Pune: A significant number of hospitals in Pune have temporarily suspended cashless treatment services for policyholders of public sector insurance companies due to ongoing disputes over the rates set for medical services. The decision, effective from January 1, affects policyholders relying on cashless facilities at prominent healthcare institutions.
Background of the Dispute:
Deenanath Mangeshkar Hospital (DMH), a leading healthcare provider in the city, is among the hospitals that have halted cashless services for policyholders of ICICI Lombard Insurance Company and GIPSA companies. The suspension is attributed to a delay in the renewal of rate contracts, which were under discussion since October 10, 2023, but remained unapproved by December 31.
Concerns Raised by Hospitals:
Dr. Sanjay Patil, Chairman of the Hospital Board of India, Pune Chapter, expressed the dissatisfaction of around 80 to 90 private hospitals over what they deem ‘unscientific’ rate lists imposed by insurance companies. This discontent has led to a reluctance in renewing contracts, resulting in the suspension of cashless services for affected policyholders.
Rate Revision Demands:
Hospitals are demanding justified revisions in rates to account for rising inflation and treatment costs. Despite attempts by the Indian Medical Association (IMA) to propose a rate list, insurance companies have not accepted the terms, causing inconvenience to patients and prompting some to shift towards private insurance policies.
Impact on Healthcare Facilities:
The situation has intensified concerns, especially for smaller and medium-sized healthcare centers, about providing cashless facilities. The dispute has raised questions about the diminishing number of hospitals offering such services in Pune, despite the city experiencing an increase in large private hospitals in recent years.
Future Implications:
As the standoff continues, the president of the hospital association in Pune emphasized the importance of hospitals having adequate facilities and skilled doctors to initiate cashless treatment services. Concerns have been raised regarding any challenges hospitals might face in providing such facilities.
In Pune, with approximately 780 hospitals and 80 to 100 offering cashless facilities, this dispute affects around 18,900 beds, including 2 to 3 thousand ICU beds and 750 to 800 ventilator beds.
