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Mediclaim dues pile up to ₹16 crore: PGIMER Chandigarh stops treating Punjab patients
Punjab government has not been settling mediclaims under Ayushman Bharat Mukh Mantri Sehat Bima Yojana since December last year, leading to dues worth ₹16 crore
With the Punjab government failing to clear health insurance dues worth over ₹16 crore owed for the past seven months, pushed to the corner, Post Graduate Institute of Medical Education and Research (PGIMER) has stopped the treatment of patients from Punjab for the first time.
The dues owed are in respect of the Ayushman Bharat Mukh Mantri Sehat Bima Yojana (AB-MMSBY). Launched in August 2019, the flagship scheme of the Punjab government provides ₹5-lakh cashless and paperless treatment cover to 39.66 lakh families in the state.
While PGIMER caters to patients from across north India, over 35% of these patients come from Punjab alone, for OPD consultations and admissions due to inadequate tertiary care government hospitals in the state.
“On average, around 1,400 patients from Punjab avail the cashless treatment facility at PGIMER every month. The institute provides all possible care to the patients by sourcing medicines, implants and other equipment from companies. But since December 21, 2021, the Punjab government has not cleared any medical claims, which have piled up to ₹16 crore, due to which we are unable to clear payments of companies,” said Kumar Gaurav Dhawan, deputy director, administration, and official spokesperson, PGIMER.
“We have sent several requests to the Punjab State Health Authority to clear the dues, but in vain. Therefore, we have stopped admitting patients under the cashless scheme. We will only provide treatment to Punjab patients who are willing to bear the cost of treatment,” Dhawan said.
A similar facility is also availed of by patients from Haryana, whose government has been making regular payments to PGIMER, according to authorities.
GMCH-32, GMSH-16 also turning away Punjab patients
Government Medical College and Hospital (GMCH), Sector 32, another tertiary care hospital in Chandigarh, had also stopped admitting patients from Punjab under the same scheme in March this year after the dues reached ₹2.3 crore.
“Since March, we are only admitting those patients from Punjab who are ready to pay from their own pockets. Without funding from the government, it is difficult for the hospital to run the scheme. We wish to provide treatment to all needy families, but the government must clear the dues,” said Dr Sudhir Garg, medical superintendent, GMCH.
The Punjab government also owes ₹3 crore to Government Multi-Specialty Hospital (GMSH), Sector 16, Chandigarh, that stopped giving benefits to Punjab patients since last week, according to Dr Suman Singh, director, health services, Chandigarh.
₹300 crore owed to hospitals: Punjab health secretary
Meanwhile, Punjab health secretary Ajoy Sharma said, “At present, the Punjab government owes ₹300 crore to various hospitals in lieu of treatment provided under the health insurance scheme. The private company responsible for the scheme had refused to settle the claims last year. We have served it a notice. Also, we have already asked the finance department to allocate funds to pay the hospitals, so that patients don’t suffer.”
Around 250 government and 200 private hospitals in Punjab and Chandigarh are empanelled under AB-MMSBY that covers 1,579 treatment packages, including treatment, surgeries, hospitalisation expenses and day care.
The Punjab government claims to have offered free treatment worth ₹1,112.41 crore to ₹9.63 lakh beneficiaries under the scheme.
