Govt reluctant to crack the whip on hospitals scuttling MEDISEP

Thiruvananthapuram: The implementation of the Medical Insurance for State Employees and Pensioners, better known by its acronym MEDISEP, has reportedly left a lot to be desired one month after its launch by Kerala Chief Minister Pinarayi Vijayan on July 1.

The initial troubles are mostly blamed on the non-cooperation of many empanelled hospitals in the State.

Some hospitals are not willing to give full treatment to the insured persons as per the terms and conditions laid down in the agreement.

With the State Government reluctant to take action against these erring hospitals, many hapless patients, who have joined the scheme with great expectations, are now in dire straits.

The main stumbling block in taking action against those hospitals is that the State Government has not yet fully implemented the clinical establishment law to deal with these types of violations.

The non-cooperation of hospitals are more evident in Pathanamthitta, Alappuzha, Ernakulam, Kozhikode and Kannur districts. There are hospitals in every district which offer only partial treatment to patients under the MEDISEP scheme.

Other issues alleged by patients include of refusal of even empanelled hospitals citing the claim does not come under the MEDISEP. Some hospital authorities tell patients that the full amount will not be paid as insurance coverage and insist that 30 percent of the total amount should be paid by the latter.

Two hospitals, which had signed up for the MEDISEP, have now backed out.

Government plays down issues

But the State Government, on its part, has ruled out any major issues with regard to the scheme and clarified that these are all hiccups in the early stage.

More hospitals have expressed their willingness to be part of the scheme. About 20 hospitals will be part of the scheme by next month, the authorities claimed.

The government has further clarified that some complaints have cropped up as there are not enough hands to respond to multiple calls being made to the toll-free numbers at the same time. This will be rectified by appointing more persons in manning the toll-free numbers and by strengthening the capacity of the communication lines.

According to the government sources, training had been given to employees to effectively deal with such issues. If needed, more training will be given.