State excels in registration, claims
SHILLONG: Despite Meghalaya ranking number six in the country regarding the number of beneficiaries under the health scheme, the patients seeking claims are facing many hardships.
A health department official on Monday admitted that since hospitals in the city are getting low rate from the insurance company, the patients will not get full reimbursement for their treatment. “Even then, we have asked the hospitals to help the poor beneficiaries”, the official added.
Meghalaya has also crossed Assam in terms of number of claims submitted to the hospitals thereby making Meghalaya higher than any other Northeastern states.
However, the plight of patents is far from over as the cards under Megha Health Insurance Scheme (MHIS-IV) from the state are not acceptable in Assam.
A cancer patient from Meghalaya recently visited a Guwahati based hospital but she was told that the Meghalaya health card is not acceptable.
The state health official admitted the problem and added that though the matter was taken up, the reply from the concerned authorities was that Assam will have to first cater to its patients than those from other parts of the North East.
As per the central government health scheme, the cards are acceptable in many hospitals across the country.
The state health official said the Centre will have to give direction to Assam government to ensure that the patients from the North East get reimbursement for the treatment carried out by the patients from other parts of the North East.
While the central health scheme targets the benefiaries from the Socio Economic Caste Census, Meghalaya has gone a step ahead in ensuring universal health coverage irrespective of the poor and the rich beneficiaries except the state and the central government employees.
This has brought additional burden on the government. The government has to pay Rs 130 crore annually to the insurance company under the MHIS-IV.
Though earlier, the government had fixed deadline of August this year for registration under MHIS-IV, the Health Secretary Pravin Bakshi said the registration is an ongoing process and no deadline can be fixed.
The registration of people all over the state is 48.86%
The Megha Health Insurance Scheme- Phase IV works in convergence with Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana which was an initiative launched by the Prime Minister Narendra Modi in September last year.
The convergence brought about an enhanced coverage of up to Rs 5 lakh per family on a floater basis with no restrictions on family size and age.
Due to the fund constraint, the state government has empanelled only some hospitals in the state and the rest of the country.