The local agencies of the CNAMTS provide reimbursements to patients for medical services, audit patient claims and perform other administrative tasks. However, they are sometimes in charge of very large populations and territories and have mixed results (Auvigne etal., Beyond the convergence of the different administrative structures to best practices, lowering the number of special regimes would reduce complexity, thereby improving efficiency and co-ordination, notably in revenue collection (Cour des comptes, 2015).