SHILLONG: Irked with the glaring discrepancies cropping up in the Megha Health Insurance Scheme, Health and Family Welfare Minister AL Hek has sought for a complete report from the concerned agencies to rectify the errors.
Talking to media persons here in the city on Tuesday, Hek admitted that there are certain problems in the implementation of the scheme and assured of rectifying the errors.
“The problems have to be rectified and I have already asked the concerned agencies to review the entire implementation and accordingly take corrective action,” Hek said.
The Minister also informed that he would take up the matter with the Chief Minister and also the Cabinet and necessary actions will follow to streamline the scheme.
The Minister also admitted that the department can learn from their mistakes and take steps for effective implementation of the scheme.
Reacting to a query, Hek informed that certain treatments are not covered under the MHIS.
On the same note, the authorities of the Meghalaya Health Insurance Scheme (MHIS) on Tuesday defended the insurance company ICICI Lombard in the alleged discrepancy case unearthed on Monday where one patient, KL Nonglait, was denied full reimbursement of his hospital bill.
The State Manager of MHIS, in a statement, said that the patient had undergone certain medical investigations ) which fall beyond the pre-approved packages and presently, the Government is working it out with the insurance company to include the non pre-approved packages and their rates as well.
Generally, based on the pre-approved package rates, a beneficiary cannot avail private ward facilities, certain investigations and special foods bills in a private hospital. “Hence, any excess amount, over and above the pre-approved package rates, if any, has to be borne by the beneficiary,” the State Manager said.In one of the recent cases of anomalies in the MHIS, a patient, KL Nonglait, has been detained by Nazareth Hospital since June 8 for his inability to pay the balance hospital bill of over Rs 4000 after the insurance company (ICICI Lombard) reimbursed only Rs 2000 towards his medical expenses. Earlier too, a patient was denied full reimbursement after she underwent treatment at the same hospital and she had to foot the hospital bill worth Rs 3,004.
In another case in May, a patient was held back by the hospital authorities as he could not clear the hospital bill and was released only after the insurance company paid the full amount after the case was reported in a section of the press.
