Chennai: Chief Minister J Jayalalithaa is expected to launch Chief Minister 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, first introduced by the DMK, was scrapped in May of Jayalalithaa, who promised to launch an expanded scheme. In August, Star Health Insurance, the former contractor, was asked to run the operation and a temporary scheme was launched. In November it was decided to limit the new arrangements for public insurance and UI, New India Insurance Company, Oriental Insurance Company and National Insurance Company was listed.
UI have outsourced services to TTK Healthcare TPA Private Ltd., MD India Healthcare Services (TPA) Private Ltd and Medi Assist India TPA Private Ltd., has invited applications from hospitals to be chosen as empaneled network hospitals before 26 December.
The new system promises to pay up to RS 1.5 lakh per year for a family from the four-year ceiling of the former regime. It has expanded treatment for newborns and covers medical treatment for surgery in the previous regime.
Health officials hope the scheme will bring more money to public doctors and hospitals. In the previous scheme was Rs 10.49 crore of the Rs 850 crore disbursed claimed from public hospitals, but went to the Treasury. "It is perhaps one reason why public hospitals were not interested in making inroads," said a health department official involved in the process. This time, up to 15% of the claim should be paid to individual physicians and the rest divided among the team, department and hospital. Cheques will be issued to doctors instead of being sent via the Treasury, officials said. Public hospitals do free operations will now be able to make a claim if a patient is insured. They will be allowed to claim expenses for diagnosis in the hospital ..
The scheme only allows public hospitals to submit claims for some elective surgery such as ENT procedures, hernia, hysterectomy (without cancer) and appendicitis. "We have made it clear to the company, the government has the right to change or add treatments and procedures that are reserved for public hospitals," an official said. The Government Doctors' Association secretary Dr P Balakrishnan said, "Such schemes encourage physicians to spend more time in hospitals."
Article Source:- http://timesofindia.indiatimes.com/city/chennai/Govts-new-health-cover-gets-rolling/articleshow/11214341.cms
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