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Opp questions disparity in medical claims

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SHILLONG, March 28: The Opposition on Tuesday questioned the state government on the disparity in the medical reimbursement recommended by DHS (MI) in MMA Rules, 2021 as against what was earlier provided vide the MMA Rules, 1981.
Replying to the question raised by North Shillong MLA Adelbert Nongrum, Health Minister Ampareen Lyngdoh said that the central government health scheme (CGHS) rate is not approved by any of the empanelled hospitals in the state, except NEIGRIHMS, since there is a disparity of about 70% between the old and the new rates.
Lyngdoh said the state government will try to persuade these empanelled hospitals to approve the rates.
“We are equally concerned that the rates are not being accepted by the empanelled hospitals. An expert committee was set up under the chairmanship of the Health Secretary to look into the disparity on a case-to-case basis,” the minister said.
On the question of disparity, Ampareen said that the disparity between the bills is due to the fact that the earlier version of the MMA did not include several areas of treatment whereas the CGHS has more exhaustiveness as compared to the 1981 rule.
Nongkrem MLA Ardent Basaiawmoit said that when one talks about disparity it is understood that it is kind of a treatment which seems to be unfair and asked the minister to explain the actual reason why the disparity was allowed in the first place.
In reply, Ampareen said that the government would not have allowed any disparity if the choice was given to them but after reforms one has to conform to a pattern. “In fact after the question was brought to the notice of the House, the officials have been directed to immediately get in touch with the Government of India and apprise them that the CGHS rates for the Northeast have not been reviewed for a long time.
Congress MLA, Ronnie V. Lyngdoh suggested that the government should use the MMA rates to provide benefits to employees from the lower grade of the hierarchy since government employees are not entitled to MHIS.
In reply, Ampareen said that the points have been noted and the department will attend to the same and go with the best possible option.

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