Thiruvananthapuram: A high-level meeting here has decided to initiate stringent action against hospitals that are trying to scuttle the government's Medical Insurance for State Employees and Pensioners (Medisep) scheme.

The meeting, convened by Finance Minister K N Balagopal, decided to act tough after representatives of the partner insurance firm informed that some empanelled hospitals were not honouring the agreement signed with the government.

Complaints of some hospitals denying treatment as per the agreement, charging higher rates, and backtracking after signing the agreement, were also brought to notice of the meeting.

The minister asked the insurance company to hold talks with such hospitals, and if the issue still persisted, the government would intervene.

The Finance Department has also sought the details of action that could be initiated against erring hospitals. Health Minister Veena George informed the meeting that necessary steps have been taken for the effective implementation of Medisep in government hospitals. Secretaries of finance and health departments, too, attended the meeting.

The Medisep scheme that came into effect on July 1 this year has been envisaged to cover nearly 1,920 medical procedures.

Non-cooperative government hospitals

Complaints, however, have been raised against some government-run hospitals, saying they, too, were not cooperating with Medisep. The Medical College Hospital in Thiruvananthapuram has not been providing the benefits of the government insurance scheme.

A significant number of employees and pensioners dependent on the medical college were still shelling out huge amounts for receiving treatment from super-speciality units. It has been alleged that the authorities were sending patients back, saying the Medisep benefits were not now available.

Medisep members in Thiruvananthapuram have to depend more on the medical college since a large number of private hospitals have not partnered with the government in implementing the scheme.

The insurance firm has provided the necessary software and training to the staff of government-run hospitals to roll out Medisep. Several district hospitals, too, have not yet joined the government scheme. Medical colleges in Kottayam and Kozhikode are providing treatment under the Medisep scheme. Secretaries of finance and health departments, too, attended the meeting.

Initial hiccups

Thiruvananthapuram: Minister Balagopal, meanwhile, termed the issues at Medisep-empanelled hospitals initial hiccups. He was replying to a calling attention motion by Ramesh Chennithala in the State Assembly.

Elaborating, the minister said a three-tier grievance redressal mechanism has been set up to look into the issues employees and pensioners face while seeking treatment under the Medisep scheme. The insurance initiative covers more employees -- both serving and former -- than the existing reimbursement scheme, which would continue, he added.

Balagopal further informed that the advance payment for medical needs would also continue. He pointed out that other health insurance schemes would require a premium amount of Rs 10,000 to Rs 12,000 per annum, which would go past the Rs 25,000 mark for those aged above 50, the Medisep would require only Rs 6,000.

Scheme fleecing employees

Thiruvananthapuram: Moving the seeking attention motion, Chennithala said the Medisep scheme has been shortchanging the interests of government employees. The scheme, which has been under consideration for the past six years, was rolled out without any preparatory work.

The government has handed over Rs 700 crore to the insurance company, and most empanelled institutions are opthalmology hospitals, the Congress leader claimed while asking whether one should seek treatment for cancer at such hospitals.

People were hearing the names of many Medisep-empanelled hospitals for the first time. The government would be collecting a premium of Rs 6,000 annually in 12 installments of Rs 600 each from employees and pensioners. But only Rs 5,664 would be handed over to the insurance firm, Chennithala said.

The Congress leader further alleged that the government has been collecting Rs 40 crore from 12 lakh people. He said the scheme is not Medisep, but fleecing.