MHIS implementation

SHILLONG, JAN 8: The State Assembly’s Committee on Subordinate Legislation on Friday slammed the health department for poor implementation of the Meghalaya Health Insurance Scheme (MHIS) in the state.

According to the committee, there is absolutely no help-desk installed in the empanelled hospitals to assist the MHIS card holders while the enrollment is poor as most of the targeted beneficiaries are still left out.

Moreover, it also stated that the department has failed to give proper awareness about the scheme which has only created a lot of confusion especially about the Rs 2 lakh insurance coverage as projected in the MHIS.

The five-member committee headed by former Assembly Deputy Speaker Sanbor Shullai has also summoned the officials of the health department and the MHIS during a meeting on Friday.

Members of the committee which include – Gambegre legislator Saleng A Sangma, Sohra legislator Titus Chyne, and Mawhati legislator Julius Dorphang were also present.

“We have summoned the officials after lot of complaints was received with regards to the implementation of the MHIS scheme,” Shullai told reporters.

Stating the non-installation of help-desks have caused huge inconveniences to the patients who are beneficiaries of the scheme, Shullai said, “Most of the hospitals (empanelled) has failed to entertain the MHIS card in which we as public representatives have to intervene most times.”

Earlier in his reply to the committee, Health & Family Welfare Department secretary KW Marbaniang had informed that MHIS/RBSY helpdesks are available in all the empanelled hospitals. “But we found that helpdesk are only in paper and the reply is totally false. Therefore, we have directed the immediate installation of help desks in all the hospitals empanelled under the scheme,” Shullai said.

Under the MHIS Phase-II, a total population of 7.59 lakh is targeted to be covered.

Stating that most of the targeted beneficiaries are left out and are yet to be covered under the MHIS-II, Shullai said, “We have directed that the enrollment process should continue as of now only 3 lakh out of the 7 lakh have been enrolled.”

Directing the health department to sensitize the empanelled hospitals, doctors and public about the scheme, the committee chairman said, “There has been a lot of confusion in the implementation of the scheme, due to lack of publicity about the scheme.”

According to him, as per the scheme, it states that 5 members of a family will be covered under one card. The smart card can be used in hospitals empanelled under the scheme only. An enrolment fee of Rs 30, will provide an insurance cover of upto  Rs 2 lakh and the scheme is valid for all citizens of the state.

In addition, legislator Titus Chyne said, “Due to such publicity, people thinks that once they are admitted in a hospital, the expenses will be covered on production of the card, which however is otherwise.”

“There are cases when a patient produce the smart card for payment of a bill of around Rs 30,000, only Rs 3000 could be cut from the card while the rest of the amount had to be paid by the patient himself,” he said adding “Similarly, if the bill exceeded more than Rs 1 lakh, only Rs 10, 000 was cut from the card. Also if bill for intensive care unit (ICU) is Rs 10, 000, it is only Rs 1000 cut from the card.”

According to him, this has created a lot of resentment among the public in view of the wide publicity given by the government that health insurance coverage of Rs 2 lakh is provided under the smart card.

Moreover, legislator Saleng A Sangma added, “This entire confusion only burdens the public representatives, who have to rescue such patients for clearing their medical bills.” He said, “There is something very wrong with the scheme of the government as it is misleading the people, who have high expectation that this scheme would benefit them, which is not at all happening.”

The committee had also directed the health department to furnish the details of the beneficiaries and the type of diseases as Rs 16 crore out of Rs 19 crore was claimed as premium.

When asked, Shullai said that the officials could not give befitting clarification on the confusion about the scheme and that they were caught unaware. He informed that the committee has decided to summon the officials of the empanelled hospitals and the Insurance Company in the next meeting which will be held very soon.-By Our Reporter