Pre- and Post-Hospitalisation Expenses Must Be Provided Free of Cost, Says SHAS
The Odisha Government’s State Health Assurance Society (SHAS) has issued a strict advisory directing all hospitals empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and Gopabandhu Jan Arogya Yojana (GJAY) not to charge beneficiaries for any pre- and post-hospitalisation services covered under the schemes.
The directive was issued by SHAS Chief Executive Dr Brundha D following reports that some empanelled hospitals were allegedly collecting fees from patients for diagnostic tests and other healthcare services before admission and after discharge, despite such services being covered under the government health insurance programmes.
According to the advisory, the approved treatment package under AB-PMJAY and GJAY includes expenses related to consultations, diagnostic investigations and medicines for up to three days before admission to the same hospital. Likewise, all expenses incurred for up to 15 days after discharge, including follow-up consultations, medicines, diagnostic tests and post-operative care, are covered under the package cost.
SHAS further clarified that in surgical cases, any post-operative complications linked to the original treatment and any related re-admissions should also be covered within the existing package. Hospitals have therefore been instructed to ensure the availability of essential medicines, follow-up care and diagnostic services without imposing any additional financial burden on beneficiaries.
The society has warned that any violation of the scheme guidelines will be viewed seriously and may invite appropriate action against the concerned hospital.
Health Minister Conducts Surprise Inspections
In a move to ensure compliance with the advisory, Odisha Health and Family Welfare Minister Mukesh Mahaling carried out surprise inspections at two private hospitals in the state capital on Saturday. During the visits, the minister reviewed the functioning of help desks and assessed whether beneficiaries were receiving services as per the scheme guidelines.
He also interacted with hospital authorities and directed them to treat patients with dignity while ensuring timely and quality healthcare services. The minister emphasized that beneficiaries of government health assurance schemes must not be subjected to unnecessary expenses for services already covered under the approved packages.
The latest directive aims to strengthen transparency and safeguard the rights of patients availing treatment under Odisha’s flagship health insurance programmes.
