Earlier insurance companies too had expressed reservations about the premium amount
After insurance companies expressed reservations about the premium amount for Modicare, private hospitals have now objected to the rates for various packages.
Last month the ministry of health had notified rates for 1,350 treatment packages, ranging from Rs 1,000 to over Rs1.50 lakh, for the Pradhan Mantri Rashtriya Swasthya Suraksha Mission, commonly referred to as Modicare. If these about 600 packages would require pre-authorisation. Rates for over 20 specialties like cardiology, cancer care, neurosurgery and neo-natal care have been covered in the initial rate list.
Several private hospitals including Apollo, Medanta, Fortis and Narayana Healthcare have objected to these rates saying that they are too low to be viable.
Announced in the Union Budget this year, the health protection mission will give a coverage of Rs 5 lakh annually to 10.74 crore families.
In a letter to the Ayushman Bharat CEO, Association of Healthcare Providers (India) have written: “It appears that, overall, no scientific basis has been applied to arrive at the rates. Under these conditions, you may kindly appreciate that private healthcare providers would not be able to sustain themselves in providing quality healthcare unless the rates are reasonable and scientifically arrived at.”
Announced in the Union Budget this year, the health protection mission will give a coverage of Rs 5 lakh annually to 10.74 crore families. It will be the decision of the states whether they want to implement the scheme through a trust or by roping in insurance companies.
Insurance companies have already expressed their reservations about the premium amount calculated by Niti Ayog. While the Ayog estimates that a premium of Rs 1082 per family will suffice, the insurance companies told the government some time back that nothing less than Rs 2500 premium is viable.
Notwithstanding the reservations from various quarters, the Union health ministry has already started signing memoranda of understanding with states for its implementation.
