Non-payment of bills under PMJAY in Gujarat poses the threat of patients care under jeopardy

More than Rs 370 crores are due from Government claim the agitated doctors

 Tens of private hospitals have already started terminating the treatment under PMJAY scheme in Vadodara, Ahmedabad and Surat – hundreds to follow within days


Ahmedabad, Feb 13: The much-hyped Pradhan Mantri Jan Arogya Yojana (PMJAY) is failing to hold the ground across Gujarat with private hospitals and dialysis centres currently facing the heat due to the pending of payments as well as the rejection of cases which is in turn affects the overall patient care.

Tall claims of the Centre and Gujarat government regarding the welfare and medical assistance to the poor and needy seem to be seeing the dirt of the moment with more and more private hospitals of Gujarat deciding to discontinue treating the patients under the PMJAY cover.

This comes after the agitated doctors of the private hospitals and institutes of Gujarat decide to stop the treatment under the scheme.

Addressing the media of Ahmedabad at the AMA on Tuesday evening, a group of doctors representing the association expressed their total dismay over the careless and unwelcoming attitude of the state government despite their repeated pleadings and requests.

Dr Rameshbhai Chaudhary from Palanpur addressed the media with few other doctors including Dr Ramesh Godhani and others explained the issues that they are facing.

When things went totally out of their reach they had to appear before the media so that the beneficiaries of the PMJAY scheme are aware of the fact that they were ready to serve them but the limit to spending by the doctors due to the non-payment of bills by the government had reached a saturation point.

The management of the private hospitals said that the issue of delay in the payments, as well as the rejection, is rampant and almost all the private empanelled hospitals are facing a tough time.

“It is because of the non-payment of PMJAY yojana bills from the Government end since last three (3) years to private hospitals, hospitals and trusts in Gujarat are in financial crisis because of which Prime Minister Narendra Modi’s dream project is in doldrums in his own state” observed Dr Chaudhary..

In Gujarat, PMjay Yojana is effective in which there is tri-party Memorandum of Understanding (MoU) exists in between State health authority service providing hospital and insurance company. According to the MoU specifications, a private hospital that is providing cashless services to the patients and payment should be done by insurance company within 15 days on failing which company need to avoid 0.1% interest to the service providing hospitals.

Still insurance companies and government has not paid last 2 year bills of policy number 5, 6, 7 and approximate rupees more than 370 crores are pending to be paid from Government end.

Now when large amount of Bills are pending to be paid since long time, hospitals and trust are not able to reach the extreme amount of expenses incurred while providing cashless service to the patients. Hospital needs to pay the medicine bills, anesthetic bills, locum staff salary hospital rents and other bills every month, while the payable amounts are not paid from government for months and years due to which hospitals and many trusts are facing extreme financial crisis.

Even after many complaints and visits to insurance company officials, related government officials and government highest authorities only assurance has been provided that the immediate payments will be done but the payments are still pending. For continued service to PMJAY needy patients its utmost necessary that government reimburses the pending amount to the hospitals immediately.

“To add to the plight, despite us providing proper and complete care to the patient, the present insurance company Bajaj is making undue deductions in PMJAY payable tariff or rejects the whole case based on nonsense and silly reasons under industrial targets. We have reported this menace to responsible officers namely CDHO and Collector regularly who have the power to Blacklist that insurance company but even after finding companies in fault surprisingly they keep mum. Because of which hospitals and trusts are on the way to financial bankruptcy, as such even the tariffs in PMJAY Yojana carries nominal profit, because of deductions/rejections hospitals get heavy amount of losses. A height of shamelessness is counted when the large amount of deduction and rejections are always continued while movement against such menace is going on” explain the doctors.