Treatment under Swasthya Sathi: Restrictions set for pvt hospitals

MP | 31 Dec 2022 | Kolkata: State Health department issued a guideline imposing certain restrictions on the private hospitals when it comes to treatment under Swasthya Sathi scheme. 

The new guideline said that if a private health establishment refers a patient without completing the treatment it will get only 50 per cent of the package cost or if the hospital transfers the patient after performing several tests but without carrying out the required surgery, only the 25 per cent of the package cost will be reimbursed. 

If a patient is referred to one hospital to another before initiating proper treatment or if a patient dies, the state government will not reimburse the first hospital with the total package cost. 

If any private hospital finds beforehand that a surgery cannot be performed on the patient only 35 per cent of the package cost will be given to the hospital. If the surgery is partially done the health department will reimburse only 50 per cent of the package cost. 

If a surgery turns out to be a failure, the hospital will get the costs of implants and 30 percent of the package cost. If it is found that kidney or gall bladder stones are not fully removed during the surgery, the hospital can claim only 60 per cent of the package costs. 

The hospitals will get 25 per cent of the package costs if a patient dies before a required surgery. Around 50 per cent would be reimbursed if a patient dies during operation. If a patient died within 24 hours after the operation only 70 per cent of the package cost would be reimbursed. Health department has found several irregularities in the bills submitted by many private hospitals. 

Earlier the health department cracked the whip on multiple packaging under the Swasthya Sathi scheme, which had been rampantly done by private hospitals against patients, thereby clubbing several packages together, eventually leading to an exorbitant bill amount. Most of the multiple packaging cases were spotted where patients required treatment under the medicine department. 

There had been a rampant practice of treating a patient under multiple packages and also classifying them under an 'unspecified' category so that more money could be taken from the government. 

https://www.millenniumpost.in/kolkata/treatment-under-swasthya-sathi-restrictions-set-for-pvt-hospitals-503925