Pvt hospitals under scanner over HIMCARE irregularities

Ravinder Sood

Palampur, August 8

Following alleged financial bungling in the flagship Ayushman Bharat scheme and subsequent searches by the Enforcement Directorate’s (ED) under the Prevention of Money Laundering Act (PMLA) at various private hospitals last week, the HIMCARE health reimbursement scheme, too, is on the ED radar.

Information gathered by The Tribune revealed that the state government had already shared with the ED the details of over Rs 988 crore payment made to the hospitals.

Official sources said a new scheme will soon replace HIMCARE after plugging all loopholes so that government money is not misused in future. The Chief Minister had stated that his government was committed to provide a transparent health reimbursement scheme for the residents of the state at par with HIMCARE. Following the reports of misuse of HIMCARE cards by various hospitals, the state government had discontinued the scheme in the private hospitals last week.

Official sources said various hospitals while entertaining the HIMCARE cards crossed the permissible limit, besides forcing patients to pay extra amount in cash.

This was in violation of the rules laid down by the state government for the treatment of patients. There are fixed packages for a particular disease or surgery under the HIMCARE scheme.

The state Health Department during a presentation made to the state Cabinet brought several such irregularities to light. In one case, a private hospital charged Rs 1 lakh for a hernia surgery even as the procedure does not cost more than Rs 25,000.

The HIMCARE reimbursement scheme was launched in the state by the previous Jai Ram Thakur regime in 2018. The Congress government led by Sukhvinder Singh Sukhu continued the scheme. However, Chief Minister Sukhvinder Singh Sukhu during the past one year had expressed his concern over the functioning of the scheme and sought a report from the Health Department.

Between 2018 and 2024, the state government had spent Rs 988 crore under the HIMCARE scheme on the treatment of 7,64,707 patients. At present, the state government has a liability of Rs 370 crore payable to various private hospitals.

The CM has already clarified that the amount would be released only after a report on the alleged financial irregularities detected in the bills of private hospitals is submitted to the state government.