Andhra Pradesh – Private hospitals may pull out of Aarogyasri #healthcare


As was anticipated and warned, the private healthcare industry is showing its true colours and indulging in supplier ‘hold-up’ and increasing the costs.

TNN | Apr 4, 2013,

HYDERABAD: Private hospitals in the city will pull the plug on the state’s flagship Aarogyasri scheme from May 3 after the government refused to accept a minimum 30% hike on the existing tariffs and said henceforth they would only admit patients who can be discharged before the deadline.

If private hospitals go ahead with their plans, thousands of poor people will be denied quality care in top private hospitals in Hyderabad and elsewhere in the state, and is likely to force the government to take action.

About 250 private hospitals in the state treat about 2 lakh patients annually under the Aarogyasri scheme for the 938 listed ailments and diseases.

“It is a sad decision but we are not in a position to carry the burden of the scheme anymore,” said Dr B Bhaskar Rao, president, ASHA.

“Since the scheme’s inception in 2007, costs have gone up steeply but the government is still reluctant to revise the tariffs. Initially, we were told that 28% of the population falls under BPL and will be covered under the scheme, but the fact is 82% of the population is eligible to avail this scheme,” he said.

“We have been requesting the government for a revision since last two years, but nothing has been done.”

In another development, the AP Private Hospitals and Nursing Homes Association (APNA) and AP Specialty Hospitals Association (ASHA), served a notice to the CEO of Aarogyasri trust, demanding a minimum 65% hike in the tariffs, over and above the revised tariffs for healthinsurance scheme for state government employees and their dependants for twin sharing of rooms.They also demanded a 100% hike over and above the revised tariffs for single private rooms. The notice comes at a time when the state government is planning to launch the scheme for government employees on the lines of Aarogyasri from Ugadi.

 

16,000 ‘illegal’ hysterectomies done in Bihar for insurance benefit #VAW


Aug 27,2012- Indian Express

Over 16,000 hysterectomies (surgical removal of the uterus), most of them “unnecessary”, have been reported at private hospitals across Bihar during the last one year allegedly to “avail insurance benefit” under the Rashtriya Swasthya Bima Yojna.

The RSBY was launched by the Centre in April 2008.

Preliminary investigation by Samastipur, Madhubani and Chhapra district authorities, which reported the maximum number of complaints, showed 10,000 hysterectomies took place in these three districts alone. While Samastipur administration found 1,300 of such operations suspicious, Chhapra has put 1,700 such cases under the scanner. Madhubani conducted over 1,200 such surgeries in a year.

Under the RSBY, a BPL family can avail maximum Rs 30,000 in case of hospitalisation. A BPL family has to pay Rs 30 for getting registered under the health scheme. The government pays the annual premium amount for BPL families.

Bihar has 76 BPL families availing the scheme, under which a biometric smart card is given.

The labour resources department, which is the nodal agency for implementation of RSBY, has sought report from district magistrates of 38 districts. Samastipur DM Kundan Kumar has finalised his report. Saran (Chhapra) DM Vinay Kumar has set up an inquiry team under sub-divisional officer V K Pandey. His report says that most women having undergone the surgery were below 30 years.

Chief Minister Nitish Kumar ordered inquiries into the alleged illegal uterus removals last month.

Bihar Labour Resources Minister Janardhan Singh Sigriwal told The Indian Express: “It will be too early to call it a scam. Only five per cent of women in the state have gone for hysterectomy as against the national average of over seven per cent.”

He said that if DMs’ reports suggest any nexus between private hospitals, NGOs and intermediaries to siphon off insurance amount, the government would take action.

“We are waiting for reports from DMs. We have heard about some initial findings from Chhapra and Samastipur. We will get the cases examined by medical teams and then arrive at any conclusion on police action,” Sigriwal said.

IN SAMASTIPUR

8,000 hysterectomies in year — maximum in the state

5,000 in clinics in and around Samastipur town

Private hospitals claimed reimbursement of Rs 12 crore over last one year

One hospital claimed Rs 1.28 crore while another got Rs 97.18 lakh

A clinic in Shahpur Patiori block claimed reimbursement of Rs 55.42 lakh

Another at Dalsingsarai claimed Rs 32.24 lakh

DM’s report said 489 operations were summarily conducted without any need

Some surgeries conducted only on paper

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