Punjab government faces flak over non-payment of dues under AB-MMSBY

The Centre-State health insurance scheme covers nearly 40 lakh families, makes treatment accessible at govt. and empaneled private hospitals

The Centre-State health insurance scheme covers nearly 40 lakh families, makes treatment accessible at govt. and empaneled private hospitals

After facing severe criticism from several quarters over non-payment of reimbursements worth crores of rupees to the public and private hospitals across the state under Ayushman Bharat-Mukh Mantri Sehat Bima Yojana (AB-MMSBY), the Aam Aadmi Party (AAP) government seems to have woken up from its slumber.

The Health and Family Welfare department has now directed all civil surgeons across the State to submit with the department all the details surrounding government and non-government outstanding payments under the scheme within 24 hours.

Not just political parties but medical sector organizations also had launched a major offensive against the government, blaming the AAP government for failing to provide adequate health services in the state.

The AB-MMSBY was launched on 20 August 2019 and was covering around 40 lakh families including ration card holders, the families listed in Socio-Economic Caste Census 2011, farmers holding J-forms and sugarcane weighing slips, registered construction workers, small traders etc. . It provides an entitlement-based cashless health insurance cover of ₹5 lakh per family per year which gives access for treatment at government and empaneled private hospitals.

Chief spokesperson of AAP in Punjab, Malvinder Singh Kang, told The Hindu this is a Centre-State scheme and Chief Minister Bhagwant Mann had received some complaints of bogus claims and bills after which he sought a probe. “During the previous regimes of the Congress and Shiromani Akali Dal-BJP there had been cases of scams.. The AAP government wants that the benefit under the AB-MMSBY scheme should go to the actual beneficiary and because there are few doubts about bogus claims and bills relating to previous regimes the matter is being investigated. The government will release the funds on a case-to-case basis and would ensure complete transparency,” he said.

Punjab Finance Minister Harpal Cheema said ₹100 crore had been released by the government against the outstanding dues. “The balance will be released on a case-to-case basis,” he said The Hindu.

Expressing concern over the state of affairs surrounding the scheme, the Punjab State Medical Services Association (PMSA) has urged the state government to fast track its efforts to resume the scheme.

“The scheme became virtually inoperative after December 29 last year once the insurance company backed out on certain issues, but it somehow dragged on for a few months. The situation, however, turned bad in the past two-three months as the government did not pay the outstanding amounts to the hospitals. The dealers who provided the implants or operation theatre-related items stopped it. For the past two-three months surgeries, especially general and orthopedic under the scheme, have stopped in government hospitals. Additionally a wide range of services under the scheme in the empaneled private hospitals have also come to a standstill in the past two months,” said Dr. Akhil Sarin, president PMSA on Friday.

“This scheme is meant to provide health insurance cover to the poor and vulnerable sections of the society. We hope for an early resolution to the technical glitches in the resumption of the scheme, so that the deprived and the underprivileged sections get access to the cashless health benefits that they are duly entitled to,” said Dr. Sarin.

Indian Medical Association, Punjab chapter president, Dr. Paramjit Singh Mann, said the government has to clear outstanding dues to the tune of ₹350 crore to private hospitals under the scheme. “We have had several rounds of meetings with the government, but nothing beyond assurances have come out. Until the payments are cleared it’s not possible for us to entertain patients under the scheme,” he said.

Former Health Minister Balbir Singh Sidhu said that people suffering from renal failures, cardiac complications and other serious diseases are losing hope and waiting for their surgeries for two months as the government has failed to pay outstanding bills of private hospitals. “Thousands of patients of renal failure and heart diseases are suffering owing to lack of dialysis and treatment as private hospitals refused to provide health services under the scheme,” he alleged.

“As per a status report of the scheme, till September 17, 2021, the total number of hospitalization was 8,44,073 and the total approved amount was ₹980.52 crore. Till November 2021, the average daily admissions under the scheme were 2,000 while the average daily admissions have now (in the past two-three months after the AAP formed the government) dropped to 400 to 500,” said Mr. Sidhu.

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