Karunya, MEDISEP schemes hit roadblocks; private hospitals on the verge of dropping out

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Representative image | Photo: ANI

Thiruvananthapuram: Two insurance schemes of the Kerala government, Karunya Health Insurance Scheme (Karunya Arogya Suraksha Padhathi - KASP) and MEDISEP, have hit roadblocks.

Around Rs 150 crore is pending to be cleared by the Kerala government under KASP, say private hospitals. Meanwhile, the number of cases facing payment decline under MEDISEP is increasing day by day.

Private hospitals said that they have approached the government for clearance of dues in Karunya. However, the State Health Agency which runs the KASP said that the majority of dues are already paid and only a small amount is pending. Dues were cleared from Rs 200 crore alloted to the agency recently. Pending payments are awaiting audit advice, sources said.

"KASP has several unattractive packages. Social commitment is the only reason we continue with the scheme. As per the agreement, the government has to clear claims in 15 days. If the government is not ready to consider clearing dues on time, we will have to think about withdrawing from the scheme,” said Hussainkoya Thangal, president of the Kerala Private Hospital Association.

KASP was started in 2019 and has 41.87 lakh families.

As many as 5,664 claims from private hospitals and 1,549 claims from government hospitals were denied by the insurance company under the MEDISEP scheme. Earlier, the company would notify the hospital that the claim would not be cleared within an hour of patient discharge. Now it takes up to two days. Hospitals later asking patients to pay are causing problems. There is a possibility that private hospitals will withdraw from MEDISEP.

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