News Life and Health08 Jun 2018

India:Leeway granted in pricing medical procedures in national health plan

08 Jun 2018

Prices of some medical procedures under the proposed government-run Ayushman Bharat Scheme (National Health Protection Scheme or NHPS) may be increased in some states to match rates in existing schemes, as the central government makes a bid to attract more states to get on board the scheme.

Earlier, the government had allowed states the leeway to increase prices by up to 10% only, reports Times of India.

"We have given directions that under the scheme, states can retain their existing package rates,” said NHPS chief executive Indu Bhushan, adding that this would be allowed even if the rates exceed the 10% limit.

Five of India’s largest private hospitals have raised concerns that the caps set on the pricing of certain medical treatments is too low.

States like Punjab, West Bengal, Chhattisgarh and Delhi had opposed the scheme primarily on grounds that some of the rates are not in line with those in their existing schemes.

A major concern is related to the financial contribution of the state to the NHPS, under which the central government will contribute to 60% of the cost. The states are afraid that they might have to contribute the excess premium over and above the national ceiling limit fixed by the central government.

According to sources, while the Centre has now in-principle agreed to share the excess premium, states which manage to set the premium lower than the national ceiling will get an incentive.

The NHPS, popularly known as Modicare, aims to cover nearly 500 million beneficiaries with an annual health cover of INR500,000 ($7,484) per family of five per year.


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