The health authority that runs hospitals in Paris revealed on Thursday the amount of debt accumulated by foreign nationals or insurance companies who have not paid their bills for treatment.

According to a report presented by the Assistance Publique – Hopitaux de Paris (AP HP), foreign nationals as well as French people living abroad or probably more to the point their insurance companies, owed a total of €118.6 million as of November 2014. 

AP- HP now intends to put in place a process so the authority can recover what is owed when it treats foreign nationals and has decided to force those seeking health treatment in France to pay upfront.

The country that owes the most is Algeria, whose citizens have racked up a bill of €31.6 million that is yet to be paid, followed by Morocco, which owes €11 million.

Then comes the United States which owes €5.7 million, due to treatment which has either been given to US visitors or French nationals resident in the US.

Next in line comes Belgium (€4.9 million), Tunisia (€4.7 million) and Italy (€4.1 million).

The report revealed that between 2010 and 2014 the number of hospital stays by patients resident abroad rose by almost 10 percent.

The amount does not include the cost of treating foreign nationals resident in France, who will normally be covered by a combination of social security and private insurers.

Since 2013, the AP-HP has applied a 30 percent mark-up on its rates for patients living abroad (excluding emergencies or where there is reciprocal agreements in place with other countries).

That mark-up was worth around €10 million to the AP-HP in 2014.

Treating foreign patients can be a money earner for Paris’s 38 public hospitals which are under pressure to make €150 million worth of cuts.

The authority wants to boost its service to foreign nationals but at the same time stem the rise on the number of unpaid bills.

So from September onwards foreign patients or companies will have to pay in advance for any treatment given at state hospitals in Paris.

The amount will be calculated on the cost of a day plus the 30 percent mark-up.  

If no payment is received the hospitals will refuse to accept the patients.