Even as the Indian Medical Association, an influential body of doctors in the country, is up in arms against the proposed package rates for several procedures under the Ayushman Bharat-National Health Protection Scheme, the Centre on Wednesday launched the “formal process” to empanel public and private hospitals in the scheme.
Dr Dinesh Arora, Deputy CEO, Ayushman Bharat invited all private and super-specialty hospitals across India for empanelment as they “play a critical and indispensable role in this mission”.
“We are making every effort to ensure that the empanelment process is conducted in a transparent, time-bound and non-partisan manner based on specific criteria, eligibility and guidelines,” he said, while making the announcement.
The Centre's call for empanlement has come after the IMA declared its “unwillingness” to work with the government over costs of several procedures that will be reimbursed by insurance companies under the scheme.
According to the doctors' body, the rates fixed for several medical procedures were not based on any scientific costing, and need to be “renegotiated”. These rates are so low that small and medium establishments will fall into a “debt trap” and shall be forced to shut shop, IMA President Dr Ravi Wankhedkar said.
The IMA has said that its demand to renegotiate prices is specifically meant to benefit establishments outside metros. Nursing homes and hospitals in these places provide the “last mile connectivity”. The government will need these places to ensure the scheme's success, according to the IMA leadership.
However, in a Twitter exchange over the subject, Alok Kumar, adviser, health and nutrition, Niti Aayog, said that package rates for the scheme were fixed on a scientific basis, and costs could not be raised for providing a "fancy environment".
As per the announcement on Wednesday, the State Health Agencies (SHAa) will now have to start empaneling private and public health care service providers and facilities in states and Union territories. The Centre also plans to hold workshops at the district, sub-district and block level, to brief hospitals on the details of the empanelment criteria, packages and processes.
According to health ministry officials, SHAs are to ensure empanelment of hospitals within the stipulated timelines—the scheme is likely to be launched on August 15—provided that the applicants meet the essential criteria for general or specialty care facilities.