General Insurance Council proposes cashless for all rates after Supreme Court intervention

The Supreme Court had recently reprimanded the Central Government on the expensive treatment charges in private hospitals and said that the Center should decide on a standard tariff in private hospitals, else the Apex Court would impose CGHS rates across hospitals. After SC's intervention, an important meeting of General Insurance Council (GIC), National Health Authority (NHA), Department of Financial Services (DFS) and Insurance Regulatory and Development Authority of India (IRDAI) was held.

In this meeting, the GIC proposed that it is ready to share with the government the same rate card which has been used to implement 'Cashless for all' facility. After this, GIC stated that the Center - in collaboration with state Governments, can decide a standard rate card in private hospitals.

GIC has suggested that there should be grading of hospitals under which high frequency basic surgeries like cataract, appendicitis should have fixed rates, as per the grade of the hospital.

After the rate is fixed private hospitals should publicize the rate card in their hospital so that the customer are aware of what their bill will be after the surgery.

Insurance companies believe that after the rate card is fixed, the health insurance premium can also reduce because inflation is rising by 15-20 per cent every year in the health sector. Due to inflation there is an increased pressure on profit margins.

After fixing the rates of high frequency surgeries, it is possible that insurance companies may not apply to IRDAI to increase the premium after three years.

It is important to note that insurance companies can only increase the premium after receiving IRDAI approval and they can only increase the premium after three years.

What do hospitals want?

Private hospitals are strongly protesting against the Supreme Court's threat to implement CGHS rate card.

Hospitals are ready to accept 'Cashless for all' facility as per grading of hospitals, if it is formally implemented.

Many big hospitals are reluctant to accept the suggestion, but the Council has stated that the move will not affect their business as the hospitals will gain business from higher volume of patients.