Surprise Inspections, Toll-Free Helpline: Madras HC Issues Directions For Effective Implementation Of Health Insurance Scheme In Hospitals
The Madras High Court has issued a slew of directions for the effective implementation of the Health Insurance Scheme by hospitals.
The bench of Justice R. Mahadevan and Justice J.Sathya Narayana Prasad directed the State Empowered Committee to conduct periodical review meetings to consider complaints and irregularities related to implementation of the scheme and deaths of patients covered by such schemes.
The bench also directed surprise inspections of the empaneled hospitals. The bench further directed to provide a Toll-free number for the public to enquire and register grievances related to the hospitals and the scheme.
The Court has also ordered to designate a nodal officer in every District Government Hospital to provide ready assistance to the public seeking to avail the benefits of the scheme.
The Court directed the insurance companies approved by the government to process and sanction reasonable claims without any delay.
The Court issues these directions while dealing with a plea by a Cardio Thoracic Surgeon. The petitioner alleged that while he was working in a hospital, a patient, covered by the Chief Minister's Comprehensive Health Insurance Scheme, had died after the anesthetist left the surgery mid-way to cater to another patient, not covered by the said Scheme.
According to the petitioner, large number of people are not aware of various insurance schemes introduced to provide world-class health care to the people, especially designed for poor, through government and empaneled private hospitals.
Advocate L.Infant Dinesh appeared for the petitioner whereas Central Government Standing Counsel V.B.Sundareshwar and Government Pleader P.Thilak Kumar appeared for Respondents.
The Court noted that "…the Government medical schemes are important for ensuring that the citizens have access to quality healthcare, however, the implementation of these schemes have come under threat due to the empanelled private hospitals, which have been attempting to exploit the system for their own personal gain."
"The inadequacies in the implementation and monitoring of the scheme has led to a decrease in the quality of healthcare available to the citizens, who are already struggling to make their ends meet. Therefore, certain directions necessarily be issued to the authorities concerned, for effective implementation of the insurance Scheme.", the Court observed further.
Cause Title- Dr. Karthick v. Union of India & Ors.