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Patients left in lurch as deadlock continues over Punjab’s Sarbat Sehat Bima Yojana settlement claims
Private hospitals have been denying treatment to patients under Sarbat Sehat Bima Yojana scheme citing pending payments of approximately ₹130 crore
Punjab government’s much-hyped health insurance scheme, ‘Ayushman Bharat - Sarbat Sehat Bima Yojana’, has been left in the lurch with the state health department and the private company tasked with running it, failing to end the deadlock over settlement claims.
Private hospitals have been denying treatment to patients under the scheme citing pending payments of approximately ₹130 crore. Ground reports suggest that the absence of the scheme has hit poor patients as private hospitals have been turning them away since February 25, the day when the state government had informed the hospitals that the private company SBI-GIC has refused to settle the claims.
According to the state president of Punjab Chapter of Indian Medical Association (IMA), Dr Paramjit Singh, only a few hospitals are offering the scheme in absence of any clarity from the government.
“Only corporate hospitals have been admitting patients under the scheme as they have a huge financial backing. How can private hospitals run the scheme when our dues, to the tune of over ₹125 crore, are on hold since September last year,” said the IMA state president.
Notably, the company, according to a senior health functionary, had stopped payments citing exaggerated amounts being claimed by hospitals.
Private hospitals, however, have termed the allegation as baseless.
“There is hardly any scope for exaggerating settlements as the private company regularly checks the bills of patients being given treatment under the scheme,” said the IMA state president.
Ayushman Bharat-Sarbat Sehat Bima Yojana was launched in August 2019 as an extension of the central government’s scheme. The Centre’s scheme covers nearly 14.65 lakh families as per the socio-economic caste census data, the premium cost of which is borne by the Centre and state at 60:40 ratio. The premium cost of the 16.49 lakh beneficiary families added under the Punjab government scheme is borne by the state alone. There are around 200 private hospitals and 250 government hospitals empanelled under the scheme.
Till date, treatment worth ₹1,112.41 crore has been provided under the scheme.
Principal secretary, health, Raj Kamal Chaudhary, said the issue is likely to be discussed in a special meeting on Sunday.
“Any comment at this stage will be premature. I will be able to tell you something on the issue tomorrow,” said the principal secretary health.
A senior government official of the health department disclosed that the issue may linger on till the new dispensation takes over after the assembly poll results are announced on March 10.
