Srinagar, Oct 29: The J&K government has said that the SEHAT scheme was being implemented as a flagship programme across government and private hospitals and no laxity in extension of its benefits to the masses would be tolerated.
Additional Chief Secretary to J&K Government, VivekBhardwaj said that the government was closely monitoring and improvising the Ayushman Bharat SEHAT Scheme to increase the number of Golden Card holders as well as the scope of its coverage.
He said that the government had transferred funds for the scheme implementation to the Health Insurance Agency.
While underlining the “zero tolerance” to laxity in the scheme, he said, “We have even fined the insurance agency Rs 5 crore for some errors that had been committed.”
Bhardwaj said that the fines pertained to “rejection of claims” that were unjustified and said the “common masses had pinned their hopes on the Golden Cards for providing them cashless benefits and it was the duty of the government to make access to quality healthcare seamless.
“People are availing treatments worth crores of rupees in both the government and private sector now without any inhibition and worry,” he said.
Ayushman Bharat SEHAT Scheme was launched in December last year, and started with only government hospitals extending the cashless benefit to Golden Card holders in J&K.
Over the next few months, J&K government empanelled many private hospitals in the scheme, providing a reprieve to the patients.
The patient could then choose where they wanted to avail the treatment for a medical emergency or disease and even in the most expensive of hospitals the burden was not on their pockets.
However, the administrations of some private hospitals in J&K said that they were jittery about extension of their empanelment beyond December when it was set to expire due to this issue.
One of the administrators said that the reluctance stemmed from the fact that there had been an inadvertent delay in settling the claims made in the beginning of this year.
“In February this year, the government made changes in the time frame for submission of documentation of a case claim and reduced it to three days from the existing five,” he said.
The administrator of the hospital said that the order and its implementation and changing the entire procedure in hospitals took time and many hospitals now find that all the cases carried out during that period had not been paid for by the insurance agency.
“We provided cashless treatment to the patient but the agency has been citing delay in submission of documents as a reason for non-payment of our dues,” he said.
These hospitals have sought intervention of the government towards what they called “inadvertent delay in payment of dues by the insurance company”.
Their representatives said that it was “only for the transition period” following the reduction in the submission window period that was stuck in papers.
“However, that amount runs into crores of rupees,” he said. “Over the months, all the private institutions in J&K have had a clean and trustable record.”
Bhardwaj said that the issue pertained to the insurance agency while the government on its part had carried out its duty on time.