IMA Punjab stops admitting patients under Ayushman Bharat scheme

Rues delay in claim settlements; patients to bear the brunt; IMA, Punjab, has stopped admitting new patients under Ayushman Bharat scheme from Saturday onwards
The IMA, Punjab, has stopped admitting new patients under Ayushman Bharat scheme from Saturday onwards. Say their finances have been exhausted and the government has failed to resolve their issues. (HT File Photo/ Representational image)
The IMA, Punjab, has stopped admitting new patients under Ayushman Bharat scheme from Saturday onwards. Say their finances have been exhausted and the government has failed to resolve their issues. (HT File Photo/ Representational image)
Updated on Oct 24, 2021 01:48 AM IST
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ByHT Correspondent, Ludhiana

Criticising the state government and the SBI general insurance for allegedly failing to resolve the issues related to the delay in payment of claims and inspections, the Indian Medical Association (IMA), Punjab, has stopped admitting new patients under the Pradhan Mantri Jan Arogya Yojana (PMJAY) - Ayushman Bharat scheme - from Saturday onwards.

Stating that they have been working to transfer the benefits of the scheme to the poor in society, IMA members said their finances had been exhausted and the government had failed to resolve the issues by October 22, as assured after a meeting held with the deputy chief minister, OP Soni, recently.

The IMA has also written regarding this to the Prime Minister, chief minister, health minister among others on Saturday.

The members rued that the SBI general insurance had failed to implement the scheme properly since it had taken over the operations in August and the hospitals are facing problems due to which doctors were not able to transfer the benefits of the scheme to people.

They said delayed authorisation due to which a patient had to wait for 2-3 days before starting treatment, delayed claim settlement, claims deducted even after authorisation, unnecessary queries for claim settlement, claim rejection on flimsy grounds, harassment due to inspections by BAMS/BDS/BHMS and medical and hospital audit not as per guidelines were among the problems being faced by hospitals.

The patron and former president, IMA, Punjab, Dr Manoj Sobti said, “The government has failed to resolve the issues due to which hospitals have been forced to take this step. A majority of claims settlements have not been made after the SBI general insurance took over the operations in August. Earlier, we had warned of mass quitting the scheme if the problems are not resolved.”

The members rued that 194 packages, including packages of gynae-obstetrics and ophthalmology, were reserved for government hospitals under the scheme and patients were forced to visit government hospitals. They demanded that packages should not be reserved so that patients could avail the facilities at private hospitals too.

Residents to bear the brunt

With the IMA stopping all empanelled hospitals to stop admitting new cases, patients will have to bear the brunt of the tussle between both parties as they will not be able to get the benefit of the scheme.

The Ayushman Bharat PMJAY is the health assurance scheme which aims at providing a health cover of 5 lakh per family per year for secondary and tertiary care hospitalisation.

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Tuesday, December 07, 2021