#SFHS2611637AFrance removes several AMOENA breast prosthesis models from reimbursement
AI-generated summary for informational purposes only. Not legal advice. See the original source for the authoritative text.
This order removes a set of AMOENA external silicone breast prostheses from the French reimbursable products list as of 30 April 2026. It mainly affects healthcare providers, pharmacies, and patients who rely on reimbursement for these specific models, including standard, technical, and adhesive versions. In practice, companies and prescribers should check which AMOENA models remain covered and prepare for claims to stop after the end date. The order takes effect the day after publication in the Official Journal.
AI-generated summary. May contain errors. Refer to official sources for legal decisions.
Key Changes
- Several AMOENA external silicone breast prosthesis codes are amended so their reimbursement ends on 30 April 2026.
- The affected list includes standard models, technical non-adhesive models, and technical adhesive models.
- The order applies from the day after publication in the Official Journal, so claims after the end date should be planned for cutoff.
Obligations
What this law requires
Healthcare providers, pharmacies, and other reimbursement claimants must stop seeking French social security reimbursement for the AMOENA external breast prosthesis models listed under codes 2464376, 2461679, and 2483445 after the end of coverage date of 30 April 2026.
Prescribers must verify that any AMOENA breast prosthesis prescribed remains on the reimbursable list before issuing prescriptions for reimbursement purposes, because the specified models are removed from coverage as of 30 April 2026.
Companies distributing AMOENA external silicone breast prostheses must update product and claims workflows so that reimbursement claims are not filed for the removed models after 30 April 2026.
Stakeholders must distinguish between AMOENA models that remain reimbursable and those specifically removed by this order, and limit reimbursement requests only to models still covered under the LPPR nomenclature after 30 April 2026.
The order applies from the day after its publication in the Official Journal of the French Republic; affected parties must implement the reimbursement change from that effective date.