Private hospitals in Tamil Nadu oppose insurance council’s ‘unrealistic’ Covid treatment rates

CHENNAI: Following the General Insurance Council (GIC)’s announcement capping Covid-19 treatment rates, private hospitals in Tamil Nadu said they may have to turn away insurance holders as the rates were “unrealistic” and not economically feasible.

Indian Medical Association (IMA) Tamil Nadu on Tuesday wrote to the GIC saying it was absurd not to involve service providers before finalising the rates as assured by Insurance Regulatory and Development Authority (IRDA). The association said the stratification of rates based on geographical location of hospitals was unfair as the cost involved is almost the same throughout the country.

Smaller hospitals in remote areas have to pay their staff more to get them to work amid fear and call experts like anaesthetists only during an emergency paying them ?4,000-?5,000 per visit. So they should be allowed to charge more, said A K Ravikumar, state secretary of IMA. But GIC allows such hospitals to collect only 75% of what metro hospitals can collect.

Dr T N Ravishankar, head of city-based Sudar Hospital, said even in metro hospitals, there can’t be any compromise on accessories needed for healthcare workers to treat a patient. They can’t wear the same Personal Protective Equipment (PPE) throughout the shift. And except for anti-viral injections, there is not much regulation on cost of other drugs and injections which would cost at least ?1lakh for two shots.

So insurance companies, which are in great financial pressure now because of lesser new policies and increased claims, can’t work on a fixed budget rate and shift it to hospitals even as governments too are unable to function within a fixed budget. They should come forward and take a justifiable decision by releasing claims on a case-to-case basis, he added.

“What will happen is that many hospitals might not take up insurance patients as it won’t be feasible for them. They might say that beds are full and they have no vacancy to admit new patients. So ultimately patients are going to be affected,” IMA’s Ravikumar said.

Insurance companies, however, claimed that some hospitals gave undue bills even after cost of PPE was reduced, saying the actual cost would have been at least 20% lesser.

Source: The Times of India

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