KOCHI: In a potentially devastating setback for the most vulnerable population in the state, private hospitals are preparing to halt the treatment of patients covered under the Karunya Arogya Suraksha Padhathi (KASP) from next month. Accumulating arrears owed by the state government and its reluctance to implement the Health Benefit Package (HBP) Version 2.2 have prompted the decision.
The Kerala Private Hospitals Association, representing 1,362 healthcare providers, asserted that the 400 KASP-empanelled hospitals are grappling with impractical package rates and extended delays in settlement and payments. The issues, they said, pose a substantial threat to the institutions’ financial viability.
Implemented in 2020, the KASP is an amalgamation of various Central and state health insurance schemes. It offers a health cover of `5 lakh per family annually for secondary and tertiary hospitalisation. It covers 42 lakh poor and vulnerable families, approximately 64 lakh beneficiaries, constituting the bottom 40% of the state’s population, according to State Health Agency, Kerala.
Hussain Koya Thangal, KPHA president, said the arrears amounted to over Rs 350 crore, and there was lack of government commitment in fulfilling the agreement.
“We have no option but to withdraw from the scheme. It is straining our resources, and small hospitals, particularly in rural areas, are finding it difficult to survive.” he said. KPHA is also alarmed by the government’s reluctance to transition to HBP 2.2, which offers enhanced benefits to empanelled hospitals and beneficiaries, especially in terms of procedures and package rates.
50 hosps have stopped taking patients under KASP: Assn
Hussain Koya Thangal highlighted that most states have already adopted the new version. “Kerala is still adhering to HBP 2.0, which is not beneficial for hospitals or beneficiaries. The new version has introduced significant changes and it should be implemented in Kerala soon,” the KPHA president said.
In response to a contempt petition filed by KPHA, the government issued an order on November 15, saying it has decided not to implement the revised HBP. The order said the revised rates cannot be implemented given the state’s current financial situation, and the matter may be reconsidered when Central aid is enhanced.
Dr E K Ramachandran, chairman of TM Hospital in Chettuva, emphasised the vulnerability of hospitals in rural areas, especially those unable to turn away gravely-ill patients or those in need of critical procedures like dialysis. His hospital in the coastal and rural region of Thrissur is burdened with pending arrears amounting to Rs 45 lakh.
“Presently, 50 hospitals have stopped admitting patients covered under the scheme. We will be compelled to cease cooperation with the government unless there is an enhancement to the scheme and the pending amount is cleared in a timely manner,” he said.