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Ludhiana: Pvt hospital slapped ₹5L fine for denying Ayushman Bharat cover
Denying treatment under Ayushman Bharat has cost a private hospital 10 times the treatment cost in fine
Denying an accident victim cover under the Ayushman Bharat scheme cost a private hospital dear as it was asked to pay ₹5 lakh fine and refund nearly ₹3 lakh it had charged an accident victim, officials said.
According to the officials, the government would have paid ₹50,000 for the treatment the patient was given, had the hospital, Arora Neuro Centre, agreed to treatment under the Ayushman Bharat Mukh Mantri Sehat Bima Yojana (AB MMSBY)when the patient was brought in.
The state health agency (SHA), after a meeting with the State Grievance Redressal Committee, upheld a decision by the district grievance redressal committee (DGRC), which had asked the hospital to refund the treatment cost, ₹2,96,271, and pay the compensation as well.
The SHA had issued a letter in this regard on August 27 and given 30 days to the hospital to comply.
However, officials said the hospital is yet to act on the order.
SHA chief executive officer Babita Kaler said, “They haven’t obliged with the order yet and may be planning to appeal against it . We will decide further course of action accordingly.”
On November 25, 2023, 68-year-old Ravi Shankar Tiwari was riding his bicycle to the Labour Court on Gill Road when he was hit by a bike on Jaimal Road.
“Around 9 am that day, I got a call from my father’s cell phone. Someone from the accident spot had called me as I was the last dialled contact. I asked them to take him to a nearby hospital,” the victim’s son, Dipankar Kumar, said.
Kumar said his father was twice referred by nearby hospitals because of the nature of his injuries and ended up at Arora Neuro Centre.
“We told them my father was insured under the Ayushman Bharat scheme. However, we were told that the hospital didn’t accept the card and that they could only treat him according to the hospital’s cost structure” Kumar added.
“My father’s condition was critical and we accepted. He was taken into the intensive care unit [ICU],” he added.
As the hospital lacked a chest specialist, Tiwari was later treated as SPS Hospital as well.
Kumar said the treatment cost them ₹11 lakh in total.
Two days after his father was discharged, he filed a complaint on the Ayushman Bharat Portal.
He alleged after the second DGRC hearing, a doctor representing the hospital offered them ₹1 lakh to settle.
Arora Neuro Centre managing director Dr OP Arora could not be approached.
His son, Dr Prashant Arora, said that they have challenged the SHA decision in the high court.
He said SHA guidelines say that complaints lodged within a month could be considered but this one was filed after a month. He alleged that their hospital was victim of ’extortion’.
