HBI, IMA claim ‘Cashless Everywhere’ initiative is impossible

As per the initiatives for elective procedures, the policyholder should inform the insurance company at least 48 hours prior to the admission and within 48 hours of admission during emergency treatment

At a time when the General Insurance Council (GIC) in consultation with general and health insurance companies has recently announced the ‘Cashless Everywhere’ initiative, the Hospital Board of India (HBI) and Indian Medical Association (IMA) have claimed that the initiative is impossible and lacks clarity.

HBI has warned its members that the sustainability of hospitals will be at stake if they accept ‘Cashless Everywhere’ in the current, announced format. (REPRESENTATIVE PIC)

The GIC last month announced the ‘Cashless Everywhere’ initiative under which, policyholders will be eligible to be treated in any hospital that they choose and a cashless facility will be made available by the insurance company even if the hospital is not in its network. However, the HBI has warned its members that the sustainability of hospitals will be at stake if they accept ‘Cashless Everywhere’ in the current, announced format. In Pune, there are over 120 hospitals associated with the HBI.

The HBI headquarters in a letter issued to all its branches on Wednesday, stated, “The initiative has been launched without clarifying and clearing the issues raised by the IMA and HBI. Though any policyholder can walk into any hospital that complies with the IRDA guidelines and get treated, there is a one-time, temporary memorandum of understanding (MoU) between the insurance company and hospitals about which there is no clarity. The packages, freebies, discounts on which insurance companies and third-party administrators (TPAs) insist are non-scientific, against the law, and will lead to a compromise on quality and an injustice to patients.”

As per the initiatives for elective procedures, the policyholder should inform the insurance company at least 48 hours prior to the admission and within 48 hours of admission during emergency treatment.

Dr Sanjay Patil, chairman, HBI, Pune chapter, said that hospitals have refused to be empanelled with the insurance company because of low packages offered by the companies and very little chance of such packages being accepted under the ‘Cashless Everywhere’ initiative. “The rates and packages that will be given for non-network hospitals will be minimal. Also, there is no provision for co-payment and the decision is unscientific. This will hamper the quality of care provided by the hospitals and will result in a loss for the policyholder,” he said.