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RGJAY: govt to replace TPA companies

The Maharashtra government has decided to change third party administrator (TPA) companies in the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) after unfair trade practices and irregularities worth Rs 500 crore were brought to light by a government-appointed task force.

State Health minister Deepak Sawant reviewed the implementation and the money spent on the scheme, and conceded that 20 per cent commission is being given to the TPA companies.

“We have not appointed TPA companies. It is the responsibility of insurance companies to appoint them to handle cases and administrative works at the hospital level. We have taken cognisance of complaints about the TPA companies and have decided to change them by the end of November,” Mr Sawant said.

According to the report submitted to Chief Minister Devendra Fadnavis by the task force set up to address the agrarian crisis in the State, malfunctioning and financial misdeeds in the scheme has resulted in a loss of Rs 500 crore to the State exchequer in the last three-and-a-half years.

Farm activist and task force president Kishore Tiwari held the RGJAY Society, a government body, and the TPA companies responsible for the corruption.

The term of insurance companies under the RGJAY scheme is already over, but they have been given an extension till September. The government will call in for new tenders for the next three years.

“We have paid a premium of Rs 2,350 crore since the inception of the scheme. Every year, we pay around Rs 700 crore to Rs 750 crore as premium. The TPA companies have received Rs 470 crore as commission according to 20 per cent rate mentioned in the agreement,” Mr Sawant said.

He said hospitals, which have misused the scheme or cheated patients, have been banned and removed from the empanelled list. — PTI

Report submitted to CM mentions malfunctioning and financial misdeeds in the scheme


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Printable version | Oct 1, 2022 6:54:29 am | https://www.thehindu.com/news/cities/mumbai/news/rgjay-govt-to-replace-tpa-companies/article8588216.ece