Pvt hospitals agree to resume MHIS services with riders

SHILLONG, Sep 3: Private hospitals in the city have decided to resume the Megha Health Insurance Scheme (MHIS) services with immediate effect after setting an October 20 deadline for the state government to clear their dues and address other issues.
The decision was made during a meeting held at Nazareth Hospital which was attended by the management of all the private hospitals. The suffering of patients from BPL families influenced the decision.
A representative of one of the city hospitals said the surgeries of many patients, scheduled on Monday and Tuesday, had to be postponed after they decided to discontinue the services under the MHIS from September 1. The patients on dialysis were the most affected, he added.
“There was a hue and cry as many patients are dependent on the MHIS for their treatment,” he said.
The private hospitals subsequently submitted a joint letter to the state government, asking it to address their grievances within the stipulated time.
The private hospital authorities have been airing their grievances regularly during the meetings of the State Grievance Redressal Committee of the MHIS, the last of which was on August 7.
“We did not get any positive response,” a representative of one of the city hospitals told The Shillong Times.
He said the hospitals resumed Phase VI of the MHIS which concluded on August 31. “The question of signing a fresh agreement for Phase VII does not arise as the issues at hand need to be resolved first,” he added.
The dues of the hospitals are pending from Phase IV of the service.
Health Minister Ampareen Lyngdoh on Tuesday said the representation made by seven Shillong hospitals regarding their pending dues has come to the notice of the department.
“After rejections, a claim of Rs 48 crore is pending for payment. Of this amount, Rs.18 crore is pending for all private hospitals in the state. The insurer has approved the payments but they have not gone through due to the technical issues,” she said in a statement.
She said an emergent meeting was convened by the chief executive officer of MHIS on Monday and it was found that a new transaction management software was at the root of the problem.
“Most of the issues highlighted were resolved after a meeting on August 2 but they cropped up again during the last four weeks,” she said.
Lyngdoh said MHIS has continued to grow with 1,53,445 claims – the largest ever – made from September 2023 to August 2024 for a total value of Rs 216 crore.
“A total payment of Rs 141 crore has been made. Although these matters have been taken up with the National Health Authority (NHA) multiple times, the matter has remained unsolved,” she said.
She said the CEO of the MHIS is scheduled to visit the NHA office on September 5 to press for the matter again.
Lyngdoh said efforts have been made to make the payments offline because of the technical glitches.
“The Health Department is continuously monitoring the progress. The department realises the financial constraints the hospitals might have faced but appealed to all the hospitals during Monday’s meeting to provide uninterrupted services to the people,” she said.