Latest news with #StateHealthAuthority
Time of India
19-05-2025
- Health
- Time of India
Why pvt hosps are hesitant in joining cashless health scheme
New Delhi: More than 50 private and 15 Delhi govt hospitals have enrolled under the State Health Authority (SHA) to provide cashless treatment to patients under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). However, many private facilities are reluctant to join the scheme over concerns of low rates being offered by govt. Most private healthcare facilities previously registered with AB-PMJAY through the National Health Authority (NHA) during the previous AAP regime were automatically transferred to city authority oversight. However, several prominent private hospitals raised issues regarding AB-PMJAY reimbursement rates, stating these do not adequately cover treatment expenses and could lead to financial deficits. While smaller healthcare facilities might find the scheme workable, larger hospitals consider it financially unviable due to substantial operational expenses, including infrastructure and advanced medical equipment. Clarifying why corporate and larger hospitals are reluctant to participate, Dr Sunil K Khetarpal, director, Association of Healthcare Providers India (AHPI), cited inadequate package rates for advanced medical procedures. He also highlighted concerns about delayed payments reported in some states implementing this scheme. AHPI, representing about 15,000 private hospitals, including Fortis, Max Healthcare, Manipal, Medanta, Narayana and Apollo, has sought discussions with Delhi govt to address these concerns. Girdhar J Gyani, AHPI's director general, has written to chief minister Rekha Gupta, stressing the necessity of establishing a dedicated grievance redressal system and accelerating reimbursements process under Delhi's recent inclusion in AB-PMJAY. Dr Narin Sehgal, medical director, Sehgal Neo Hospital, and AHPI secretary, Delhi, acknowledged the scheme's significance as the largest health insurance programme. He noted widespread hesitation in enrolment and suggested reconsideration of rates by govt and timely payments, citing issues with similar schemes, like CGHS. Despite AHPI's intervention and NHA's promises to revise the rates, the adjustments remained selective and insufficient, said Dr Sehgal. On April 5, Delhi govt entered an agreement with the Centre to implement AB-PMJAY, with card distribution beginning April 10. Very few private hospitals joined afterwards. CM Gupta said Delhi govt will cover 2,35,000 families in the first phase. Currently, 67 out of over 1,000 Delhi hospitals are participating in the scheme. Govt facilities include Lok Nayak, Deep Chand Bandhu Hospital, Rajiv Gandhi Super Specialty Hospital and Delhi State Cancer Institute while private participants include Dharamshila Narayana Superspeciality Hospital, Metro Hospital & Cancer Institute and Sri Balaji Action Medical Institute. Most of the empanelled private hospitals are in New Delhi district and are dedicated to eye care, general surgery, oncology, obstetrics and gynaecology. The scheme offers free treatment covering 1,961 medical procedures across 27 specialities, including medicines, diagnostics, hospitalisation, ICU care and surgeries.
Mint
23-04-2025
- Health
- Mint
Delhi reached out to private hospitals to join Centre's PMJAY health insurance scheme
New Delhi: The Delhi government is gearing up to implement the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY) and is onboarding large corporate hospitals to help reach the Centre's free health insurance scheme to more than 654,000 families. However, big corporate hospitals have raised concerns over delayed payments and low package rates. The National Health Authority, which is the implementing agency for the scheme is training state health authority officials and doctors on the scheme's modalities. The Delhi government has allocated ₹ 2,144 crore for PMJAY, which is the world's largest health assurance scheme, benefiting the poor as well as over-70s. 'NHA informed that it has started handholding Delhi government to implement the scheme. It has started the training of the State Health Authority, sensitizing hospitals, officials etc to onboard the scheme,' said an official familiar with the matter requesting anonymity. The official said the Delhi government is aware of the concerns raised by private hospitals and discussions are on. Dr Girdhar Gyani, Director General, Association of Healthcare Providers said, 'Delhi government had earlier had its own scheme. The government had earlier issued an order that all those empaneled with the Delhi government schemes are deemed to be empaneled unless they certify that they are not interested. Those bigger hospitals who are not part of the Delhi government scheme had a meeting a few days back to discuss the key concerns regarding the scheme implementation.' 'The main issue is that hospitals are concerned about timely release of funds within one month. We have to understand that treatment package rates are low and if cash flow is not good, it would be difficult for them. Private hospitals are planning to meet the Delhi government to discuss the matter,' he said. Major private hospital chains are not fully participating in the Ayushman Bharat scheme, primarily due to the inadequate pricing structure. The scheme's reimbursements fail to cover the genuine costs incurred by large hospitals, and these rates have not been adjusted for inflation, said on the corporate hospitals requesting anonymity. Dr. Narin Sehgal, Sehgal, Medical Director, Sehgal Neo Hospital and Secretary Delhi Chapter AHPI said the basic problem with PMJAY is payments to the hospitals are very low. 'The smaller hospitals will be able to take the PMJAY willingly, but bigger corporate have been urging to modify the rates. PMJAY is very good scheme. But, hospitals like Max, Fortis and Apollo may consider the scheme if government consider their requests. We are in touch with the Delhi government to discuss PMJAY implementation in the city," Dr Sehgal. Notably, Delhi has become the 35th state/UT to implement the PMJAY scheme. It is estimated that around three million poor and another 600,000 senior citizens will be the eligible beneficiaries, making a total about 3.6 million people in Delhi. A senior Delhi government official aware of the matter said there is no shortage of funds and the government is in continuous talks with the bigger hospitals to onboard them on PMJAY. 'We have held several meetings with the big corporate hospitals to discuss the scheme implementation. We are listening to their concerns and we are hopeful that we will join us,' the official said. A representative of Apollo Hospital said they are awaiting directions from the Delhi government. Queries sent to the Delhi government, health ministry, Max Hospital, Fortis ands Apollo spokesperson remained. First Published: 23 Apr 2025, 10:11 PM IST
