BHUBANESWAR: The State Government will initiate criminal proceedings against hospitals refusing treatment to patients covered under health insurance schemes.
This was decided at a high level meeting chaired by Chief Minister Naveen Patnaik here on Wednesday.
As complaints are coming in large numbers against hospitals, mostly in the private sector, refusing hospitalisation to patients covered under Rashtriya Swasthya Bima Yojana (RSBY) and Biju Krushak Kalyan Yojana (BKKY), the Chief Minister asked the Health and Family Welfare department to take strong action against defaulting hospitals.
Emphasising on strengthening of the grievance redressal mechanism, the Chief Minister directed the department to issue show-cause notice to hospitals denying treatment to beneficiaries having health insurance coverage. Criminal proceeding should be drawn against the authority of those hospitals whose explanation is not satisfactory or prima facie found at fault.
After deliberation on the creation of a separate directorate for monitoring implementation of the two health insurance schemes, the Chief Minister asked the department to take quick measures in this regard.
Proper and timely health services to poor is one of the priority areas of the State Government and the objective of the two health insurance schemes is to provide better treatment to the needy and marginalised section of the society. Any deviation in implementation of the schemes should not be tolerated, Naveen said.
He further directed the Health department to review works of help desks set up in Government hospitals on a regular basis. The Chief Minister said he will review the progress of the two schemes every two months.
Official sources said the total coverage under BKKY so far is 55 lakh against a target of 60 lakh and over `26 crore disbursement has been made to the beneficiaries.
Similarly, the enrolment under RSBY is more than 44 lakh and disbursement to the beneficiaries on hospitalisation is `108.46 crore.
The beneficiaries are entitled to hospitalisation coverage of up to `30,000 for most of the diseases. The Government has even fixed package rates for hospitals for a large number of interventions. Pre-existing conditions are covered from Day One and there is no age limit.
The coverage extends to five members of a family which includes the head of household, spouse and up to three dependents. Beneficiaries need to pay only `30 as registration fee, while Central and State governments pay the premium to the insurer.