Avenues created to gain from falling sick !
Source: The Sangai Express

Imphal, November 21 2013: Thanks to absence of 'package rate' State Government employees or their immediate dependants can still gain heftily, financially, even after they are confronted with life-threatening diseases and require major surgeries.

It is said that lack of official process for putting in place medical treatment 'package rate' by the Government is not only having an adverse effect on the State's economy due to non-plan expenditure in the treatment of the employees, their family members or immediate dependants at empanelled private hospitals but also provides golden opportunity to the patient parties to make substantial gain by furnishing false/exorbitant expenditure voucher.

According to an official source there are a number of private hospitals both in the State and outside that are empanelled to facilitate State Government employees and their dependants undergo specialised treatment or surgical procedure.

The empanelled private hospitals where an employee-patient is commonly referred to by the State Medical Board in the past many years are said to be Sankardeva Opthalmology Hospital (Guwahati); The Guwahati Neurological Research Centre (GNRC); GNRC Cardiac/Heart Institute; Rabindranath Tagore International Institute of Cardiac Sciences (Kolkata); Narayana Hrudalaya (Bangalore), Sir Ganga Ram Hospital (New Delhi); Sitaram Bhatia Institute of Sciences; Pratiksha Hospital (Guwahati); Max Health Care (New Delhi); Jaslok Hospital (Mumbai); Fortis Flt Lt Ranjan Dhall Hospital (New Delhi); and Imphal-based Shija Hospitals and Research Centre and Sky Hospital and Research Centre.

With the Government of Manipur failing to chart out its own 'package rate' treatment/surgical procedures at these empanelled private hospitals mean the patient coughing up medical bill prepared at the prevailing rate of these medical centres, even though the expenditure will be reimbursed to the patient by the Government at a later stage.

Apart from common knowledge that treatment at private hospitals necessitates more expenditure compared to Government hospitals, patients in collusion with management of private hospital normally furnish false expenditure voucher to make substantial financial gain at the time of reimbursement by the Government, explained the source.

Providing a comparative explanation, the source said that for Central Government employees, Department of Family Welfare under the Ministry of Family Welfare has a scheme called Central Government Health Service under which not only the ailing employees are referred to treatment at empanelled hospitals but also has a 'package rate' considered affordable for the patients as well as acceptable to the private hospitals.

The said model is also said to be adopted by many other States.

At the current rate under the Central Govt Health Service scheme a Central Government employee in need of appendicectomy (surgical removal of the vermiform appendix) may avail the facility at an empanelled NABH (National Accreditation Board for Hospitals) recognised hospital at the rate of Rs 8108 while at non-NABH but empanelled hospital the amount will be Rs 7050 .

Similarly for Cholecystectomy (surgical removal of the gall bladder) the expenditure for a Central Government employee at NABH hospital stands at Rs 10,293 and Rs 8950 non-NABH centres.

lacking such a policy (package rate) means a State Government employee having to spent no less than Rs 12,000 for appendicectomy at an empanelled private hospital in the State and Rs 20,000 for Cholecystectomy.

These rates do not vary much at private hospitals outside Manipur, informed the source pointing out that 'package rate' exists in the State the treatment cost could be nearly halved.

Over and above such excessive expenditure, State authorities have to knowingly tolerate that the patient-employees in collusion with hospital management have been furnishing false document(s) of treatment for official reimbursement procedures.

Such unethical practice subsequently leads to huge non-plan expenditure for the Government of Manipur, maintained the source.

On the otherhand, information has been received about the State's Medical Directorate proposing to the Government for preparing a list to empanel private hospitals and clinics along with finalising 'package rate' acceptable to these private medical centres.

Significantly, some private hospitals/clinics already aware of the Directorate's proposal are said to be suggesting to the State that the 'package rate' be above the amount/rate of the Central Government Health Services scheme.

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