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Tuesday, December 27, 2011

Govt’s new health cover gets rolling

CHENNAI: Chief minister J Jayalalithaa is likely to launch the Chief Minister's Comprehensive Health Insurance Scheme next month. The government has tied up with United India Insurance Company (UI) for the scheme which will benefit more than one crore families in Tamil Nadu.

The public health insurance scheme, first introduced by the DMK, was scrapped in May by Jayalalithaa, who promised to launch an enhanced scheme. In August, Star Health Insurance, the previous contractor, was asked to wind up operations and an interim scheme was launched. In November, it was decided to restrict the new scheme to public insurance companies and UI, New India Insurance Company, Oriental Insurance Company and National Insurance Company were short-listed.

UI has outsourced services to TTK Healthcare TPA Private Ltd, MD India Healthcare Services (TPA) Private Ltd and Medi Assist India TPA Private Ltd who have invited applications from hospitals to be selected as empanelled network hospitals before December 26.

The new scheme promises to pay up to Rs 1.5 lakh per annum for a family against the four-year ceiling in the previous scheme. It has extended treatment to newborns and covers medical management, against surgical interventions in the previous scheme.

Health officials hope the scheme will bring more money to government doctors and hospitals. In the previous scheme, Rs 10.49 crore of the Rs 850 crore paid out was claimed from government hospitals but went to the state treasury. "That's possibly one reason why government hospitals weren't interested in doing surgeries," said a health department official involved in the process. This time, up to 15% of the claim will be paid to individual doctors and the rest divided among the team, department and the hospital. Cheques will be issued to doctors instead of being routed through the treasury, officials said. Government hospitals doing surgeries for free will now be able to make claims if a patient is insured. They will be allowed to claim costs for diagnosis at the hospital..

The scheme allows only government hospitals to make claims for some elective surgeries such as ENT procedures, hernia, hysterectomy (without cancer) and appendicitis. "We have made it clear to the company that the government holds the right to alter or add treatments and procedures that are reserved for government hospitals," an official said. Government Doctors Association secretary Dr P Balakrishnan said "Such schemes encourage doctors to spend more time in hospitals."

As reported in: http://timesofindia.indiatimes.com/city/chennai/Govts-new-health-cover-gets-rolling/articleshow/11214341.cms