State govt should ensure cashless treatment under NHIS: TNGEA

Tamil Nadu Government Employees Association (TNGEA) complained to the State authorities that it has not addressed the issues within the New Health Insurance Scheme-2021 whereas renewing it.

“We had appealed to the State government to have consultations with the government employees before renewing NHIS as the scheme had many shortcomings in the past. However, the government has renewed it with effect from July 1, 2021 without addressing any of issues we had raised,” mentioned C.E. Kannan of TNGEA, Virudhunagar.

Ever since NHIS got here into existence, cashless treatment — an essential facet of medical insurance scheme — had remained solely on paper. “Even in the renewed scheme, there is no scope for preventing the hospitals, approved by the insurance company, from collecting advance money from patients during admission under the cashless treatment,” mentioned S. Tamilselvi, State president of the affiliation.

Stating that cataract surgical procedure and hysterectomy (surgical procedure for eradicating uterus) have been frequent surgical procedures undertaken by the beneficiaries, the affiliation had already demanded the State authorities that the insurance coverage scheme should meet the precise bills for these surgical procedures. However, nonetheless the higher restrict of medical help for cataract has been mounted at ₹30,000 and for hysterectomy at ₹50,000.

“The cost for uterus removal in approved hospitals in Madurai is around ₹1.5 lakh. Hence, the beneficiaries end up footing high hospital bill from their pocket despite the insurance scheme,” Mr. Kannan complained.

Similarly, fashionable treatment like oral chemotherapy which doesn’t require hospital admission was not included within the insurance coverage scheme. Patients must pay for testing of blood acquired via donors for surgical procedures as blood testing payment had not been included.

The affiliation has additionally demanded that the nodal officers should promptly attend to complaints towards hospitals on non-compliance of insurance coverage scheme norms.

The State authorities has elevated the premium collected from the beneficiaries to ₹3,540 for the NHIS-2021 as towards ₹2,100 for the earlier scheme.

Though the insured quantity has been elevated from ₹4 lakh to ₹5 lakh, the federal government shouldn’t be making any contribution in direction of the premium in contrast to prior to now schemes.

“We want the government to ensure that even when the insured amount has been increased, the beneficiaries should be spared from fleecing on various heads by the empaneled hospitals,” Ms. Tamilselvi mentioned.