Mukh Mantri Sehat Bima Yojana: ‘Safe Exit’ to Health Insurance Company Under AAP Government Target


Patiala: The “unilateral” decision of the previous Congress government of Charanjit Singh Channi in Punjab to terminate the contract of Ayushman Bharat – Mukh Mantri Sehat Bima Yojana (AB-MMSBY) – with a private insurance company a week before the The arrival of the model code of conduct in force before the 2022 National Assembly polls without taking action against the company has gone under the scanner of the AAP government.

More than 45 lakh families in the state are unable to get cashless treatment for the past six months under the flagship health insurance scheme launched on August 20, 2019. Under this scheme , financial health protection was provided to 65% of the population in the state, providing entitlement-based cashless health insurance coverage. 5 lakh per family per year in public and private incorporated hospitals.

The contract was terminated on December 29, 2021, which would otherwise have ended on August 18, 2022, citing that the company was taking more than the stipulated 15-day period to settle hospital payments.

In a memo to Chief Minister Bhagwant Mann (HT has access), Punjab Health Secretary Ajoy Sharma said that after the dismissal, the insurance company had been cleared of liability, putting the struggling patients. Since the termination of the contract, most private hospitals as well as some public hospitals have stopped treating patients under this program.

Following the note from the health secretary, CM Mann asked him to submit a detailed dossier for action.

The memo further states that the clearance was not taken by the state finance department prior to the termination of the contract. Had this been done, the Ministry of Finance would not have agreed as it potentially imposed an additional burden of almost 600-700 crore from the state treasury and benefited the insurance company from this amount, the note reads.

According to the agreement, the ministry should have given 30 days’ notice to the company to make corrections and a heavy penalty could have been imposed. However, no such thing was done. On the contrary, the company benefited from the immediate termination of the contract, reads the note.

The health secretary confirmed he had reported the irregularities. “But I cannot release them as the matter is pending with the Chief Minister. But I can say that it has caused a huge loss to the public treasury and left the patients stranded,” Ajoy Sharma said. “I feel pain when cancer, kidney and other patients are denied treatment due to the department’s apathy,” he said.

Shortly after the contract was terminated, the department issued new tenders and received the most suitable offer at triple the price of the previous premium. While the contract with the previous company was made at 1,050 per beneficiary, she received the new offer for a premium of More than 3,000 per beneficiary, reads the note.

While then health minister OP Soni could not be contacted despite repeated attempts, a senior government official said: “This is the tip of the iceberg. Before passing an immediate termination order, the Punjab government and the health department did not even think of the 45 lakh families who were receiving treatment under the scheme.

Former Principal Health Secretary Raj Kamal Chaudhary said: ‘I had recommended blacklisting the company but nothing was done. The termination notice was issued by the public health agency not even sending me a file. The national health agency can explain why they did not send the file back to me for approval of the draft termination or any legal issues before sending it to the insurance company. I had also asked to send the file to the financial department, which was not respected either.


    Senior Correspondent Vishal Rambani is the Patiala Bureau Chief. He covers politics, crime, the energy sector, the environment and socio-economic issues, with several investigative reports to his credit.
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