Private Hospitals Seek Review of Health Scheme Rates

Private hospitals in Kolkata are calling for a review of package rates under government health schemes like Ayushman Bharat PM-JAY. The Association of Private Hospital and Nursing Home (APHNH) stated that current rates, especially for orthopaedic procedures and implants, are lower than those under the phasing-out Swasthya Sathi scheme. This disparity may compel nursing homes to use lower-quality materials.

The association also highlighted the need for a clear mechanism to review package rates regularly, including for ICU care and complex surgeries. They seek provisions to cover clinical complications and additional treatment costs beyond package limits. Furthermore, APHNH has requested a published schedule with binding timelines for the settlement of outstanding dues and future claims.

To ensure transparency, APHNH members, representing 1,200 private health units, have demanded digital claim tracking and written explanations for any claim deductions or rejections. An independent appeal mechanism is also sought to address disputes effectively. The association aims to collaborate with the government to uncover unethical practices while protecting patient rights.