BITTER INSURANCE PILL
* The term of previous insurance provider United India Insurance expired on March 31
* Since the tender process was still on the government extended the term till May 31
THE STUMBLING BLOCK
* All bidders have bid four times higher than what the govt was previously paying per card
* Govt had agreed to Rs 2,800 per card, the bidders have quoted between Rs 9,000 and 10,000
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TRUANT PVT HOSPITALS
* Several private hospitals have begun rejecting the Deen Dayal Swasthya Seva cards of citizens
* In one such instance, a hospital in Panaji rejected a patient's request to use the DDSSY card
GOVT SOUNDS WARNING
* Dr BV Pai, consultant of the DDSSY Scheme says necessary action against them will be taken
* He said govt was concerned about welfare of all citizens and would try to rectify the situation
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ABOUT DDSSY SCHEME
* Launched to provide health insurance coverage for those residing in Goa for five years and above
* Opportunity to seek free treatment at any of the 48 private hospitals that are empanelled
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PANAJI: With the contract with the insurance company providing services under the Deen Dayal Swasthya Seva Yojana (DDSSY) coming to an end on May 31, the government has decided that it will directly bear the cost of treatment of patients at private hospitals, officials have informed.
Sources in the Health Department have informed that since the process to finalise new insurance providers is fraught with complications, in order to keep the scheme running, the government will process the bills through an existing agency TPA and the amounts would be reimbursed to the hospitals on a weekly and fortnightly basis.
The term of the previous insurance provider United India Insurance had expired on March 31 this year, however, since the tender process was still on the government extended the term of the insurance company by another two months till May 31.
A stumbling block in the finalisation of the four bidders who have bid in response to the fresh tender, is that all of the companies have bid four times higher than what the government was previously paying per card. While the government had agreed to give the insurance company Rs 2,800 per card, the present bidders have quoted between Rs 9,000 and 10,000 per card.
In addition to this, several private hospitals have begun rejecting the Deen Dayal Swasthya Seva cards of citizens of the state sending alarm bells ringing through the health circles in the state.
In one such instance, Campal Clinic on Thursday rejected a patient's request to use the DDSSY card, issuing a letter to him stating, “we regret to inform you that the same cannot be entertained due to pending payments of past cases which were initially approved and then denied payment later on.”
The letter went on to call the previous cases for which the Clinic wasn't reimbursed “a financial burden” and was apologetic to the patient for refusing his request.
When contacted about the same, Dr B V Pai, the consultant of the DDSSY Scheme said that the TPA is aware of what these hospitals are doing and will take necessary action against them.
“We are aware of this particular case and have referred the matter to the TPA agency. Once they submit a report, necessary action will be taken,” he said.
“If some hospitals who are in agreement with the government over the DDSSY scheme have decided that they do not want to be a part of this agreement any longer, then they should inform the TPA so that other hospitals can be empaneled in their stead,” he added.
Pai also went on to say that it was wrong of these hospitals to make patients suffer and that the government was very concerned about the welfare of all citizens and would try to rectify the situation at the earliest.
The patient who received the letter from Campal Clinic wasn't refused aid by the hospital at the outset, but was told at the end of the hospitalisation period that his DDSSY card would not be accepted.
The DDSSY was launched by the government to provide health insurance coverage for those residing in Goa for a period of five years and above. The contract of the insurance company that was covering this scheme ended in March 2018 and was extended for a period of two months upto May 2018. Four companies have made a bid, but the proposal to finalise them is pending.
The Government's Deen Dayal Swasthya Seva Yojana (DDSSY) or Universal Health Insurance Scheme offers every resident of the state an opportunity to seek free treatment at any of the 48 private hospitals that are empanelled and are of the programme. However with hospitals, a cloud of uncertainty hovers over the scheme.
