Hyderabad: Aarogyasri services in the empanelled private hospitals under Telangana Aarogyasri Network Hospitals Association (TANHA) have been suspended since midnight of Tuesday, September 16, due to pending reimbursements amounting to Rs 1,400 crore.

Meanwhile, Rajiv Aarogyasri Health Care Trust CEO Uday Kumar on Tuesday appealed to all the empanelled hospitals to continue their services, which serve as the backbone of health security for over 99 lakh BPL (Below Poverty Line) families in the state.

According to reports, members of 323 empanelled hospitals under TANHA met on Sunday and decided to withhold their services after failed deliberations with the government over reimbursement to the hospitals.

Speaking to the media, TANHA president Dr Vaddiraju Rakesh stated that according to protocol, funds must be released every 40 days, but currently, the reimbursements are being delayed by 400 days or more.

TANHA’s demands

TANHA’s primary demand includes the clearance of pending dues, a consistent and predictable payment schedule and revised package rates to keep up with the rising cost of medical services.

They have also requested the establishment of a formal grievance redressal mechanism and a revision of the Memorandum of Understanding (MoU) with the Aarogyasri Trust.

The strike is expected to hit rural areas the hardest as the majority of the population there relies on Aarogyasri health cards.

This is the third time this year that TANHA has threatened to call off services due to delays in reimbursement. In January this year, hospitals had called for a strike, which was suspended after 10 days of talks with the Health Minister.

Following this, they had threatened suspension of services from August 31, but the resolution fell through following assurances from the government.

CEO Uday Kumar’s appeal to hospitals

Rajiv Aarogyasri Health Care Trust CEO Uday Kumar on Tuesday appealed to the hospitals to continue their critical services, stating that 99 lakh Below Poverty Line families covered under the scheme would be affected.

The CEO explained that under the new government, the scheme’s coverage expanded significantly to cover 163 new high-cost procedures and revised rates for 1,375 procedures, bearing an additional cost of Rs 487.29 crore. He also said that the annual insurance per family has been doubled from Rs 5 lakh to Rs 10 lakh.

Kumar has stated that in the financial year 2024-25, the government made record-high payments of Rs 95 crore per month under the scheme. During the same time, total claim payments amounted to Rs 1,779 crore.

He further added that pending claims are being settled with phase-wise monthly payments of Rs 75 crore for the period of December 2023 to December 2024.

He said that this is a substantial increase from the average of Rs 57 crore released monthly between 2014 and November 2023.

Additionally, based on representation from private hospitals, their monthly payments have been increased to Rs 100 crore.

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