Specialty hospitals withdraw Employees Health Scheme

Vijayawada: Andhra Pradesh Specialty Hospitals Association (ASHA) withdrew services for the employees health scheme (EHS) in AP with effect from January 15, as the government had been postponing the tariff revision and other related issues, said Dr. Murali Krishna, president, ASHA on Tuesday.

At a press meet organised at Indian Medical Association (IMA) hall here, he said that the issue was brought to the notice of Jitendra Sharma, Principal Secretary Health and Advisor to government, along with representatives of the employees association and CEO of the trust several times. No action was taken by the government to solve the issue.

The government had been postponing the tariff revision related issues for the past two years, in spite of ASHA's participation in the EHS healthcare initiative of AP Government, hoping that it would take genuine problems and issues on tariff revision and MoU terms especially for the employees and their dependents, he said.

ASHA hospitals were forced by the government of AP to take up EHS scheme on the same tariff rates, terms and conditions similar to Dr. N.T.R. Vaidya Seva, which was intended for BPL families covering over 80 percent of population in the state of AP, he complained.

The tariff rates of Dr NTR Vaidya Seva were being continued at the old tariff since 2013 which was not workable and the ASHA hospitals were incurring huge losses, he lamented.

Recently, the government of AP had launched Aarogya Raksha without specifying any details and without considering the issues in healthcare with all the stakeholders.

ASHA hospitals had informed that they would not take up Aarogya Raksha cases.

In view of the above circumstances, ASHA hospitals withdrew / stopped services to EHS on cashless basis from January 15. However, the ASHA hospitals would accept the packages for EHS as given to Telangana employees.
Among other demands, the ASHA hospitals wanted enhancement of Dr NTR Vaidya Seva by at least 50 percent of EHS, annual enhancement as per CPI, enhancement of quality inventive to a maximum of 15 percent which was a national benchmark for NABH by CGHS keeping in view of uniformity of case irrespective of category, resolution of issues related to operational guidelines/ MoU terms.

Under Employees Health Scheme, surgical packages by 4 years of cumulative CPI, Medical treatment based on the tariff proposed by ASHA, room rent correction for both surgical and medical packages, No free outpatient evaluation, continuation of quality incentive 25 percent for NABH hospitals, annual enhancement based on CPI, retrospective payment of the differential amount as promised by CM, resolution of issues related to operational guidelines.

In Aarogya Raksha, the ASHA wants de-linking of EHS tariff.