Cash crunch: Kerala govt bans knee, hip replacement in private hospitals under Medisep

Thiruvananthapuram/Kozhikode: The acute financial crisis of the Kerala Government has affected the Medisep health insurance scheme for employees and pensioners and an order has been issued restricting beneficiaries from carrying out knee and hip replacement surgeries in private hospitals.

According to the order of the Finance Department, which came into effect on April 1, these surgeries can be done only in government hospitals enrolled with Medisep.

The insurance company associated with Medisep had recently written to the government seeking additional money as the corpus fund of Rs 35 crore which was meant to carry out treatment of serious diseases had been exhausted. However, staring at almost empty coffers, the government issued an order banning the knee and hip replacement surgeries in private hospitals.

As per the latest government decision, the amount for organ transplant for a month has been restricted to Rs 3 crore. The stipulation on obtaining prior permission for surgeries will continue.

The government had noticed that several private hospitals were carrying out unnecessary knee and hip replacements, which led to the ban. Advanced operation theatres and expert medical professionals such as ortho surgeon and anaesthetist are required to perform these surgeries. In the government sector, only certain medical colleges, general hospitals and district hospitals possess these facilities.

At the same time, such government hospitals are already overloaded with patients and when Medisep cases also reach there, all surgeries would be delayed inordinately.

During the previous nine months, 1,575 knee-replacement surgeries were carried out under Medisep and claims amounting to Rs 30.22 crore sanctioned. In addition, Rs 2.02 crore was allotted to 114 hip replacements.

As per the latest government order, from now on, surgeries need to be cleared by a Medical Board. All surgeries will not be allowed under Medisep, it added.