Private hospitals deny Covid patients Ayushman Bharat plan benefits


New Delhi: Private hospitals, especially in the tier 2 cities and those in rural and semi-rural area, are refusing to treat Covid-19 patients despite them being covered under Prime Minister Narendra Modi’s pet project, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).The Union Ministry of Health and Family Welfare (MoHFW) on 4 April last year, had announced that testing and treatment of Covid-19 would be free for those who were registered under the Ayushman Bharat scheme.

However, reports reaching The Sunday Guardian from states like Bihar, Chhattisgarh, Madhya Pradesh, Jharkhand and The Sunday Guardian’s own investigation confirmed that hospitals empaneled with the AB-PMJAY were simply refusing to admit Covid-19 patients by giving either of the two reasons—“We are not treating Covid-19 patients” or more commonly, “We are not treating PMJAY card holder for Covid-19”, implying that patients of Covid-19 have to arrange for the cost of treatment from their own end even if they have the Ayushman Bharat card.

The Sunday Guardian called up multiple private hospitals in Patna and surrounding districts seeking treatment for a Covid-19 patient who was a Ayushman Bharat card holder. A majority of them refused.

The same was the feedback that was received from multiple hospitals that The Sunday Guardian randomly called from the list of the PMJAY empaneled hospitals in Jharkhand, Madhya Pradesh and Chhattisgarh.

Earlier this week, a video went viral on various social media platforms where an hospital employee with Chirayu hospital, which is the biggest private hospital of Bhopal, was seen refusing to admit a Covid-19 woman patient who was a Ayushman Bharat card holder. The woman later died.

Social media platform Twitter is also filled with requests and complaints from users tagging the Prime Minister and the Union health minister stating how they and their kin are being denied treatment by hospitals despite having the Ayushman Bharat health card.

The Sunday Guardian sent a detailed questionnaire on the issue to the top official of the National Health Authority (NHA), which is the apex body responsible for implementing Ayushman Bharat across the country. However, no response was received till the time the story went to press.

An owner of a Patna-based hospital, told The Sunday Guardian that he was not “happy” with the price list that was fixed under Ayushman Bharat for Covid-19 patients and hence, he had no option but to deny admission to patients who were covered under the scheme.

As per the guidelines issued by the Government of India on 8 April 2020, treatment of Covid-19 under Ayushman Bharat is classified under multiple categories of illness depending on the severity including–“type ½ respiratory failure” under which the maximum amount a hospital can charge from a patient carrying a Ayushman card for providing a bed in ICU (with ventilator) is Rs 4,500 per day.

Last year in August, the Bihar government, after getting complaints of over-charging by hospitals, had announced three slabs of maximum applicable daily charge for treatment of patients in private hospitals depending on the districts where they were located.As per the Bihar state government order, all the National Accreditation Board for Hospitals and Healthcare Providers (NABH)-accredited hospitals in Patna district were allowed to charge Rs 10,000 per day from patients with moderate symptoms. Severe patients were required to pay a maximum of Rs 15,000 per day for ICU bed without ventilator.

On 6 May 2021, the Madhya Pradesh government revised its Covid-19 rate list for Ayushman Bharat beneficiaries while allowing Rs 11,500 for ICU bed having ventilator facility.

“The officials at NHA should do a survey on the ground to find out what is the actual amount that the hospitals are charging from patients. Do these officials really believe that they will get a ICU bed with ventilator for Rs 4,500 per day? Why would a hospital admit a Ayushman Bharat card holder when he can ‘sell’ the same bed for Rs 20,000-Rs 25,000 per day to any other patient? The central and the state governments need to bring a uniform policy fixing a reasonable price the hospitals can charge for the service they render which needs to be arrived at in consultation with the medical experts and the hospital owners and ensure that it is strictly followed. Unless that happens, no health scheme will succeed, as we are seeing with Ayushman Bharat,” a senior cardiologist with a private Delhi-based hospital said.