Enrollment in Government Health Schemes Mandatory: Maha Govt tells Charitable Hospitals

Mumbai: In the wake of the tragic incident at Deenanath Mangeshkar Hospital in Pune, where a mother of twin babies lost her life reportedly being denied admission, the Maharashtra government has made it mandatory for all charitable hospitals in the state to must enroll in government health schemes. These include the Mahatma Phule Jan Arogya Yojana (MPJAY), the Pradhan Mantri Jan Arogya Yojana (PMJAY), and the National Child Health Programme.

The decision came after a government-appointed committee found that Pune’s Deenanath Mangeshkar Hospital, a charitable hospital, had refused to admit a woman during childbirth and tragically, the woman died after giving birth on March 31. 

Medical Dialogues had recently reported that a seven-month pregnant woman carrying twins died after allegedly being denied admission at the Deenanath Mangeshkar Hospital in Pune due to non-payment of an advance of Rs 10 lakh. The 30-year-old woman was reportedly facing severe pregnancy-related complications when she was rushed to the hospital, but was turned away for treatment.

The patient was the wife of BJP MLC Amit Gorkhe's personal secretary. Allegedly, the gynaecologist who attended to the patient had demanded the deposit before admitting her and starting the treatment. The woman's husband alleged that the hospital demanded a sum of Rs 10 lakh for treatment, even as he expressed his willingness to pay Rs 2.5 lakh upfront. He alleged that the hospital's refusal to admit her or provide immediate medical care caused significant delays. As her condition deteriorated, the situation became increasingly critical. Left with no choice, the family rushed her to another hospital, but tragically, she passed away shortly after giving birth to her twin daughters.

In response to the incident, the state health department has formed a five-member panel to investigate the matter. The committee, constituted by the state health department, visited all three hospitals where the woman was taken by her family before and after delivery. After reviewing the circumstances surrounding her death, the committee concluded that Deenanath Mangeshkar Hospital failed to fulfill its responsibility by not admitting the patient when she sought care.

To prevent patients from facing such situations, a government resolution (GR) issued on Monday by the state’s law and judiciary department said that all charitable hospitals must register under the three health schemes from now on. Until now, joining these schemes was optional for private and charitable hospitals.

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"It has come to light that a woman was denied admission by Deenanath Mangeshkar Hospital, Pune, during her delivery. An inquiry committee was constituted under the relevant government resolution to investigate it. The matter of issuing instructions for necessary action in accordance with the recommendations of the panel is under consideration of state govt. The committee constituted under the chairmanship of the joint commissioner of charity, Pune, also submitted its report and recommendations to the govt. In accordance with it, the charity commissioner should instruct all the charity hospitals to effectively implement the Charity Hospital Scheme for patients belonging to the lower and weaker sections," mentioned the GR. 

According to a TOI news report, as of now, Maharashtra has a total of 2,031 hospitals empanelled under the govt health insurance schemes. The new GR mentioned that the updated information regarding the Indigent Patient Fund (IPF) account of charitable hospitals should be updated regularly on the charity commissioner's website. All charitable hospitals must immediately treat a patient coming to the emergency ward, including pregnant women seeking medical attention.

The GR also stated that many charitable hospitals transferred a major source of their income to external sources like pharmacy and diagnostic tests (pathology, radiology or microbiology).  As a result, the main hospital’s income appeared lower, and less money was going into the Indigent Patient Fund (IPF), which is meant to support poor patients. To fix this, the government has now said that even outsourced services must contribute 2% of their yearly income to the IPF. Under the charity scheme, a hospital has to reserve 2% of the annual gross bill for the IPF account.

Further, it stated "All charitable hospitals should take prior approval of the "Charity Hospital Emergency Room" at the Mantralaya through the online system to provide reserved beds to patients belonging to indigent and weaker sections, and for their scheduled treatment/surgery. Similarly, in case of emergency, charitable hospitals should urgently admit and treat patients concerned. The facilities should register them through the online system and send the proposal to the Charity Hospital Emergency Room of the ministry for approval within the next 48 hours for post-operative approval.

Restrictions have been imposed on charitable hospitals through the GR on demanding unreasonable money from patients. Hospitals have also been restricted from asking for additional documents from patients, apart from those prescribed by the high court or the govt. The facilities must ensure that no patient was denied treatment owing to lack of funds."

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