BHUBANESWAR: A day after private hospitals expressed their reluctance to accept the low package rates and other unrealistic paraphernalia for settlement of bills under the newly-launched Ayushman Bharat-PMJAY and Gopabandhu Jan Arogya Yojana (GJAY), the government on Tuesday issued a stern warning to empanelled private hospitals directing them not to deny treatment to any eligible patient.
Health and Family Welfare minister Mukesh Mahaling cautioned that any negligence or refusal of care to Ayushman cardholders would attract strict legal action. The warning came amid ongoing tension between the state government and private hospitals over issues ranging from technical glitches to unsustainable treatment package rates.
Several hospitals have reportedly expressed their inability to conduct certain procedures due to what they describe as ‘very low-value’ under the health scheme, making it impossible for them to maintain the treatment quality.
Mahaling, however, clarified that the technical bottlenecks in the current system flagged by the hospitals, especially Aadhaar-based OTP authentication related to PAN-India card integration, and OTP verification are being reviewed for active resolution.
On the demands to increase treatment package rates, the minister said, the matter is also being looked into. The state government is examining feedback from various stakeholders, including patients and hospitals, and verifying the cost of treatment under the scheme in other states to come up with a solution that is acceptable to all, he said.
The All Odisha Private Medical Establishments Forum (AOPMEF) has raised several problems warning that the current design of the scheme is financially unviable. Stating that the package rates are at least 15 to 20 per cent less than the previous BSKY scheme, the forum demanded a minimum 30 per cent hike, citing inflation and increasing operational costs.
Forum secretary Dr Indramani Jena said pricing for implants, including Rs 75,000 for pacemakers and Rs 10,000 for spine implants, is unsustainable. While the packages for ortho surgeries, knee replacement and neurological procedures are down by over 15 per cent, Rs 70,300 is being offered for spinal surgery instead of the old rate of Rs 84,000. For a teflon mesh, only Rs 800 allotted for its minimum price of Rs 1,700, he pointed out.
Amid allegations that many beneficiaries are yet to get health cards, Mahaling informed eligible people possessing ration cards with Aadhaar authentication are automatically included. “They can produce the cards as proof of eligibility, or simply show their Aadhaar card to check eligibility at the hospitals until they are provided cards. The state has also used e-KYC drives to onboard more beneficiaries and is working on mechanisms to include those still outside the system,” Mahaling added.