Mumbai, February 28 The Maharashtra government said on Saturday that it will hold a meeting with major hospitals in the Mumbai Metropolitan Region in a month to encourage their participation in central and state government health schemes, amid concerns over low enrollment and inadequate reimbursement rates.
Raising the issue in the state legislative assembly, some members said that despite extensive publicity of the Ayushman Bharat and Mahatma Phule Jan Arogya schemes, their benefits are not reaching people in Mumbai and suburban areas due to the limited number of empanelled hospitals.
They alleged that the reimbursement rates fixed under the scheme are too low for hospitals in Mumbai and MMR, discouraging multi-specialty and reputable hospitals from joining. The members also sought a separate rate structure for metropolitan cities, considering higher operational costs.
Responding to the discussion, Minister of State for Health Meghna Bordikar said that since July 1, 2024, the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and the Mahatma Phule Jan Arogya Yojana are being implemented in an integrated assurance mode, providing insurance coverage of up to Rs 10 lakh to nearly 2.5 crore families (around 12.5 crore beneficiaries) in the state.
The number of diseases covered under the scheme has increased from 1,369 to 2,399, while the number of empanelled hospitals has risen from around 2,000 to more than 4,000, with a target to further expand, she said.
Meetings are underway with major hospitals in Mumbai and its metropolitan region to encourage them to join the schemes, she said, and assured that concerns regarding higher treatment costs in the region would be discussed.
The members raised the issue of delays in payments to hospitals and sought annual revision of package rates in view of inflation.
The minister said that Rs 3,419 crore have been disbursed this year for the treatment of nearly 6.95 lakh patients, and claimed that there are no delays in bill payments.
She clarified that private hospitals cannot be compelled to join the scheme, but discussions are underway to bring more multi-specialty and charitable hospitals on board.
The government also informed the House that the registration of 24 hospitals was cancelled and 75 others were de-empanelled for not providing benefits under the scheme.
On the inclusion of knee replacement procedures, the government said it would consider the demand.
It added that over six lakh Ayushman cards have been distributed to citizens above 70 years under the expanded coverage.
Assuring further action, Bordikar said that a meeting with MMR legislators and hospital representatives will be held within a month to address the issue and expand access to quality healthcare under the scheme.
"Discussions are underway with multi-specialty private hospitals in Mumbai and its suburbs to implement the Ayushman Bharat scheme, but they cannot be forced to join," the minister said, adding that they will be persuaded to come on board.
