The Senate wants to eliminate the CASS insured person certificate by 2027

The Senate has adopted a legislative proposal whereby healthcare institutions and service providers will no longer be able to require patients to present a paper-based CASS insurance certificate when insured status can be confirmed directly through the electronic system of the National Health Insurance House. The measure is to be implemented gradually, by 31 December 2027.

What remains unchanged

The bill does not alter the rules governing who holds insured status, nor the obligations relating to the payment of social health insurance contributions (CASS). No new categories of insured persons are being introduced, and the basic healthcare services package remains unchanged. The only significant change concerns the manner in which insured status is proved.

Electronic verification as the primary method of confirmation

Under the proposal, electronic verification of insured status becomes the primary method of confirmation, and its result will carry the same legal weight as a physical certificate. Should written proof be required, the healthcare service provider will be able to generate, download and retain an electronic document, secured by a qualified electronic seal and timestamp, which may be used as evidence.

When a paper certificate may still be requested

A physical certificate may only be requested in exceptional circumstances where electronic verification is not possible — for example, in the event of technical problems, temporary unavailability of IT systems, or inability to identify the individual. In all other cases, if insured status can be verified electronically, the patient may no longer be asked to present a paper document.

Absence of a health card should not mean paying out of pocket

The bill provides that the absence of the national health card or certificate cannot result in healthcare services being provided on a paid basis, provided that insured status is confirmed through the electronic system. The insured person need only supply the data required for verification, without being automatically obliged to present documents.

Exception for those who decline a health card

Persons who decline, on religious or conscientious grounds, to receive the national social health insurance card will continue to be able to receive and use the insurance certificate to prove their status.

Transition period

Until 31 December 2027, both the national social health insurance card and the electronic identity card may be used interchangeably for authentication on the Health Insurance IT Platform and for proving insured status. This transition period is intended to allow IT systems to be adapted accordingly.

The Senate vote

The bill was adopted by the full Senate with 111 votes in favour and two votes against. It is now to be debated by the Chamber of Deputies, which is the decision-making chamber. If adopted and promulgated in its current form, the bill would reduce the need to present physical documents and simplify procedures for patients required to prove their insured status.