IMA to help empanel small, medium hospitals with insurance scheme

Doctors attached to the association said the partnership was signed after the government agreed to revise the base rates following a costing study.

The Ministry of Health and Family Welfare has managed to bring on board Indian Medical Association (IMA) under Ayushman Bharat to facilitate empanelment of hospitals with the insurance scheme.

The IMA will aid in enrolling small and medium scale hospitals — with minimum 10 beds — to apply for the scheme, focussing specifically on rural and tribals areas. The medical lobby signed a partnership agreement with the Union ministry after a three-hour negotiation on package rates of various surgeries.

According to IMA officials, a conflict remains on the package cost that will be offered to private hospitals and nursing homes empaneling with the National Health Protection Scheme (NHPS).

While the National Accreditation Board for Hospitals and Healthcare Providers (NABH) certification is not compulsory for hospitals to enroll, those with certification will receive higher package rates ranging between 10 and 15 per cent, the IMA said. Hospitals enrolling in tribal and difficult areas are also set to receive 10 per cent more than the laid down package cost.

“The IMA will be a public-private interface for the NHPS,” said Dr Parthiv Sanghvi, IMA Maharashtra secretary.

Doctors attached to the association said the partnership was signed after the government agreed to revise the base rates following a costing study. The final rates for Maharashtra are yet to be decided.

“Currently, Maharashtra is not in the first lot of 10 states, which are rolling out NHPS. We are yet decide based on what pricing the government fixes,” said Sanghvi.

According to Dr Ravi Wankhedkar, the IMA national president, a team of doctors prepared a cost analysis in the past three months and presented to the Union government. From four states — Tamil Nadu, Kerela Telangana and

Andhra Pradesh — IMA doctors have already presented the basic cost analysis to reach the break even point. In Maharashtra, hospitals have argued that the government should at least offer rates on a par with the existing insurance scheme — Mahatma Jyotiba Phule Jan Arogya Yojana — to encourage empanelment.


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