VIJAYAWADA: Finally, the State government is going ahead with clinical audit of all those private hospitals that are offering medical services under the NTR Vaidya Seva scheme.
The AP Medical Services and Infrastructure Development Corporation (APMIDC), which invited tenders for clinical audit, has selected an agency for entrusting the task.
Meanwhile, members of the Indian Medical Association (IMA) are opposing the clinical audit.
With allegations against several private hospitals for indulging in manipulation of medical bills and committing other irregularities while treating the people having NTR Health Card, the APMIDC has decided to conduct clinical audit.
In April this year, the APMIDC issued a tender notification for selecting an agency to conduct the audit of NTR Vaidya Seva scheme. The tenders were opened on May 10 and closed on May 31.
In March also, the APMIDC tried to invite tenders, but due to stiff opposition from the doctors of private hospitals, it dropped the plan.
Now, the APMIDC has selected an agency through the tender process and NTR Vaidya Seva Trust is framing the guidelines for the audit.
According to the tender notification, the scheme consists of more than four lakh pre authorisations, which have been given since June 2014 in government institutions alone.
Apart from this, approximately 1.2 million authorisations have been given in private institutions. As many as 1.5 million surgeries or therapies have been performed under the scheme since June 2014 and of the total more than 70 per cent of them have been done in the private sector. The total amount preauthorised for the inpatient procedures has been approximately around `4,400 crore. Further, almost 75 per cent of the amount has been allocated to the private sector.
In 2015 alone, there were 3,21,671 claim cases, resulting in an outgo of about `815 crore. Since 2014, there have been over 16 lakh claim cases and to this the total amount paid was `4,428 crore.
Speaking to TNIE, Dr Ravi Pattanshetti, CEO of Dr. NTR Vaidya Seva Trust, said, “The government has taken the decision to conduct the clinical audit.
The APMIDC has invited tenders and selected the agency to do the audit. “Currently, we are framing guidelines and procedures to perform the clinical audit, which will be completed soon.”
Meanwhile, the IMA members are vehemently opposing the clinical audit stating that there is no such audit for the treatment given by a doctor in the entire world. Dr N Appa Rao, former president of IMA, AP Chapter, says, “This is one of the wrong decisions taken by the government and we are strongly opposing it.”
“There is no stipulated process to determine the treatment that we have given or the surgery that we performed, since the condition of the patient varies from case to case. For a simple fever, one may require a tablet and another may need IV fluids or some serious medication. We are not going to support the clinical audit.”
Medical bill
4 lakh pre-authorisations have been given in government institutions since June 2014
1.2 million
authorisations have been given in private institutions
As many as
1.5 million surgeries or therapies have
been performed under
the scheme
Over 16 lakh claim cases with a total amount of R4,428 crore since 2014
3,21,671 claim cases in 2015 with an outgo of
K815 crore