Crackdown on hosps charging Ayushman beneficiaries
Varanasi: Taking a serious note of increasing complaints from Ayushman card holders that they were charged the treatment cost by listed hospitals, the district administration directed officials of these hospitals to either return the money charged from beneficiaries or be ready to face stern action.
As many as 26 beneficiaries have filed complaints for being charged money despite having Ayushman cards. In view of the complaints lodged by Ayushman beneficiaries against hospitals listed under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, chief development officer (CDO) Himanshu Nagpal convened a meeting on Saturday evening. He made it clear that as all beneficiaries are eligible to receive free treatment as per rules and if any expenses have been charged from them during treatment by any hospital, it should be reimbursed immediately.
Punitive action would follow in case they do not follow the directives, he said.
The CDO added if any hospital is found involved in charging extra money from an Ayushman beneficiary, its association with the scheme would be revoked by notifying senior officials at the State Agency for Health and Integrated Services (SACHIS), while their registration would also be cancelled. Last year, 26 Ayushman card holders lodged complaints against a few hospitals accusing them of charging the treatment cost.
Health officials informed the CDO that of the 26 complainants, the money of 20 has been reimbursed so far. Three cases are still being processed and three have been sent to SACHIS. Complaints against at least three hospitals have been forwarded to the state-level controlling authority (SACHIS) for action, said officials.
The CDO emphasized that patients visiting listed hospitals must provide a consent form indicating if they hold an Ayushman card, which should be verified using their Aadhaar card on the portal.
All affiliated hospitals should update and inform the office about the information, education and communication (IEC) material, help desks and kiosks related to the Ayushman Bharat scheme. The help desk should display the presence of an Ayushman Mitra along with their phone numbers as well as the phone numbers of the hospital.
In compliance with Section 28 (Display of Information) of the UP Clinical Establishment (Registration and Regulation) Rules 2016, hospitals should display the specialty registration number, director's name, bed count, method of treatment and services provided along with details of medical staff (doctors, nurses, etc.)
on a display board with a yellow background and black Hindi letters. This board should be placed near the hospital's main entrance and a complaint box should also be installed there.
Chief Medical Officer Dr Sandeep Chaudhary stated that requests to revoke claims cancelled by contracted hospitals more than six months ago will not be considered as per SACHIS instructions. Hospitals can submit an appeal to the State Grievance Redressal Committee (SGRC) within 30 days if dissatisfied with decisions made on claim forms presented at the district grievance redressal committee meeting.
Additional CMOs, including Dr SS Kannaujia, Dr Piyush Rai, and representatives of the hospitals concerned, were present at the meeting.
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Crackdown on hosps charging Ayushman beneficiaries
Varanasi: Taking a serious note of increasing complaints from Ayushman card holders that they were charged the treatment cost by listed hospitals, the district administration directed officials of these hospitals to either return the money charged from beneficiaries or be ready to face stern action. As many as 26 beneficiaries have filed complaints for being charged money despite having Ayushman cards. In view of the complaints lodged by Ayushman beneficiaries against hospitals listed under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana, chief development officer (CDO) Himanshu Nagpal convened a meeting on Saturday evening. He made it clear that as all beneficiaries are eligible to receive free treatment as per rules and if any expenses have been charged from them during treatment by any hospital, it should be reimbursed immediately. Punitive action would follow in case they do not follow the directives, he said. The CDO added if any hospital is found involved in charging extra money from an Ayushman beneficiary, its association with the scheme would be revoked by notifying senior officials at the State Agency for Health and Integrated Services (SACHIS), while their registration would also be cancelled. Last year, 26 Ayushman card holders lodged complaints against a few hospitals accusing them of charging the treatment cost. Health officials informed the CDO that of the 26 complainants, the money of 20 has been reimbursed so far. Three cases are still being processed and three have been sent to SACHIS. Complaints against at least three hospitals have been forwarded to the state-level controlling authority (SACHIS) for action, said officials. The CDO emphasized that patients visiting listed hospitals must provide a consent form indicating if they hold an Ayushman card, which should be verified using their Aadhaar card on the portal. All affiliated hospitals should update and inform the office about the information, education and communication (IEC) material, help desks and kiosks related to the Ayushman Bharat scheme. The help desk should display the presence of an Ayushman Mitra along with their phone numbers as well as the phone numbers of the hospital. In compliance with Section 28 (Display of Information) of the UP Clinical Establishment (Registration and Regulation) Rules 2016, hospitals should display the specialty registration number, director's name, bed count, method of treatment and services provided along with details of medical staff (doctors, nurses, etc.) on a display board with a yellow background and black Hindi letters. This board should be placed near the hospital's main entrance and a complaint box should also be installed there. Chief Medical Officer Dr Sandeep Chaudhary stated that requests to revoke claims cancelled by contracted hospitals more than six months ago will not be considered as per SACHIS instructions. Hospitals can submit an appeal to the State Grievance Redressal Committee (SGRC) within 30 days if dissatisfied with decisions made on claim forms presented at the district grievance redressal committee meeting. Additional CMOs, including Dr SS Kannaujia, Dr Piyush Rai, and representatives of the hospitals concerned, were present at the meeting.
