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Le rapport CDF-25604 estime à 743 millions de francs les avantages accordés en 2024 dans le seul domaine des médicaments. Seuls 88 millions auraient été répercutés. Tout le solde n’est pas nécessairement illicite, mais le CDF considère que 266 millions d’escomptes et déductions comparables à des rabais devraient être restitués. L’OFSP manque de données et n’avait encore jamais ordonné de répercussion lors de l’audit.

Le même problème touche les analyses de laboratoire. L’OFSP reconnaît désormais que les « fees for service » sont une double rémunération à répercuter intégralement. Leur suppression dès juillet 2026 ne règle pas le passé.

Les avantages ne prennent pas seulement la forme de rabais explicites. Des prestations en nature ou des conditions préférentielles, notamment la mise à disposition gratuite ou à prix réduit de locaux, d’appareils ou d’équipements ainsi que les cadeaux, peuvent avoir le même effet économique. Elles doivent donc être incluses dans le contrôle afin d’éviter les contournements.

Pour rendre l’examen du passé praticable, tous les fournisseurs de prestations doivent faire vérifier de manière indépendante les dix dernières années et déclarer puis rembourser les écarts. Une déclaration spontanée accompagnée d’un remboursement intégral doit être traitée comme la régularisation d’une non-répercussion par négligence et ne pas entraîner de sanction au titre de l’art. 92 LAMal. Cette incitation doit permettre de récupérer rapidement des montants sans multiplier les procédures.

Enfin, un contrôle systématique n’est crédible que si l’OFSP dispose temporairement de ressources suffisantes.

Les compétences sont fragmentées: l’art. 82a LAMal vise les médicaments et dispositifs, tandis que les autres prétentions reposent sur les assureurs ou assurés, souvent privés des informations nécessaires. Une décision arbitrale récente a en outre retenu un délai de cinq ans. Cet argent provient des primes et doit revenir aux assurés.

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Le Conseil fédéral est chargé d’identifier et de faire récupérer tous les avantages directs ou indirects qui, en violation de l’art. 56 al. 3 LAMal, n’ont pas été répercutés sur les assureurs ou les assurés ou utilisés conformément à l’art. 56 al. 3^bis LAMal. Lorsque la Confédération est compétente, elle les récupère ou en ordonne le recouvrement. Dans les autres cas, elle le coordonne et s’assure que les titulaires des prétentions agissent.

Cette opération couvre les dix années précédant le dépôt de la présente motion et la période écoulée depuis. Elle vise tous les acteurs et toutes les prestations remboursées par l’AOS, notamment les rabais, ristournes, « cashbacks » et « fees for service », ainsi que les avantages indirects ou en nature, tels que la location de locaux à des conditions préférentielles, les cadeaux ou la mise à disposition d’appareils à prix réduit liés aux médicaments, dispositifs médicaux, analyses de laboratoire ou toutes autres prestations.

Au besoin, le Conseil fédéral propose les bases légales permettant d’obtenir de toute personne ayant accordé ou reçu ces avantages l’identité des bénéficiaires, les montants et les justificatifs; d’ordonner ou de coordonner leur recouvrement; et de prévoir un délai de restitution de dix ans ainsi que les dispositions transitoires nécessaires et d’obliger tous les fournisseurs de prestations à faire établir par un organe de révision indépendant, pour les dix dernières années, une attestation indiquant si tous les avantages ont été répercutés ou utilisés conformément à la loi; tout écart doit être déclaré et remboursé.

En cas de déclaration spontanée et de remboursement intégral, la non-répercussion est réputée avoir été commise par négligence et n’entraîne pas de sanction au titre de l’art. 92 LAMal.

Le Conseil fédéral alloue à l’OFSP, pour une durée de sept ans, des ressources nécessaires pour mener cette tâche à bien

Les sommes récupérées doivent revenir intégralement et de manière vérifiable aux assurés, notamment par une restitution, une compensation ou une diminution des primes.

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Tile size shows how often a word is used.","topics_all_time","All time","topics_last_4y","Last 4 years","topics_last_8y","Last 8 years","topics_from","topics_to","topics_speeches","speeches","topics_words","words (filtered)","topics_distinct","distinct words","topics_uses","uses","topics_alt","Treemap of the {count} most-used words, sized by how often each is used. {ctx}","topics_table_alt","Table of the {count} most-used words and how often each is used. {ctx}","topics_table_toggle","Show as table","topics_table_word","Word","topics_empty","No speeches with usable text in this period. Try widening the range.","loyalty_title","Party loyalty","loyalty_subtitle","Share of a member's votes cast against their group's majority line (higher = more independent). Abstentions count as a position.","loyalty_axis","Dissent rate: share of votes against own group","loyalty_dissent","dissent","loyalty_ballots","votes","loyalty_empty","No votes in this period meet the thresholds for a loyalty score. Widen the range.","loyalty_chart_alt","Beeswarm plot of the dissent rate of {count} members, one dot per member, coloured by party. {ctx}","loyalty_table_alt","Table of {count} members with their votes, dissents and dissent rate. {ctx}","loyalty_col_member","loyalty_col_party","loyalty_col_group","loyalty_col_ballots","loyalty_col_dissents","Against","loyalty_col_rate","Dissent","loyalty_from","loyalty_to","loyalty_scale","Scale","loyalty_scale_log","Log","loyalty_scale_linear","Linear","loyalty_filters","Filters","cohesion_title","Group cohesion","cohesion_hint","mean Agreement Index (1 = unanimous)","section_alignment","Voting alignment","no_alignment","Not enough shared votes to compare.","view_all_alignment","View full alignment","alignment_agreed_of_shared","agreed on {agreed} of {shared} shared votes","sort_agreement","Agreement","sort_shared","Shared votes","facet_min_shared","Min. shared","min_shared_10","≥ 10","min_shared_20","≥ 20","min_shared_50","≥ 50","min_shared_100","≥ 100","section_body_alignment","body_alignment_subtitle","How members of this chamber vote relative to one another, from the votes they have in common. In the map, members who vote alike sit close together and opponents far apart. Colours are parties, so blocs and coalitions show up as clusters. The grid gives the average agreement between each pair of parties (the diagonal is each party's own internal cohesion).","alignment_from","alignment_to","alignment_view","View","alignment_view_scatter","Map","alignment_view_heatmap","Party grid","alignment_empty","Not enough votes in this window to build the model.","alignment_window_note","Most meaningful within a single legislative period: the model compares members from the votes they have in common. If the window spans an election or a change in composition, members with different terms barely overlap and positions become less comparable.","alignment_no_parties","No party groups to compare in this window.","alignment_scatter_alt","Scatter plot of {count} members placed by how similarly they voted, coloured by party. {ctx}","alignment_pairs","pairs","alignment_heatmap_note","Each cell is the average agreement between members of the two parties (diagonal = a party's internal cohesion). ± is the 95% confidence range and n the number of member-pairs behind it. A small range over many pairs means the alignment is well-established; a wide range means it's only suggestive.","alignment_heatmap_alt","Grid of the average voting agreement between {count} parties. {ctx}","alignment_members_heading","Members","alignment_members_table_alt","Table of {count} members with their agreement with the chamber and with their own party. {ctx}","alignment_col_member","alignment_col_party","alignment_col_votes","alignment_col_chamber","Aligns with chamber","alignment_col_party_align","Within party","alignment_zoom_in","Zoom in","alignment_zoom_out","Zoom out","alignment_zoom_reset","Reset zoom","alignment_filters","section_lobby","Lobby network","lobby_subtitle","The organizations members of this chamber declare in their register of interests, and where those ties overlap. In the network, members are dots (coloured by party) and organizations shared by two or more members are squares. Members who share the same organizations pull together. The breakdown shows how many mandates are paid versus unpaid, and who holds the most.","lobby_empty","No declared interests for this chamber in this window.","lobby_no_shared","No organizations are shared by two or more members here. See the breakdown.","lobby_network_alt","Network graph of {members} members and the {orgs} organizations they share, linked by declared interests. {ctx}","lobby_mandates","mandates","lobby_members_tied","members","lobby_unknown","Unknown","lobby_org_node","Organization","lobby_payment_heading","Paid vs unpaid mandates","lobby_top_orgs","Most-shared organizations","lobby_top_members","Members by mandates","discussion_title","Speech profiles","discussion_intro","Where members sit on a latent axis derived purely from the words they use in their speeches (Wordfish scaling).","discussion_calculating","Scaling speeches…","lobby_calculating","Computing lobby network…","discussion_error","The speech scaling could not be computed.","discussion_converged","Model converged","discussion_not_converged","Model did not fully converge. Read positions with extra caution.","discussion_members_scored","Members scored","discussion_vocab","Vocabulary","discussion_window","Window","discussion_show_all","discussion_show_reliable","Reliable only","discussion_methodology","How this is computed","discussion_range_label","Time range","discussion_range_1y","1 year","discussion_range_2y","2 years","discussion_range_4y","4 years","discussion_range_8y","8 years","discussion_plot_alt","Beeswarm plot of {count} members placed along a word-choice axis, one dot per member. {ctx}","discussion_plot_caption","Each dot is one member, placed by the words they use in their speeches. Members who reach for the same distinctive words sit close together; members who talk very differently sit far apart. So a member's spot isn't assigned by us; it comes out of how they actually speak. For example, someone who keeps saying “tax”, “budget” and “spending” lands far from someone who mostly says “asylum”, “border” and “integration”. Hover any dot for its details. Filled dots have enough speech to place reliably; hollow rings spoke too little, so read their position with caution.","discussion_empty","No speeches are available for this parliament, so its members can't be placed on the axis. This scaling reads the words members actually speak, and the data set only holds speech transcripts for a few parliaments: the federal chambers and a handful of cantons such as Bern, Basel-Stadt or St. Gallen. You can also try a longer time range above.","discussion_empty_sparse","There is too little speech transcript text for this parliament to place its members on the axis. Try a longer time range above.","discussion_pole_a","One pole","discussion_pole_b","Other pole","discussion_col_party","discussion_key_filled","Enough text (reliable)","discussion_key_ring","Below the word floor (low confidence)","discussion_align_title","Does the axis track party?","discussion_align_hint","How much of the spread in positions is explained by party membership (η²): 100% = parties are perfectly separated, ~0% = party tells you nothing.","discussion_align_strong","parties are clearly separated","discussion_align_moderate","parties are partly separated","discussion_align_weak","party barely explains the axis","discussion_poles_title","What the axis is made of","discussion_poles_hint","The words that most pull members towards each pole. The axis only means something once you read these. Its direction is arbitrary.","discussion_no_party","No party","discussion_col_name","discussion_col_position","Position","discussion_col_words","Words","discussion_col_speeches","discussion_low_confidence","low confidence","discussion_table_title","discussion_table_alt","Table of {count} members with their position on the word-choice axis. {ctx}","discussion_read_title","How to read this","discussion_read_direction","The axis direction is arbitrary: Wordfish finds the split, not which side is “left” or “right”. Read the word poles to see what each side means.","discussion_read_uncertainty","Positions are standardized, so the spread is a convention, not a real distance. Wider error bars (and hollow dots) mean less certainty, so don't over-read those members.","discussion_read_confound","Speech style reflects role as much as ideology: committee chairs, ministers and frequent speakers can land at a pole because of what they do, not only what they believe.","organizations_title","organizations_none","No organizations.","org_members","org_mandates","org_bodies","org_members_heading","org_members_table_alt","Table of {count} members with their party, body, role, payment and period. {ctx}","org_no_members","No members.","org_col_member","org_col_party","org_col_body","org_col_role","org_col_payment","Payment","org_col_period","sort_members","sort_mandates","Mandates","interest_unknown","lobby_panel_person","Declared organizations","lobby_panel_org","Members with this mandate","lobby_table_heading","Who is tied to what","lobby_table_explain","The full matrix marks every member against every shared organization: one dot per declared tie, the exhaustive view of who is tied to what.","lobby_table_large","For this chamber that is","lobby_table_cells","cells","lobby_table_show","Show table","lobby_table_alt","Table marking each of {count} members against the {orgs} organizations they are tied to, one dot per declared tie. {ctx}","lobby_select_hint","Select a member or organization to see its ties.","lobby_filters","lobby_error","The lobby network could not be computed.","lobby_clear_selection","Clear selection","close","not_found_person","Person not found","not_found_body","Parliament not found","not_found_affair","Affair not found","not_found_group","Committee or group not found","not_found_voting","Voting not found","not_found_meeting","Meeting not found","not_found_interest","Interest not found","not_found_organization","Organization not found","not_found_text","Text not found","not_found_doc","Document not found","not_found_speech","Speech not found","not_found_hint","There is no entry with the ID {id}. It may have been removed, or the link may be outdated.","not_found_back","Back to the overview","about","About","faq","FAQ","section_title","section_title_bodies","section_title_affairs","section_title_votings","section_title_texts","section_title_docs","section_subtitle_search","section_subtitle_discussion",{"_1585":1586,"_1602":768,"_1603":1604,"_1605":1606,"_1607":955,"_1286":528,"_1260":328,"_97":532,"_1608":535,"_1591":338,"_1609":1610,"_1611":739,"_1393":288,"_94":298,"_1588":440,"_99":308,"_19":538,"_101":318,"_1612":1065,"_1613":1199,"_1614":1235,"_1615":1199,"_1616":1617,"_1618":1199,"_1619":1620,"_1621":528,"_1622":707,"_1623":1199,"_1624":1606,"_1625":532,"_1592":407,"_1626":1627,"_1198":1199,"_1628":645,"_1211":1199,"_92":543,"_1629":1421,"_1630":1278,"_1631":1316,"_1632":1610,"_1633":1405,"_1593":348,"_1634":1397,"_1635":1199},"section_switcher",{"_1583":1584,"_1585":1586,"_1587":288,"_90":484,"_94":298,"_1588":440,"_1589":374,"_1260":328,"_101":318,"_1590":308,"_1591":338,"_1592":407,"_1593":348,"_1594":1595,"_1596":1597,"_1598":1599,"_1600":1601},"section_title_speeches","section_title_groups","section_title_interests","section_title_meetings","section_title_organizations","label_section","Section","home","Home","people","affairs","groups","documents","interests","meetings","organizations","group_parliament","Actors","group_proceedings","Proceedings","group_records","Records","group_lobbying","Lobbying","search","eyebrow","Data on {{name}}","overview","Overview","personal_data","memberships","access_badges","Lobby","images","texts_overview","text_details","docs_overview","doc_details","votings_overview","Voting","voting_details","voting_diagram","Diagram","voting_tally","speeches_overview","speech_details","groups_overview","contributions","interests_overview","Interest","meetings_overview","vocabulary","loyalty","alignment","lobby","discussion","organizations_overview","org_details",{"_1693":1694,"_1695":1696,"_1637":1697,"_239":1698},"intro",{"_1639":1640,"_1641":1642,"_1643":1644,"_1645":1646,"_1647":1648,"_1649":1650,"_1651":1652},"en",{"_1653":1688,"_1655":1689,"_1657":1690,"_1659":1691,"_1661":1692},"de",{"_1653":1683,"_1655":1684,"_1657":1685,"_1659":1686,"_1661":1687},"fr",{"_1653":1678,"_1655":1679,"_1657":1680,"_1659":1681,"_1661":1682},"it",{"_1653":1673,"_1655":1674,"_1657":1675,"_1659":1676,"_1661":1677},"es",{"_1653":1668,"_1655":1669,"_1657":1670,"_1659":1671,"_1661":1672},"pt",{"_1653":1663,"_1655":1664,"_1657":1665,"_1659":1666,"_1661":1667},"rm",{"_1653":1654,"_1655":1656,"_1657":1658,"_1659":1660,"_1661":1662},"cookie","Nus duvrain mo cookies essenzials e funcziunals. Nagina analitica, nagin tracking.","dataLang","La Svizra ha quatter linguas naziunalas, e questas datas datti en pliras da quellas. Intgins records èn plurilings, auters mo en ina lingua. Vus pudais tscherner en tge lingua ch'il cuntegn vegn mussà; sche vossa tscherna n'è betg disponibla per in record, vegnan duvradas las autras linguas en in urden da prioritad fix. Quai è independent da la lingua da l'interfatscha. As lascha reglar sut Configuraziuns › Lingua dal cuntegn (sura a dretga).","alt","Questa pagina è era disponibla per rumantsch.","switch","Mussar per rumantsch","dismiss","Betg pli mussar","Utilizamos apenas cookies essenciais e funcionais. Sem análises, sem rastreio.","A Suíça tem quatro línguas nacionais, e estes dados existem em várias delas. Alguns registos estão em várias línguas, outros apenas numa. Pode escolher em que idioma os conteúdos são apresentados; quando a sua escolha não está disponível para um registo, as restantes línguas são usadas por uma ordem de prioridade fixa. Isto é independente do idioma da interface. Configure em Definições › Idioma dos conteúdos (canto superior direito).","Esta página também está disponível em português.","Ver em português","Não mostrar novamente","Solo utilizamos cookies esenciales y funcionales. Sin análisis, sin seguimiento.","Suiza tiene cuatro lenguas nacionales, y estos datos existen en varias de ellas. Algunos registros están en varias lenguas, otros en una sola. Puede elegir en qué idioma se muestra el contenido; cuando su elección no está disponible para un registro, se utilizan las demás lenguas en un orden de prioridad fijo. Esto es independiente del idioma de la interfaz. 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Certaines entrées sont en plusieurs langues, d'autres dans une seule. Vous pouvez choisir la langue d'affichage du contenu ; si votre choix n'est pas disponible pour une entrée, les autres langues sont utilisées selon un ordre de priorité défini. Ceci est indépendant de la langue de l'interface. Réglable dans Paramètres › Langue du contenu (en haut à droite).","Cette page est aussi disponible en français.","Voir en français","Ne plus afficher","Wir verwenden nur essenzielle, funktionale Cookies. Keine Analyse, kein Tracking.","Die Schweiz hat vier Landessprachen, und diese Daten liegen in mehreren davon vor. Manche Einträge sind mehrsprachig, andere nur in einer Sprache. Sie können wählen, in welcher Sprache die Inhalte angezeigt werden; ist Ihre Wahl für einen Eintrag nicht verfügbar, werden die übrigen Sprachen in einer festen Prioritätsreihenfolge verwendet. Dies ist unabhängig von der Oberflächensprache. Einstellbar unter Einstellungen › Inhaltssprache (oben rechts).","Diese Seite ist auch auf Deutsch verfügbar.","Auf Deutsch anzeigen","Nicht mehr anzeigen","We use only essential, functional cookies. No analytics, no tracking.","Switzerland has four national languages, and this data comes in several of them. Some records are in multiple languages, some in only one. You can choose which language the content is shown in; when your choice isn't available for a record, the remaining languages are used in a set priority order. This is independent of the interface language. Set it under Settings › Content language (top right).","This page is also available in English.","View in English","Don't show again","settings",{"_1761":1762,"_1763":1764,"_1765":1120,"_1766":1767,"_1768":1122,"_1769":1124,"_1770":1771,"_1772":1773,"_1774":1775,"_1776":1777,"_1778":1779,"_593":594,"_1780":1781,"_1782":1783,"_1784":1785,"_1786":1787,"_1788":1789},"nav",{"_1585":1707,"_1708":1709,"_1710":643,"_1711":1712,"_1713":1714,"_1594":1595,"_1596":1597,"_1598":1599,"_1600":1601,"_1587":288,"_90":484,"_1589":374,"_1588":440,"_94":298,"_1592":407,"_1260":328,"_101":318,"_1590":308,"_1591":338,"_1593":348,"_1715":1700,"_1716":1717,"_1563":1564,"_1718":1719,"_1565":1566,"_1720":1721,"_1722":1723,"_1724":1725,"_1726":1727,"_1728":1729,"_1730":1731,"_1732":1733,"_1734":1735,"_1736":1737,"_1738":1739,"_1740":1741,"_1742":1743,"_1744":1745,"_1746":1747,"_1748":1749,"_1750":1751,"_1752":1753,"_1754":1704,"_1755":1756,"_1757":1758,"_1759":1760},{"_1653":1688,"_1655":1689,"_1657":1690,"_1659":1691,"_1661":1692},{"_1699":1700,"_1701":1702,"_1703":1704,"_1705":1706},"project.title","Project","project.desc","About parlhub: what the portal is, answers to common questions, and how the data fits together.","experiments.title","Experiments","experiments.desc","Experimental analyses and methodology showcases on parlhub, including the Wordfish scaling of parliaments from their speeches.","parlhub home","skip_to_content","Skip to main content","explore","start","Start here","start_desc","Quicklinks to chambers, cantons and communes","project","project_desc","The project at a glance","about_desc","What parlhub is and who is behind it","faq_desc","Answers to common questions","sustainability","Sustainability","sustainability_desc","How parlhub is hosted and what it costs the planet","accessibility","Accessibility","accessibility_desc","What works, what doesn't, and how to report a barrier","traffic_stats","Traffic statistics","traffic_stats_desc","Which parts of the site get requested, and by whom","imprint","Imprint","imprint_desc","Who runs parlhub, contact, and the licenses","github","GitHub","github_desc","The project's source code on GitHub","data_guide","Data guide","data_guide_desc","Every kind of data, in plain terms, with examples","data_map","Data map","data_map_desc","How the data fits together, at a glance","methodology","Methodology","methodology_desc","How each figure is calculated, with links to the code","experiments","experiments_desc","Experimental analyses and methodology write-ups","wordfish","Wordfish scaling","wordfish_desc","Placing members on an axis by the words in their speeches","menu_label","Settings","appearance","Appearance","theme","theme_system","System","theme_light","theme_dark","font_size","Font size","font_size_decrease","Decrease font size","font_size_increase","Increase font size","high_contrast","High contrast","grayscale","Grayscale","interface_language","Interface","content_language","Content language","content_language_auto","Auto (follow interface)","content_language_note","Language of the displayed data (names, titles, texts). Independent of the interface; when a record isn't available, the next language is used.","content_language_priority","Priority",{"_1765":1791,"_1770":1792,"_1793":52,"_1794":1795,"_1796":1795,"_1797":52,"_1798":-5},"system",100,"show_cookie_consent_message","ui_high_contrast",false,"ui_grayscale","msg_lang_hint","content_lang"]