Himachal's Himcare overhaul to boost transparency, curb leakages

Officials informed that several qualitative improvements have been undertaken to strengthen the scheme, under which nearly 4.33 lakh families are currently registered. Himcare provides free medical treatment in empanelled government hospitals across the state.

Under the revised framework, government hospitals will now be reimbursed the lower of the actual treatment cost, including consumables, or the pre-fixed package rate. Hospitals will be required to submit detailed bills of actual expenses along with their claims.

Key changes include exclusion of several components from reimbursement claims. Charges such as registration fees, bed charges, nursing and boarding will no longer be included. Similarly, professional fees for surgeons, anaesthetists, doctors and consultants, along with expenses related to anaesthesia, blood transfusion, oxygen, operation theatre use, surgical equipment, medicines and patient meals, have also been excluded.

These costs, the government clarified, are already being covered separately under the scheme and through budgetary allocations to government hospitals. Earlier, funding for these components was routed through dual mechanisms, leading to possible duplication.

Following the rationalisation, such expenses will now be funded directly through the state Budget rather than through Himcare package claims. Sukhu directed the department to ensure accessible, modern and quality healthcare services for all beneficiaries.