Hospitals overcharge, misinform the needy
Under the state’s insurance scheme, patients with an annual income of under Rs 1lakh should be treated for free but some hospitals collect from both the patients and the fund.
The basic term of the state-run health insurance scheme Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) is to ensure that patients whose income is under Rs 1 lakh per year are given treatment entirely for free.
RGJAY officials have again found several of the 52 participating private and public hospitals in violation – two years ago, a sting operation had led to the depanellment of three hospitals from the scheme.
RGJAY officials have issued a warning letter stating that if they are found guilty again, the RGJAY will depanel the hospital. RGJAY has received ten notifications of grievances over the past four months, the majority in private hospitals.
Mahendra Varbhuvan, Deputy CEO of RGJAY said, “We keep tracking these hospitals and warn them initially but if we find the hospital is arepeat offender, we depanel them.” He added that all the hospitals who were in violation over these four months justified their actions and made pledges toto avoid these errors.
JAMUNA DEVI MATRU PAL, 51
She was treated at Andheri’s Seven Hills Hospital for cancer in her uterus. The hospital charged her Rs 20,000 for two sessions of chemotherapy. However, RGJAY guaranteed four free chemotherapy sessions to patients. Given his mother’s painful condition, Ashok Matru Pal did not argue with them and paid the amount. “My mother was in pain and chemo was necessary so I did not argue but filed a case with RGJAY later,” he said.
SAEEDABI ANSARI, 73
She was charged Rs 15,000 for a dialysis session to treat her fistula at Jogeshwari’s Mallika Hospital. Her grandson Mustafa realised that Saeedabi was entitled to free treatment under RGJAY when the doctors were taking her picture, as the scheme requires pictures of patients to be sent to them. He got back the money after RGJAY officials intervened. “They asked us to pay up Rs 15,000 but did not tell us that they had already received payment under the RGJAY scheme,” Mustafa said.
IRSHAD ANSARI, 51
His son Sharukh filed a complaint when Ansari was denied follow-up medication after his angioplasty at Riddhivinayak Critical Care and Cardiac Centre in Malad. “My father underwent angioplasty. As per RGJAY guidelines, angioplasty patients get one year of free medication. The hospital authorities refused to do so because they alleged that they did not receive money from RGJAY. But when I spoke to RGJAY officials, they ensured my father got the medicines,” Sharukh said.
SERAJ SHEIKH, 30
Andheri’s Seven Hills Hospital charged Sheikh for her medicines, her blood work and a service bill after she underwent Coronary Artery Bypass Grafting. Her case came to light when RGJAY official Dr Abhimanyu Kotwal went for an unannounced check. “On April 2, I found that Seven Hills Hospital had charged two patients for blood tests,” Dr Kotwal said. Sheikh’s money was returned following a complaint from him.
The basic term of the state-run health insurance scheme Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) is to ensure that patients whose income is under Rs 1 lakh per year are given treatment entirely for free.
RGJAY officials have again found several of the 52 participating private and public hospitals in violation – two years ago, a sting operation had led to the depanellment of three hospitals from the scheme.
On April 2, Dr Abhimanyu Kotwal, a district coordinator for RGJAY, under whose jurisdiction the stretch from Bandra to Borivali falls, conducted an unscheduled visit and found that theyhadcharged two patients scheduled for bypass surgeries for their blood investigation work,.
RGJAY officials have issued a warning letter stating that if they are found guilty again, the RGJAY will depanel the hospital. RGJAY has received ten notifications of grievances over the past four months, the majority in private hospitals.
Mahendra Varbhuvan, Deputy CEO of RGJAY said, “We keep tracking these hospitals and warn them initially but if we find the hospital is arepeat offender, we depanel them.” He added that all the hospitals who were in violation over these four months justified their actions and made pledges toto avoid these errors.
JAMUNA DEVI MATRU PAL, 51
She was treated at Andheri’s Seven Hills Hospital for cancer in her uterus. The hospital charged her Rs 20,000 for two sessions of chemotherapy. However, RGJAY guaranteed four free chemotherapy sessions to patients. Given his mother’s painful condition, Ashok Matru Pal did not argue with them and paid the amount. “My mother was in pain and chemo was necessary so I did not argue but filed a case with RGJAY later,” he said.
SAEEDABI ANSARI, 73
She was charged Rs 15,000 for a dialysis session to treat her fistula at Jogeshwari’s Mallika Hospital. Her grandson Mustafa realised that Saeedabi was entitled to free treatment under RGJAY when the doctors were taking her picture, as the scheme requires pictures of patients to be sent to them. He got back the money after RGJAY officials intervened. “They asked us to pay up Rs 15,000 but did not tell us that they had already received payment under the RGJAY scheme,” Mustafa said.
IRSHAD ANSARI, 51
His son Sharukh filed a complaint when Ansari was denied follow-up medication after his angioplasty at Riddhivinayak Critical Care and Cardiac Centre in Malad. “My father underwent angioplasty. As per RGJAY guidelines, angioplasty patients get one year of free medication. The hospital authorities refused to do so because they alleged that they did not receive money from RGJAY. But when I spoke to RGJAY officials, they ensured my father got the medicines,” Sharukh said.
SERAJ SHEIKH, 30
Andheri’s Seven Hills Hospital charged Sheikh for her medicines, her blood work and a service bill after she underwent Coronary Artery Bypass Grafting. Her case came to light when RGJAY official Dr Abhimanyu Kotwal went for an unannounced check. “On April 2, I found that Seven Hills Hospital had charged two patients for blood tests,” Dr Kotwal said. Sheikh’s money was returned following a complaint from him.
