BENGALURU: A pivotal area of the universal health coverage scheme ‘Arogya Karnataka’ that will come into force on Monday is the transition to be made by existing private hospitals empanelled with Suvarna Arogya Suraksha Trust (the government organisation that will run the scheme).
What happens to patients who approach them from today? Will they continue providing services as per existing procedure rates till they apply for empanelment again under Arogya Karnataka?
Ajay Seth, Additional Chief Secretary, Department of Health and Family Welfare, told The New Indian Express, “For each of the existing schemes, a transition plan has been provided. All Rashtriya Swasthya Bima Yojana hospitals are available till March 31. All Yashasvini hospitals are available till June 30. All Vajpayee Arogyashree hospitals are available till May 31. Within those dates, fresh empanelment for Arogya Karnataka shall be taken up starting March 5.”
Currently, there are 164 private hospitals empanelled with Vajpayee Arogyashree Scheme (VAS) meant for Below Poverty Line patients. There are only 20 government hospitals empanelled for VAS. This raised questions about bed strength.
Dr Madan Gaekwad, vice-president, Sagar Hospitals, said, “The price fixation committee has not been formed yet. There is no notification on who the members are and what the prices of procedures will be. Since a patient has to go to a government hospital and only then referred to a private hospital, they can’t come here directly. This will probably reduce the number of patients we get through insurance. Instead of saying there is no facility they can always say beds are full and that the capacity is full, and refer the patients here.”
“We will continue to offer services under existing procedure rates. We expect the government to extend the MoU. If it is an emergency case, we will treat them; if it is an elective procedure we will ask for a referral letter from a government hospital,” he added.
Dr Govindaiah Yatheesh, medical superintendent, Apollo Hospitals, said, “For everything it is not feasible to get a referral letter from government hospital. The Centre is offering a much higher coverage at `5 lakh per family as against these state’s `1.5 lakh and its does not need referral letter from government hospital. We have to follow what the state prescribes under the rules though.”