A claim of Rs 48 crore is pending for payments under the Megha Health Insurance Scheme (MHIS).
Of the pending Rs 48 crore, Rs18 crore is pending for all private hospitals in the State which the insurer – Reliance General Insurance Company Limited – has approved but the payments have not gone through due to the technical issues.
Informing this today, the Health Department said that these matters have been taken up with the National Health Authority (NHA) multiple times but the issue has remained unsolved.
It may be noted that private hospitals in Shillong have expressed reluctance to sign the fresh agreement since the State government did not release the dues which have accumulated since the previous Phase IV of MHIS which ended on August 31. All private hospitals have to sign an agreement with the Health Department for implementation of the next phase. Due to this, surgeries and dialysis of many patients in private hospitals had to be postponed resulting in great hardship for them.
According to the Health Department, the representation made by seven hospitals from Shillong on issues pending to their claims in the hospitals has come to the notice of the department and an urgent meeting was held on September 2 at 3:30 pm by the chief executive officer of MHIS.
“In the meeting it was understood that most of the issues have come out of the recent glitches that have happened and continue to happen with the new transaction management software. From time to time, State level grievance redress meetings continue to happen. The recent one held was on August 2 even when most of the issues highlighted were resolved. However, the issues had propped up again in the last four weeks,” the department added.
Stating that it is continuously monitoring the progress, the Health Department admitted the financial constraints the hospitals might have faced but has already made an appeal in the meeting conducted yesterday to all the hospitals to provide uninterrupted services to the people.
The Health Department also informed that the CEO of MHIS will visit the NHA office in New Delhi on September 5 to reiterate on the matter.
Meanwhile, efforts have been made to make the payments offline like it was done during May-June when the issue had come up.
The Health Department also said that MHIS has continued to grow strong with the largest number of claims made ever in the scheme for the period of September 2023-August 2024 with over 1,53,445 claims made of a value of Rs 216 crore. Of this, the total payment of Rs 141 crore has been made.
