle r\u00e9affirme avec force le caract\u00e8re intangible de la prescription m\u00e9dicale comme fondement exclusif de la facturation. L\u2019autonomie de l\u2019infirmier dans son r\u00f4le propre ne lui conf\u00e8re aucun pouvoir d\u2019adapter ou de compl\u00e9ter une ordonnance d\u00e9faillante. Sa seule obligation en cas de prescription incompl\u00e8te ou inadapt\u00e9e est d\u2019en solliciter une nouvelle, en amont des soins. La d\u00e9cision consacre une approche tr\u00e8s formelle, prot\u00e9geant l\u2019int\u00e9grit\u00e9 du processus de prescription et les deniers de l\u2019assurance maladie. Elle sert d\u2019avertissement clair contre toute tentative de r\u00e9gularisation a posteriori de facturations irr\u00e9guli\u00e8res.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Le tribunal judiciaire, statuant en mati\u00e8re sociale, a rendu un jugement le 30 janvier 2026. Une infirmi\u00e8re lib\u00e9rale contestait la r\u00e9gularit\u00e9 d\u2019un redresseme…<\/p>\n","protected":false},"author":232070755,"featured_media":9436,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_kj_source_type":"judilibre","_kj_official_id":"68dc3e11b3454b98788dee24","_kj_official_url":"https:\/\/www.courdecassation.fr\/decision\/68dc3e11b3454b98788dee24","_kj_judilibre_id":"68dc3e11b3454b98788dee24","_kj_jur":"Tribunal judiciaire","_kj_lieu":"Tribunal judiciaire de Dijon","_kj_chambre":"CTX PROTECTION SOCIALE","_kj_rg":"22\/00033","_kj_date":"2025-09-30","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[7597],"tags":[],"class_list":["post-656302","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-jurisprudence"],"yoast_head":"\nTribunal judiciaire de Dijon, le 30 janvier 2026, n\u00b022\/00033 - Ma\u00eetre Hassan Kohen, avocat en droit p\u00e9nal \u00e0 Paris<\/title>\n<meta name=\"description\" content=\"Le tribunal judiciaire, statuant en mati\u00e8re sociale, a rendu un jugement le 30 janvier 2026. 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Cette derni\u00e8re avait notifi\u00e9 \u00e0 la professionnelle de sant\u00e9 un indu de 48 275,45 euros et une p\u00e9nalit\u00e9 financi\u00e8re de 5 000\u2026","rel":"","context":"In "Cour d'appel"","block_context":{"text":"Cour d'appel","link":"https:\/\/kohenavocats.com\/category\/cour-dappel\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/ali-lokhandwala-KUr51Y4dOyo-unsplash.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/ali-lokhandwala-KUr51Y4dOyo-unsplash.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/ali-lokhandwala-KUr51Y4dOyo-unsplash.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/ali-lokhandwala-KUr51Y4dOyo-unsplash.webp?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/ali-lokhandwala-KUr51Y4dOyo-unsplash.webp?resize=1050%2C600&ssl=1 3x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/ali-lokhandwala-KUr51Y4dOyo-unsplash.webp?resize=1400%2C800&ssl=1 4x"},"classes":[]},{"id":439749,"url":"https:\/\/kohenavocats.com\/en\/cour-dappel-de-pau-le-5-mars-2026-n24-01012\/","url_meta":{"origin":656302,"position":5},"title":"Cour d’appel de Pau, le 5 mars 2026, n\u00b024\/01012","author":"Kohen","date":"27 March 2026","format":false,"excerpt":"L\u2019arr\u00eat rendu par la Cour d\u2019appel de Pau, chambre sociale, le 5 mars 2026, statue sur un litige opposant une infirmi\u00e8re lib\u00e9rale \u00e0 sa caisse primaire d\u2019assurance maladie. La caisse avait notifi\u00e9 un indu apr\u00e8s contr\u00f4le de facturation. L\u2019infirmi\u00e8re contestait cette notification pour violation du principe du contradictoire. Le tribunal\u2026","rel":"","context":"In "Cour d'appel"","block_context":{"text":"Cour d'appel","link":"https:\/\/kohenavocats.com\/category\/cour-dappel\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/daphne-be-frenchie-atTJIQ5kk3E-unsplash.webp?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/daphne-be-frenchie-atTJIQ5kk3E-unsplash.webp?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/daphne-be-frenchie-atTJIQ5kk3E-unsplash.webp?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/daphne-be-frenchie-atTJIQ5kk3E-unsplash.webp?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/daphne-be-frenchie-atTJIQ5kk3E-unsplash.webp?resize=1050%2C600&ssl=1 3x, https:\/\/i0.wp.com\/kohenavocats.com\/wp-content\/uploads\/2024\/08\/daphne-be-frenchie-atTJIQ5kk3E-unsplash.webp?resize=1400%2C800&ssl=1 4x"},"classes":[]}],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/posts\/656302","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/users\/232070755"}],"replies":[{"embeddable":true,"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/comments?post=656302"}],"version-history":[{"count":0,"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/posts\/656302\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/media\/9436"}],"wp:attachment":[{"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/media?parent=656302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/categories?post=656302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kohenavocats.com\/en\/wp-json\/wp\/v2\/tags?post=656302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}