The Punjab government has de-empanelled 10 hospitals from the Bhagat Puran Singh Health Insurance Scheme after detecting malpractices in the cashless insurance cover meant for the Atta Dal scheme beneficiaries.
The action has been taken on the basis of a probe in which the hospitals were found guilty of charging from patients even as they were entitled to free treatment. Not only that, the hospitals were also claiming the treatment cost of the said patients from the insurance company that the government had hired, it is learnt.
The health insurance scheme was introduced in 2014 to provide an annual health cover of up to Rs 50,000 per family to nearly 14-lakh beneficiaries of state government’s Atta Dal scheme.
From January this year, the scheme was extended to marginal farmers, construction workers and small traders. The scheme also offers Rs 5-lakh insurance in case of accidental death.
Also, three hospitals have been suspended from entertaining any further patient till further orders as complaints against them are under scanner.
Since nine of these hospitals were also enrolled for government’s cashless health insurance scheme for its employees and pensioners, they may be removed from the list for this scheme as well.
{{/usCountry}}Since nine of these hospitals were also enrolled for government’s cashless health insurance scheme for its employees and pensioners, they may be removed from the list for this scheme as well.
{{/usCountry}}Managing director of Punjab Health Systems Corporation (PHSC) Hussan Lal said action against the erring hospitals under the employees and pensioners’ health scheme was under consideration, they have been removed from the list for Bhagat Puran Singh scheme.
He said the government was committed to streamlining both the schemes for hassle-free services to the beneficiaries.
After a meeting with members of the Punjab Pensioners Association on Thursday, Lal directed the Oriental Insurance Company to immediately reimburse the bills of those suffering with chronic illnesses.
The delay in clearance for recommended surgeries was also discussed and Lal agreed that there were several complaint on this front.
The insurance company now has been asked to simplify the process and clear the cases within the stipulated seven days.
He said the cashless scheme for employees and pensioners was successful as against Rs 29 crore premium paid by the government, the company has so far cleared treatment costs totalling Rs 32 crore.