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NO SOLUTION YET BETWEEN HEALTH INSURANCE CARTEL & VHA

The ongoing tussle between the cartel of 3 health insurance companies namely National Insurance Company Ltd, United India Insurance Company Ltd, Oriental Insurance Company and their 6 TPAs i.e. MD India Health Insurance TPA (P) Ltd, Genins India Insurance TPA Ltd, Family Health Plan TPA Ltd, Paramount Health Services & Insurance TPA Pvt.Ltd, Health Insurance TPA of India Ltd and Health India TPA Services Pvt Ltd with member hospitals of Vidarbha Hospitals Association continues to grow serious with more and more hospitals joining hands with affected VHA members. The hospitals are aggrieved because of package rates being decreed by this group of companies which is presently 50-80% less than ongoing agreed open billing rate list. The hospitals are being threatened by the cartel to either agree to deliver services in these subsidized rates or face removal from approved list of hospitals.

Insurance Beneficiaries Association and Vidarbha Private Hospital Employees Union have also thrown their weight behind VHA with their own justifications.

Beneficiaries are facing heat on account of the threat of health insurance cashless facility withdrawal announced by all major quality conscious hospitals of Nagpur including Wockhardt, Orange City, KRIMS, Alexis, Meditrina, Care, Viveka, Suretech, Arogyam, Center Point, Midas, Ortho Relief, Hope, Icon, Lotus, Samarpan, Sengupta, Treat Me, Radiance, Keshav, Swasthyam, Crescent, Sushrut, Aureus, Shravan, Grace Orthocare, Abhinav, SS.Multispeciality, Metro City, Medicare, Getwell, East End, Safal, New Era, Arihant & Shrikrishna & Criticare.

Ganesh Iyer- General Secretary of Insurance Beneficiaries Association stated that even if hospitals agree to attend patients in such minimalistic package costs which is inclusive of medicines, consumables and diagnostics; it will surely affect quality of treatment and complications may increase. Hospitals till date were issuing prescriptions to patients and they used to get the medicines on cashless basis from hospital pharmacy so the relatives were aware of what was being procured and given. If package rates are levied, they will be unaware and hospitals because of such low rates will use substandard drugs, he alleged. Moreover, when health insurance premiums are increasing day by day, why fair rates are not being offered to hospitals based on certain valuation criteria? he queried.

Prakash Shende-Working President of Vidarbha Private Hospitals Employees Union has stated that if hospitals agree for such low rates, they will be forced to either reduce remuneration or retrench personnel which will be detrimental to their members.

Citizens are eagerly waiting for an agreeable resolution to this ongoing struggle. All concur that till amicable resolution is found, both parties should agree to continue services in old agreed rates. VHA has conveyed its readiness to do so in larger interest of society and mediate in this matter. As more and more hospitals join VHA day by day to announce stoppage of cashless facility till justified rates are offered by health insurance companies, insurance companies have refused to comment on this intricate matter.

Deploring the cartelization of the health insurance companies; Dr. Ashok Arbat- VHA President said that soon all their 160 member hospitals will be forced to join this agitation if these companies do not mend their ways and offer reasonable rates.

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