IMA slams Implementation of ''Cashless Everywhere'' Initiative, calls for clarity

New Delhi: The Indian Medical Association (IMA) and the Hospital Board of India (HBI) have raised concerns over the lack of clear guidelines and procedures governing the implementation of the 'cashless everywhere' initiative.

The IMA and the HBI jointly issued an advisory on the implementation of the 'Cashless Everywhere' initiative by the General Insurance Corporation (GIC). 

The advisory comes amidst concerns raised by the medical community regarding the lack of clarity and potential implications of the newly launched program.

According to a press statement issued by Dr AK Ravikumar, chairman of IMA HBI HORS, the 'Cashless Everywhere' initiative has been rolled out without adequately addressing the concerns raised by the IMA HBI.  

While the initiative allows policyholders to seek treatment at any hospital that complies with the guidelines set forth by the Insurance Regulatory and Development Authority (IRDA), there remains ambiguity surrounding the one-time temporary Memorandum of Understanding (MOU) between insurance companies and hospitals.

The lack of clarity regarding the MOU, as well as the inclusion of packaged deals, discounts, and freebies, has raised concerns among healthcare providers.

As per a media report in HT, The HBI headquarters in a letter issued to all its branches on Wednesday, stated, “The initiative has been launched without clarifying and clearing the issues raised by the IMA and HBI. Though any policyholder can walk into any hospital that complies with the IRDA guidelines and get treated, there is a one-time, temporary memorandum of understanding (MoU) between the insurance company and hospitals about which there is no clarity. The packages, freebies, discounts on which insurance companies and third-party administrators (TPAs) insist are non-scientific, against the law, and will lead to a compromise on quality and an injustice to patients.”

The IMA HBI advisory emphasises that packaged deals should not be a mandatory requirement for hospitals participating in the 'Cashless Everywhere' programme.

Citing various court orders, the advisory states that packaged deals, discounts, and freebies are non-scientific, potentially compromising the quality of healthcare and unjustly impacting patients.

In light of these concerns, the IMA HBI has issued a series of recommendations for its members to ensure the sustainability of healthcare facilities and uphold the quality of patient care.

These recommendations include rejecting MOUs that include packaged deals, discounts, and freebies, and advocating for payment based solely on actual medical expenses.

Additionally, the advisory urged insurance companies to establish eligibility criteria for policyholders based on their sum insured, with any excess beyond actual medical expenses to be copaid by the policyholders.

The IMA HBI also suggested adopting minimum sustainable charges for healthcare services, scientifically determined based on government standards for hospitals located in Tier 2 cities.

The advisory concluded by cautioning hospitals against accepting the 'Cashless Everywhere' initiative in its current format, highlighting the potential risks involved.

It underscored the importance of prioritising quality healthcare delivery and advocating for fair and transparent practices in the healthcare industry.

With the issuance of this advisory, the IMA HBI aims to address the concerns surrounding the 'Cashless Everywhere' initiative and advocate for policies that prioritize the interests of both healthcare providers and patients alike.