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No solution to medical insurance logjam in Ahmedabad

The medical fraternity issued letters to various authorities including Right To Information (RTI) department to intervene in the matter and resolve the issue.

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The decision of the Ahmedabad Medical Association and various corporate hospitals, including Sterling, Apollo, Sal, Medisurge, Krishna and others, to call a closed-door meeting of the medical fraternity, Third Party Administrators (TPA) and government-run insurance companies on Wednesday to reach a consensus on the medical insurance dispute got further aggravated as representatives from concerned insurance companies failed to turn up at the meeting.

The medical fraternity later on issued letters to various authorities including Right To Information (RTI) department to intervene in the matter and resolve the issue. 

The insurers had decided to pay less money to the city doctors and hospitals for different treatments. The decision to protest the proposal by TPA and government-run insurance companies offering cashless mediclaim was unanimously supported by the medical fraternity. They feared that the changes would give insurance companies almost dictatorial powers not only over policy holders but also over the doctors treating them.

The doctors say the proposed changes which will reportedly be implemented from May 1 would restrict the patients' choice to a few doctors and hospitals who have accepted the new rates for treatment of different ailments. TPA and the government-run insurance firms have offered hospitals fixed amounts for treating different illnesses. But, the policy holders will still have to shell out the same amount of premium for different policies.

The slashed rate is around 35% lower than those offered to hospitals and private doctors offering their services to hospitals in Mumbai and Delhi. "The terms under the cashless mediclaim MoU offered to hospitals are unacceptable as they have quoted rates that are 50% less than the rates currently prevailing in the city," said Dr Pragnesh Vachhrajani, vice-president, Ahmedabad Medical Association (AMA).

These changes would deprive the policy holders of their choice of doctors and hospitals as the policy holders will not be able to avail of the facilities offered by hospitals and doctors who have not signed the new MoU with the TPA and the government-run insurance firms.

He further said that the city's medical fraternity, including corporate hospitals and private practitioners, reviewed the decision to boycott the new terms of cashless mediclaim MoU on Wednesday and decided to go ahead with the boycott.

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