Restructuring & insolvency lawyer — Dental centres, medical centres & outpatient healthcare sector

Sector scope

Dental, ophthalmology and multi-disciplinary health centres, multi-professional health homes, group practices and professional practice companies, imaging and laboratory centres, technical platforms and multi-site operators.

Sector context

Health centres are run by non-profit bodies or companies under a specific approval and supervision regime. The model relies on high upfront investment (technical equipment, fit-out, recruitment) amortised against publicly reimbursed revenue whose timing depends on health insurance payments. Deconventioning, suspension of activity or recovery of overpayments can abruptly interrupt collections while lease, equipment and payroll costs continue. Distress therefore requires French insolvency law and healthcare and professional conduct rules to be analysed together.

Key legal issues

• Approval and supervision of health centres: health project and operating rules, approval, and the regional health agency's powers of inspection, suspension and closure (Arts. L. 6323-1 et seq. of the Public Health Code, in particular L. 6323-1-11 and L. 6323-1-12).
• Relations with the health insurance fund: conventioned status, direct billing, audits and recovery of overpayments (Art. L. 133-4 of the Social Security Code), with deconventioning having an immediate cash impact.
• Professional independence and ethics: prohibition of fee-sharing and of patient referral inducements, practitioners' freedom of prescription, and practice agreements subject to review by the relevant professional council.
• Practice structures: professional practice companies and financial holding companies governed by Act No. 90-1258 of 31 December 1990 and Ordinance No. 2023-77 of 8 February 2023, and the allocation of capital and voting rights.
• Equipment financing: leasing and hire of chairs, imaging systems and equipment, retention of title clauses and the true perimeter of saleable assets.
• Commercial lease and fit-out: unamortised fit-out investment, permitted use, and compliance and accessibility of premises open to the public.
• Staff and practitioners: a mix of employees and self-employed practitioners, possible reclassification, employee claims and the AGS scheme, and works council information and consultation.
• Continuity of care and medical records: duties to retain and transfer records, hosting of health data, and the treatment of data on a sale or liquidation.

How a matter is handled

1. Diagnosis: review of available cash, due and payable liabilities, tax and social security instalments and existing security, in order to establish whether cessation of payments is characterised (Art. L. 631-1 Commercial Code).
2. Choice of procedure: arbitration between confidential out-of-court tools (ad hoc mandate, conciliation) and formal proceedings, in light of the sector's own timetable.
3. Negotiation: discussions with banks, strategic suppliers, the AGS wage guarantee scheme, the tax authorities and URSSAF, and where relevant before the CCSF.
4. Implementation: preparation of the filing, representation before the commercial courts, monitoring of the observation period, and preparation of the plan or of the sale.

French procedures at a glance

A declaration of cessation of payments must be filed within 45 days of that state arising, unless a conciliation request is filed within the same period (Art. L. 631-4 of the French Commercial Code).

Frequently asked questions

Can a health centre be placed in insolvency proceedings?

Yes. French insolvency proceedings apply to any private-law legal entity and to any self-employed person, including healthcare professionals and managing associations (Arts. L. 620-2, L. 631-2 and L. 640-2 Commercial Code), subject to healthcare and professional conduct rules that continue to apply.

What happens if the regional health agency suspends activity?

Where a breach compromises the quality and safety of care, the director general of the regional health agency may suspend or close all or part of a health centre (Art. L. 6323-1-12 of the Public Health Code). The resulting loss of reimbursed revenue must be factored immediately into the cash-flow diagnosis.

Can a claim for recovery of overpayments be challenged in the proceedings?

The health insurance body must file its claim in the proceedings under Art. L. 622-24 Commercial Code. The claim may be disputed before the supervising judge, without prejudice to the specific remedies available in social security litigation.

Can a dental centre be acquired by a third party?

The court may adopt a sale plan where the statutory conditions are met (Art. L. 642-1 Commercial Code). Operation by the purchaser additionally requires compliance with the regime applying to health centres, including the transfer or obtaining of authorisations and compliance with capital ownership rules for practice structures.

How are patient medical records dealt with?

Duties of retention, confidentiality and transfer of medical records continue regardless of the proceedings. Their handling, including on cessation of activity, must be settled with the liquidator or administrator and, where relevant, with the regional health agency and the competent professional council.

Contact

Phone: +33 1 45 03 20 20
Email: accueil@macmahon-avocats.fr
Address: 33 avenue Mac-Mahon, 75017 Paris, France

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