Private hospitals refuse treatment under government insurance schemes

The Chhattisgarh government has had to accept yet another setback while trying desperately to rope in private players to strengthen public health care services.

At least 20 major private hospitals have refused to provide treatment under the Chief Minister’s health insurance scheme — Mukhyamantri Swasthya Bima Yojana (MSBY). Reportedly, they are also not following guidelines to provide treatment under the national health insurance scheme, Rashtriya Swasthya Bima Yojana (RSBY), and are charging money from the patients.

Hospital owners claimed that the insured amount paid for treatment of the patients below poverty line (BPL) under RSBY is “very low.” In addition, introduction of a scheme for the people above poverty line (APL) under MSBY will “seriously damage business and thus will affect services.”

State health officials, hospital management and representatives of insurance companies and Third Party Administrators (TPA) held a meeting on Thursday. According to local news reports, Director, Health Services, Dr. Kamalpreet Singh, said rates had already been “upwardly revised” under RSBY and MSBY after consultation with private hospitals.

Under the new list, 272 categories of treatment, commonly called ‘packages,’ were increased by four to 200 per cent. Another 22 packages had been added and the new list will be applicable from April 1. However, major private players are not happy with the revised rate list and refused to implement the insurance schemes in their hospitals. The move angered the government and the health department has decided to de-panel the hospitals, the sources said.

Earlier this month, the government faced a setback while trying to introduce the policy of Public Private Partnership (PPP) in public health facilities. No private diagnostic centre had come forward to set up radiology and laboratory facilities in the two most underdeveloped divisions with high percentage of rural population — Bastar in south and Surguja in north Chhattisgarh following governments directives.

The Chhattisgarh Government’s Directorate of Health Services had to seek fresh bids for newly aligned divisions. According to the sources, while a good number of applications were filed for affluent divisions such as Raipur and Bilaspur, not receiving a single application for the poorer divisions illustrate the private players’ reluctance to acknowledge health care as a social service. However, the proponents of Chhattisgarh’s public-private venture in health care were optimistic about its future, even after these recent rounds of setbacks.